Woke Up Gasping

[vandownbytheriver]

Thanks all, The old unit is the Aircurve 10s with last best settings of CM=11 PS=9. Good to know concerning rehabbing the old unit with a new motor.

That's some insane pumping... I can't see any way to get that kind of response out of an APAP limited to EPR3. I have an Aircurve 10 vAuto but I only use it as an S machine... basically 17cm PS4, limited at 21cm. I forget if you had gastric bypass or what would have convinced your doctor to take you off bi-level... OSA does not cure itself, quite the opposite without physical changes like BMI or surgery.

[ozij]

Sure.
Unless there is a significant leak, the volume of air inspired should be close to that of the volume expired.
In your beginning three breaths of your original post the volume of air exchanged between 21:04:36 and 21:04:40 is fairly equal between Inspiration and expiration.
( the area under the curve represnts the volume of air)
for example:

Where red is the inhalation volume and blue is the exhalation volume.

Compare those three breaths at the start of your posting with the next 11 breaths, where the volume being exhaled is significantly less than the volume that had just been inhaled.

Thanks dataq1.....I see that now. And it then begs the question, what goes in must come out and leaks register as good. As I tape my mouth that question is a bit of a mystery.

That's why your brain woke you up - to make sure you get over that obstruction and breath out properly. No mystery.

[dataq1]

That's why your brain woke you up - to make sure you get over that obstruction and breath out properly. No mystery.

If so (obstruction only affecting exhalation) might have anticipated choking - too much air - rather than gasping (too little air). But whatever, ….what goes in must come out.

[Airyhead]

Thanks all, The old unit is the Aircurve 10s with last best settings of CM=11 PS=9. Good to know concerning rehabbing the old unit with a new motor.

That's some insane pumping... I can't see any way to get that kind of response out of an APAP limited to EPR3. I have an Aircurve 10 vAuto but I only use it as an S machine... basically 17cm PS4, limited at 21cm. I forget if you had gastric bypass or what would have convinced your doctor to take you off bi-level... OSA does not cure itself, quite the opposite without physical changes like BMI or surgery.

Meant to say PS=2. Should have read IPAP=11 EPAP=9.

[vandownbytheriver]

Meant to say PS=2. Should have read IPAP=11 EPAP=9.

OK... that makes more sense. Still, bi-level gives better support than EPR IMO... when I was using EPR I'd feel my palate slap hard when supine during the breath transition to exhale. Even though I'm on more differential it's better because a) the inhales are pumped instead of the exhales ducked and b) peaking much higher pressures.

What I was experiencing was it 'slapped', catching on exhale like a reed valve... a huge expiratory flow limitation. That looks just like your zoomed graph. With bi-level 17cm and PS4 it's gone. With EPR the machine's making it worse. All IMO, good luck.

[Airyhead]

I moved back to the old machine, the Resmed Aircurve 10S and kept the old settings of IPAP=11, EPAP=9 and had an OK night. Of note, I had a very stuffy nose and a significant amount of rainout. Here's the SleepHQ data https://sleephq.com/public/df133944-f36 ... debe89b14b with the Apple Watch sleep stage plot. It appears the the C-S type wave patterns were less in frequency and in magnitude. Based on what I see in the wave tops and the few hypopneas I had, I was thinking I'd increase IPAP to 12 and increase EPAP to 10 though I can see making EPAP 11 based on the number of Centrals I had. I'd like to get the rainout corrected and stuffy nose open before I make too many changes. Also vandownbytheriver I have not had a gastic bypass. I'm of a somewhat good BMI and active though I've had ablative surgery for Afib several years ago. Appreciate thoughts and suggestions and as always, thanks!

[vandownbytheriver]

I believe you're on the right road... the more you increase your pressures the less the differential will cause CA due to stripping CO2 if you keep the same differential. You appear to respond better to the bi-level algorithm than the EPR algorithm. Good luck! Let us know how it goes.

[Airyhead]

Thanks, will do.

[Airyhead]

Well, interesting night. I increased both IPAP and EPAP by 1cm and decreased humidity to level 6. Rain-out was mostly resolved but minor leaks were bothersome all night. Gross parameters didn't change much, but waveform tops looked smooth and exhalation support looked better. Most remarkable to me was the periodic breathing seemed to dissipate somewhat. I'll pause here to acclimate and also work on better fitment for the F20. Making progress. https://sleephq.com/public/fdd900d4-b29 ... e1fcb9fa7a

[vandownbytheriver]

Well, interesting night. I increased both IPAP and EPAP by 1cm and decreased humidity to level 6. Rain-out was mostly resolved but minor leaks were bothersome all night. Gross parameters didn't change much, but waveform tops looked smooth and exhalation support looked better. Most remarkable to me was the periodic breathing seemed to dissipate somewhat. I'll pause here to acclimate and also work on better fitment for the F20. Making progress. https://sleephq.com/public/fdd900d4-b29 ... e1fcb9fa7a

Pressures still say 11/9cm... actually both SHQ's were for Sunday the 12th. Supposedly you're on 12/10 now?

[Airyhead]

Sorry vandownbytheriver, somehow I copied the wrong link. Here's this mornings data. https://sleephq.com/public/368e5ff6-a70 ... f41affaa31

[vandownbytheriver]

Sorry vandownbytheriver, somehow I copied the wrong link. Here's this mornings data. https://sleephq.com/public/368e5ff6-a70 ... f41affaa31

It *does* look better! I'd keep working it up as you can... I expect the CA's to disappear, we'll see.

[Airyhead]

Notwithstanding the weird stuff that happened around 11pm, I think it's again slightly improved. Periodic breathing is definitely better https://sleephq.com/public/59a810fd-7d6 ... c7f1a2531d. Regarding the weird stuff around 11pm in SleepHQ, OSCAR does not show the same anomalies. I clipped the section between 10:50pm and 11:15pm for a comparison (see below).

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2024-05-15_08-33-35.jpg (160.53 KiB) Viewed 1435 times

[Airyhead]

Just a FYI. Troubling shooting the odd data that SleepHQ reported, I downloaded the SD card to the SleepHQ site from my PC instead of from my iPhone and the anomalies went away. But also just now seeing that there is no flow limit data from the Resmed 10S. The Resmed 11 did report that data. Does anyone know if this is normal for the 10s data set?

2024-05-15_09-54-29.jpg (154.32 KiB) Viewed 1271 times

[Pugsy]

I believe that when using the AirCurve in S mode (fixed bilevel pressures) that the FL sensor is disabled and that's why no flow limitation graph.

It's my understanding that a person needs to use Auto Bilevel mode to get FL graphs.

You can still use the same settings if you wish ....just change to AutoBilevel mode.