I need hand holding

[palerider]

the IPIAPmax was set at 25-- I changed it to 12.

You shouldn't have, don't change the max unless there's a *reason* to do so You're preventing the machine from being able to do it's job when you do that.

—feels like I’m pulling too hard to get air. I want a slightly larger volume of air to come into my lungs, and I want it to flow in much more easily.

Raise the MinEPAP.

—feels like I’m pushing too hard to exhale against the pressure. Also when I’m done exhaling, I feel there’s still air in my lungs that needs to come out—and to get it out means I have to consciously force more out.

Try increasing the PS one or two.

[Miss Emerita]

I’m so glad you’re here to help, PR!

[loggerhead12]

—feels like I’m pulling too hard to get air. I want a slightly larger volume of air to come into my lungs, and I want it to flow in much more easily.

Yeah, 5 is pretty low for most people. Try 7 or 8.

[Miss Emerita]

—feels like I’m pulling too hard to get air. I want a slightly larger volume of air to come into my lungs, and I want it to flow in much more easily.

Yeah, 5 is pretty low for most people. Try 7 or 8.

The 5 would have been the exhale pressure; the inhale pressure would have been 8. But I'm eager to hear how PR's suggested settings work for the OP.

[loggerhead12]

The 5 would have been the exhale pressure; the inhale pressure would have been 8. But I'm eager to hear how PR's suggested settings work for the OP.

Yep, S mode, my bad.

[palerider]

I’m so glad you’re here to help, PR!

Sorry, last week was busier than usual

I'm looking forward to seeing what my suggestion results in too

[GrumpyHere]

There are two more settings you can consider changing in the future.

Caution: placing these two sensitivity settings too high can lead you to feel as if the CPAP is driving your breathing pattern rather than you being in control of the CPAP machine.

—feels like I’m pulling too hard to get air. I want a slightly larger volume of air to come into my lungs, and I want it to flow in much more easily.

Changing the Trigger setting to High or Very High will speed up when the CPAP transitions from EPAP to IPAP. This change might help with your perception of needing to pull hard to get air.

—feels like I’m pushing too hard to exhale against the pressure. Also when I’m done exhaling, I feel there’s still air in my lungs that needs to come out—and to get it out means I have to consciously force more out.

Similarly setting the Cycle to High or Very High will speed up the CPAP in transitioning from IPAP to EPAP.

However the feeling that you have air left over to breathe out could mean that the Trigger setting is too high.

So these two settings can both work for/against what you feel.

As PR explains:

Trigger is how sensitive the machine is to your starting to take a breath... the lower the trigger, the more of a breath you have to take before the machine goes "AHA! time to switch to IPAP".

TiMin is the minimum amount of time that it will stay at IPAP.

TiMax is the maximum amount of time it'll stay at IPAP.

Cycle is how sensitive the machine is to your starting to exhale.... and when it'll drop the pressure back to EPAP, (if TiMax hasn't already expired, if TiMax expires, then the machine goes back to EPAP then.

For *most* people, just leave those settings at default.

Page 5 of the VAuto Clinical Guide has a diagram showing the timing.

Here's a link to to the guide if you don't have it yet.

Code: Select all

https://www.respshop.com/manuals/37212_clinician_menu.pdf

Good luck.

[Bigcatdaddy]

thx Grumpyhere

I can say that with the above mentioned settings from you 3, the machine has become comfortable to breath with! Thx so much, I have never felt that sensation before. It felt almost normal. I was so pleased.

Yest after reading with it on, I awoke to find that I had nodded off for 30 min, then awoke, and all was still good.

So last night I figured heck--why not just sleep with it on.
Hard to relax and sleep, but I must have worn it about 1 hr for some type of sleep. I awoke to use BR, still it was on my face and I felt ok.

Again, very hard to transition to sleep with it back on after BR break. Now I fell back aeep about 3 AM, awoke startled and panicked at 6 AM--mask partly off my mouth, mouth open, choking because my tongue and palate were glued together like the Sahara! I could not even mouth breath until I dashed for some liquid. Took 30 min for that feeling to go away. This is one of the reasons I quit trying over last 15 yrs. I have mask tight enough to prevent awake leaking--near uncomfortable, but always then awake to the Sahara in my mouth.

[Bigcatdaddy]

My sleep data came in mail yesterday.

The May 2017 MD report says I have OSA with emergent CA's. I had insufficient time to determine effective treatment.

Brought back for additional night of titration 1 month later--June. The diagnosis at end of that from MD report was, severe OSA with treatment of emergent CA, with documented BiPAP and ASV failure.

So they set me up on one of these machines I have, on something called IVAPS, which they thought I responded better to during this second study.
These were the settings:
IVAPS
EPAP--17
Max PS--13
Min PS--4
Resp rate--13
Target vent--7.1
Ti max--3
Ti min--0.3
Trigger cycle--high

After 3 nights of failing this at home--15 years, 3 sleep studies--I chucked machine in closet and gave up until now.


I'll do some reading on how to post the sleep data over next day or so.

[ozij]

Sometimes, treatment emergent CA (central apnea) calms down after you get used to the treatment. Not something they can find out during the titration.

How many nights did you spend on the other machines?

[Miss Emerita]

Did you ever answer the question about whether you breathe through your nose during the day? It'd help to know.

[Bigcatdaddy]

1st machine--tried for 2 months--I think I never could fall asleep, mask and airflow so uncomfortable. I remember always pulling it off after 2 hrs in frustration.

Next machine, tried almost 3 weeks. Occasionally slept, more nights. I toolk it off--frustration in getting to sleep. Or the dreaded dry mouth upon waking in middle of night.

This last machine--never slept full night. Tried 2 weeks. Hard to breath, hard to get to sleep, or awake with dry mouth and panic.


I nose and mouth breath, sometimes at same time.

[palerider]

Changing the Trigger setting to High or Very High will speed up when the CPAP transitions from EPAP to IPAP. This change might help with your perception of needing to pull hard to get air.

A better way to say that is that setting trigger higher will make the machine more sensitive to the start of your inhalation, and trigger the switch to IPAP with less inspiratory effort, the transition happens at the same speed though.

—feels like I’m pushing too hard to exhale against the pressure. Also when I’m done exhaling, I feel there’s still air in my lungs that needs to come out—and to get it out means I have to consciously force more out.

Similarly setting the Cycle to High or Very High will speed up the CPAP in transitioning from IPAP to EPAP.

Again, it has nothing to do with speed. Changing cycle is something that's in there for people with lung diseases, that have *physical* trouble exhaling, so you want the machine to help them more.

However the feeling that you have air left over to breathe out could mean that the Trigger setting is too high.

I don't believe that to be the case.

So these two settings can both work for/against what you feel.

[palerider]

on something called IVAPS,

iVAPS is the ST-A machine. iVAPS is one of it's available treatment modes.

[GrumpyHere]

A better way to say that is that setting trigger higher will make the machine more sensitive to the start of your inhalation, and trigger the switch to IPAP with less inspiratory effort, the transition happens at the same speed though.

Again, it has nothing to do with speed. Changing cycle is something that's in there for people with lung diseases, that have *physical* trouble exhaling, so you want the machine to help them more.

Thanks for clarifying.

When I had the two settings on "very high", the timing of the extra help made the breathing feel pushed and rushed. Hence the caution about the perception of control when changing the sensitivity.