Exhale blockage

[SKOLsnore]

Without CPAP, I cannot sleep on back or on side due to throat closing and blocking inhale. With CPAP sleeping on side works fine, but my shoulders get sore, I would much prefer to sleep on my back, but I have exhale blockage that feels different than the non-cpap choking/gasping. It is not difficulty due to the feeling of hard to exhale against the pressure, but rather I can actually feel an airway closure higher towards the nasal area than the lower throat inhale feeling.

I have a Resmed 10. It was set by doctor in bipap mode (S) with IPAP at 14 and EPAP at 11. Trigger is Medium, Ti-max is 2.0; Ti-min is 0.5, Easy Breath is on. I have also gone in and set to straight CPAP at 12 and later at 10 and all work the same - sleeping on side is fine, on back I get failure to exhale. Doctor keeps saying his settings should work because it did for 5 minutes in the sleep study - that doesn't help me at all and I have lost confidence in him but would rather not start over with a whole new titration study with a new doc.

Any thoughts?

[LSAT]

Be specific as to what machine you have...What exactly does it say in the lower RH corner??

[SKOLsnore]

ResMed AirCurve 10 VAUTO

[Pugsy]

How about using Auto mode and just letting the machine fight any supine issues automatically with a little more pressure instead of the fixed pressures you are using now?

[SKOLsnore]

I did try that, but despite "auto" label there were still a bunch of parameters to be entered - I don't recall what numbers where there the few nights I tried it.

[Pugsy]

Use SleepyHead software to see what is going on and it will also show a history of any setting changes you have made in the past.
https://sleepyhead.jedimark.net/

[SKOLsnore]

Thanks, I have not previously had an SD card in the slot, so I added one this morning and will track for a few nights. Would it make sense to do this on vauto rather than S? I just checked and my vauto mode is defaulting to EPAP 4 IPAP 18, PS 0, trigger medium, TiMax 2, TiMin 0.3 - Or should I go back to S mode per above settings?

[Pugsy]

The default EPAP of 4 cm in Auto mode is likely way too low but impossible to know what you really need without seeing some data.
Probably explains why Auto mode didn't work out so well for you. It will auto adjust the pressures but it still can't make big jumps in a relative short period of time. We have to have a more optimal starting point for it to increase to where it needs to be for stubborn supine events.

There is still some data available after you insert the SD card because the machine still stores summary data on the internal memory and that gets written. It's perfect data but it's close enough to get a little bit of an idea what has been going on. It's missing the graphs and thus the summary AHI is maybe a little off but it's still real close.

Given that you EPAP was 11 and IPAP was 14...that means PS would be 3...
if you want to use Auto mode I would set minimum EPAP to 11 and PS to 3 and just open up max IPAP to 25 and see where it wants to go.
It won't go anywhere without a good reason. Heck, it may not even go higher than 14 or 15 for all we know.
That's what I would do and sleep in any position I wanted and just see what happens.

I would change over to Auto mode right now...not wait. You aren't real happy with S mode at the moment and there is some data available as to how S mode worked for you...you just don't have any graphs which since you were using a fixed pressure probably aren't going to be particularly useful in the pressure data.

[SKOLsnore]

Thanks for the advice! I will give it a go for the week and see what the experience/data suggests and will re-post if I have more questions (which I certainly will unless it magically is perfect).

[zonker]

Without CPAP, I cannot sleep on back or on side due to throat closing and blocking inhale.
<snip>
Any thoughts?

welcome to the zoo! you are in good hands and i have no further advice along those lines.

however, when you have time, could please put your equipment in your profile? when you do that, it will show up at the bottom of yours as mine does. this will be helpful in the future so that you don't have to keep telling people what your equipment is.

thanks and good luck!

[SKOLsnore]

Done (I think)

[zonker]

Done (I think)

you did. thanks!

[SKOLsnore]

If I were to post my CPAP data from sleepyhead, but particular graphs are useful, and at what time resolution do you need? (For example, the flow data looks very different zoomed in)

[zonker]

If I were to post my CPAP data from sleepyhead, but particular graphs are useful, and at what time resolution do you need? (For example, the flow data looks very different zoomed in)

please see here for help-

viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

then if you need more help, feel free to ask!

oh! and if the experts need something zoomed in, after they see the charts, they'll let you know.

[SKOLsnore]

Here is last night's sleepyhead data APAP, EPAP 10, IPAP 18, PS 3, Trigger Medium