High AHI numbers

[Miss Emerita]

Hey, no quitting now, just when you made your wife’s life better!

I’m curious what the experts think about the PS of 4. I know zip about the VAuto machine, but I do wonder whether higher pressures on inhalation, to knock down the OAs, would be more tolerable if the PS were greater.

[palerider]

I do wonder whether higher pressures on inhalation, to knock down the OAs

It doesn't work that way.

OAs are 'knocked down' *between* inhalations. ie, it's the EPAP that prevents OA..

OP needs higher min epap.

Now, more PS can make that higher EPAP 'feel better' because of the pressure drop at the end of inhalation... but too much PS might exacerbate the CAs

[Pugsy]

EPAP set at 10 did bring down the AHI to 15.

What is the breakdown into each category of that AHI?
How much of it was the clear airway/central index?
How much of it was OA index?
How much of it was hyponea index?

[ajack]

To me it looks like you have some positional apnea as well and my benefit from a $10 foam cervical collar to see if that helps your airway. Hopfully you will get your treatment pressures lower.

On that chart I would have the min epap at 16 and may need more.

this titration guide may help
https://www.resmed.com/us/dam/documents ... er_eng.pdf

[Pugsy]

I figured that going higher than 10 cm minimum EPAP would be a big enough challenge and your trying 12 cm and having problems confirmed it.

First of all...we need to know what kind of events you are having...and if the bulk of those events can be fixed with more pressure anyway...and if they can the we go slower with the increases in EPAP that will probably be needed.
That's why I asked about what category of events compose that AHI of 15.
They are probably obstructive in nature but I don't like to go on probably....I want to base plans of attack on facts.
If the bulk of the AHI is central now...we do something different....so really important to know what kind of events we are fighting.

If you do end up needing more minimum EPAP....we go with smaller increases and give your body a chance to get used to them.

[Miss Emerita]

palerider, thanks for your help with my continuing education.

[palerider]

palerider, thanks for your help with my continuing education.

Think about it like this... most machines (except for the ventilators like ST, VAPS and ASV) are triggered to go to a higher pressure (even counting EPR/*flex) by your starting an inhalation.

If you don't have enough pressure *between breaths* (EPAP) to hold your airway open, then you can't take that next breath, and the machine never goes to the higher pressure.

Thus, you eliminate OA with EPAP, and twiddle with PS for a variety of other things that it can help.

[Miss Emerita]

Got it! (Now to REMEMBER it....)

[TCW]

Here's what happened last night.

AHI 12.81
Obstructive index 9.26
Hypopnea 1.65
Clear airway index 1.90

Toms Stats ver 2.jpg (814.32 KiB) Viewed 1654 times

Many thanks to all of you!

Tom

[palerider]

Here's what happened last night.

Please review the formatting directions for sleepyhead/oscar:
wiki/index.php/Sleepyhead:Organize
So that you don't waste your time posting things that aren't useful.

[raisedfist]

You spend like no time at your starting pressures which means they are inadequate

[Pugsy]

What were the settings last night? EPAP and IPAP?
Looks like EPAP was lower than 10 or 11...is that correct?
If so, did you do that because you just couldn't manage 10/11 EPAP and 14 IPAP ????

If you would do the screen shots in the usual way we could see the settings and stuff on the left side and the events graph and the other graphs on the right side...and get a better idea what happened.

[TCW]

Thanks again to all of you who tried to help.

I have also developed swelling in my eyes and cheeks. My right eye is almost swollen shut.

I tried. I really did. I'm done. I'm gone.

Tom

[zonker]

Thanks again to all of you who tried to help.

I have also developed swelling in my eyes and cheeks. My right eye is almost swollen shut.

I tried. I really did. I'm done. I'm gone.

Tom

well, i hope that you really aren't gone and that you came back. i know it seems like a long time in hell, but you haven't given it long enough.

you can do this. stick with it. keep on keepin' on, as the kids today say.

(NARRATOR: kids today don't say that.)

[HoseCrusher]

Tom, let's back up a moment...

The machine is working to keep your airway open. Is it possible that the swelling in the eyes and cheeks are being caused by something else?

I totally agree that you tried... I am sorry I was unable to help you succeed.