Tweety: Tweaking Aircurve VAuto settings for aerophagia

[Dog Slobber]

I think you should consider the Zonker Aerophagia solution.

Although he used APAP and not Fixed BiLevel.

He used a maximum pressure that was below the level where he experienced aerophagia. This was at the expense of optimized treatment.

He slowly increased the maximum pressure by the smallest possible units (0.2 cm) over a long period of time. When ever he experienced aerophagia he went back to the previous level and kept it there for a while.

I don't know the time frame it took him but I believe he is now got his device wide-open and aerophagia is no longer a problem

Perhaps, he can fill in some of the details. Let me see if he's around.

Attention Walmart shoppers, if there is someone who goes by the CPAPTalk member name zonker, could you please report to the customer service desk.

Thank you

[Tweety]

I think you should consider the Zonker Aerophagia solution.

Although he used APAP and not Fixed BiLevel.

He used a maximum pressure that was below the level where he experienced aerophagia. This was at the expense of optimized treatment.

He slowly increased the maximum pressure by the smallest possible units (0.2 cm) over a long period of time. When ever he experienced aerophagia he went back to the previous level and kept it there for a while.

I don't know the time frame it took him but I believe he is now got his device wide-open and aerophagia is no longer a problem

Perhaps, he can fill in some of the details. Let me see if he's around.

Attention Walmart shoppers, if there is someone who goes by the CPAPTalk member name zonker, could you please report to the customer service desk.

Thank you

Hey, I was just composing my message when you posted this! Yes, exactly what I would love to have happen to me (although without zonker's get-up, )

Pugsy, thank you, this exercise has been so helpful for me, I was just floundering around trying to figure something out and getting nowhere. I never would have landed on S mode by myself.

I'm wondering if needing these very low pressures is a temporary thing for me. Earlier this year I was able to tolerate a minimum of 7 with 3 EPR on the For Her, and it's only when I hit a cycle of reflux >aerophagia >more reflux >more aerophagia that I couldn't get past it. Maybe I can slowly move up to slightly higher pressures as my LES heals up. Then, if my hiatal hernia acts up, or whatever the trigger is, I can drop back to S mode.

[zonker]

I think you should consider the Zonker Aerophagia solution.

Although he used APAP and not Fixed BiLevel.

He used a maximum pressure that was below the level where he experienced aerophagia. This was at the expense of optimized treatment.

He slowly increased the maximum pressure by the smallest possible units (0.2 cm) over a long period of time. When ever he experienced aerophagia he went back to the previous level and kept it there for a while.

I don't know the time frame it took him but I believe he is now got his device wide-open and aerophagia is no longer a problem

Perhaps, he can fill in some of the details. Let me see if he's around.

Attention Walmart shoppers, if there is someone who goes by the CPAPTalk member name zonker, could you please report to the customer service desk.

Thank you

meerkat.gif

why didn't you just activate the zonker signal?

dog slobber speak with straight tongue. i was filling in someone about my journey just a few days ago. without looking it up, i had hit a dead end of minimum pressure set at 8.8. through my reading here, i KNEW it had to be set higher. but, damn!, i couldn't see how.

that pain from my tightened belly would wake me up in the wee hours and stay with me until i could get rid of the gas. so what could i do?

what i could do is get a machine that would allow incremental increases of .2 at a time. palerider was quite skeptical that i could feel that .2 difference, but i sure could. so it went as DS remembers. i'd increase, hit that damned aerophagia, then turn it back. settle down then try again.

i started out this journey in october of 2018. how long did it take? let me go look at my therapy thread....

my thread shows that as of march 2019 i was at a min of 13.

my thread shows i was at min of 13.8 first week of april.

i think you can get the idea from that. by this time, iwas sleeping comfortably with no aerophagia and an ahi of <1.

eventually, i got up to my current min of 15.4. and still sleeping comfortably. my ahi now is typically 0.22 to 0.66 with the odd(very odd) 0.0 thrown in.

so yeah, i did it. it took a long time. can you do it? i dunno. we are each of us different.

but there's nothing preventing you from trying.

if you want to read the whole ugly mess-

viewtopic/t173195/zonkers-cribsomewhere ... r%27s+crib

good luck!

[Pugsy]

I think maybe stick with S mode for a little while so you can use 3 cm EPAP....use 6 or 7 IPAP...both do a good job in terms of OSA prevention. If 7 IPAP feels better in terms of comfort and you can still keep the aerophagia monster away with it...do it.
As it stands right now there's no urgent need to use higher settings and while it would be nice to make use of the auto adjusting feature...not at the expense of the aerophagia monster returning. Just not worth it and you don't urgently need to anyway.

Give yourself maybe a month or two....let the stomach and esophagus and that Lower Esophageal Sphincter heal up and the maybe reintroduce more EPAP minimum with a little auto adjusting range and go slow.

Maybe after the damage done by GERD flare up is healed up then maybe you could go back to a little higher pressures without the aerophagia issues raising their ugly head.
There's simply no sense in using more pressure if it makes you sick doing it.

[Tweety]

why didn't you just activate the zonker signal?

zonker-signal.jpg (41.7 KiB) Viewed 3281 times

The signal goes on and he shows up. That's the way it's been, that's the way it will be.

if you want to read the whole ugly mess-

viewtopic/t173195/zonkers-cribsomewhere ... r%27s+crib

good luck!

Thanks zonker . Yours is one of the first threads I followed when I started reading this forum. Very aspirational. I ribbed you about your "getup", above, but without your enthusiastic promotion of the scunci I never would have solved my chipmunk cheeks.

[Tweety]

I think maybe stick with S mode for a little while so you can use 3 cm EPAP....use 6 or 7 IPAP...both do a good job in terms of OSA prevention. If 7 IPAP feels better in terms of comfort and you can still keep the aerophagia monster away with it...do it.
As it stands right now there's no urgent need to use higher settings and while it would be nice to make use of the auto adjusting feature...not at the expense of the aerophagia monster returning. Just not worth it and you don't urgently need to anyway.

Give yourself maybe a month or two....let the stomach and esophagus and that Lower Esophageal Sphincter heal up and the maybe reintroduce more EPAP minimum with a little auto adjusting range and go slow.

Maybe after the damage done by GERD flare up is healed up then maybe you could go back to a little higher pressures without the aerophagia issues raising their ugly head.
There's simply no sense in using more pressure if it makes you sick doing it.

Ok, that's a plan then. I like that I can experiment with the smaller increments between EPAP 3 and 4 in S mode, so that might allow me to very slowly inch upward, similar to zonker's method. Thanks Pugsy!

[zonker]

why didn't you just activate the zonker signal?

zonker-signal.jpg
The signal goes on and he shows up. That's the way it's been, that's the way it will be.

if you want to read the whole ugly mess-

viewtopic/t173195/zonkers-cribsomewhere ... r%27s+crib

good luck!

Thanks zonker . Yours is one of the first threads I followed when I started reading this forum. Very aspirational. I ribbed you about your "getup", above, but without your enthusiastic promotion of the scunci I never would have solved my chipmunk cheeks.

WOW! consider that stolen-

memestolen.jpg

and ME??!? aspirational? and you grabbed the scunci??

i can now die happy, knowing i've been such a good help to you.

hat-tip.gif

[Dog Slobber]

I ribbed you about your "getup", above, but without your enthusiastic promotion of the scunci I never would have solved my chipmunk cheeks.

You really need to be careful about ribbing zonker about his scunci setup, he might be self-conscious about it.

[zonker]

I ribbed you about your "getup", above, but without your enthusiastic promotion of the scunci I never would have solved my chipmunk cheeks.

You really need to be careful about ribbing zonker about his scunci setup, he might be self-conscious about it.

self-conscious, what does this mean?

[babydinosnoreless]

I think you should consider the Zonker Aerophagia solution.

Although he used APAP and not Fixed BiLevel.

He used a maximum pressure that was below the level where he experienced aerophagia. This was at the expense of optimized treatment.

He slowly increased the maximum pressure by the smallest possible units (0.2 cm) over a long period of time. When ever he experienced aerophagia he went back to the previous level and kept it there for a while.

I don't know the time frame it took him but I believe he is now got his device wide-open and aerophagia is no longer a problem

Perhaps, he can fill in some of the details. Let me see if he's around.

Attention Walmart shoppers, if there is someone who goes by the CPAPTalk member name zonker, could you please report to the customer service desk.

Thank you

meerkat.gif

why didn't you just activate the zonker signal?

dog slobber speak with straight tongue. i was filling in someone about my journey just a few days ago. without looking it up, i had hit a dead end of minimum pressure set at 8.8. through my reading here, i KNEW it had to be set higher. but, damn!, i couldn't see how.

that pain from my tightened belly would wake me up in the wee hours and stay with me until i could get rid of the gas. so what could i do?

what i could do is get a machine that would allow incremental increases of .2 at a time. palerider was quite skeptical that i could feel that .2 difference, but i sure could. so it went as DS remembers. i'd increase, hit that damned aerophagia, then turn it back. settle down then try again.

i started out this journey in october of 2018. how long did it take? let me go look at my therapy thread....

my thread shows that as of march 2019 i was at a min of 13.

my thread shows i was at min of 13.8 first week of april.

i think you can get the idea from that. by this time, iwas sleeping comfortably with no aerophagia and an ahi of <1.

eventually, i got up to my current min of 15.4. and still sleeping comfortably. my ahi now is typically 0.22 to 0.66 with the odd(very odd) 0.0 thrown in.

so yeah, i did it. it took a long time. can you do it? i dunno. we are each of us different.

but there's nothing preventing you from trying.

if you want to read the whole ugly mess-

viewtopic/t173195/zonkers-cribsomewhere ... r%27s+crib

good luck!

.2 at a time helped me greatly. I too can feel the difference in the small increments. The Ymmv sticker belongs on that one. Maybe because I am not one who can open my mouth and talk without all the air rushing out. I don't have that cool switch internal switch like some of you. The aerophagia monster likes to take advantage. It took a combination of many of the the different suggestions I got for things to finally click.

[zonker]

.2 at a time helped me greatly. I too can feel the difference in the small increments. The Ymmv sticker belongs on that one. Maybe because I am not one who can open my mouth and talk without all the air rushing out. I don't have that cool switch internal switch like some of you. The aerophagia monster likes to take advantage. It took a combination of many of the the different suggestions I got for things to finally click.

hmm. i wonder if there is some connection? i can't do that mouth open thing either.

nor am i able to keep my tongue sealed against the roof of my mouth.

<sigh> some people have all the fun.

[babydinosnoreless]

.2 at a time helped me greatly. I too can feel the difference in the small increments. The Ymmv sticker belongs on that one. Maybe because I am not one who can open my mouth and talk without all the air rushing out. I don't have that cool switch internal switch like some of you. The aerophagia monster likes to take advantage. It took a combination of many of the the different suggestions I got for things to finally click.

hmm. i wonder if there is some connection? i can't do that mouth open thing either.

nor am i able to keep my tongue sealed against the roof of my mouth.

<sigh> some people have all the fun.

yes and some people wouldn't have any luck at all if it weren't for bad luck. Thats me.

[Tweety]

.2 at a time helped me greatly. I too can feel the difference in the small increments. The Ymmv sticker belongs on that one. Maybe because I am not one who can open my mouth and talk without all the air rushing out. I don't have that cool switch internal switch like some of you. The aerophagia monster likes to take advantage. It took a combination of many of the the different suggestions I got for things to finally click.

hmm. i wonder if there is some connection? i can't do that mouth open thing either.

nor am i able to keep my tongue sealed against the roof of my mouth.

<sigh> some people have all the fun.

Yep, me neither. I'm doing the tongue thing and breathing out of my nose more during the day, but at night the little air bubbles sneak around the back of my tongue and around the front of my teeth and, Blooey! out my lips. It was only entertaining for my husband the first night, and then he was over it.

[Tweety]

I think maybe stick with S mode for a little while so you can use 3 cm EPAP....use 6 or 7 IPAP...both do a good job in terms of OSA prevention. If 7 IPAP feels better in terms of comfort and you can still keep the aerophagia monster away with it...do it.
As it stands right now there's no urgent need to use higher settings and while it would be nice to make use of the auto adjusting feature...not at the expense of the aerophagia monster returning. Just not worth it and you don't urgently need to anyway.

Give yourself maybe a month or two....let the stomach and esophagus and that Lower Esophageal Sphincter heal up and the maybe reintroduce more EPAP minimum with a little auto adjusting range and go slow.

Maybe after the damage done by GERD flare up is healed up then maybe you could go back to a little higher pressures without the aerophagia issues raising their ugly head.
There's simply no sense in using more pressure if it makes you sick doing it.

Alright, I'm going to give this some time. Just for comparison I did the S mode with PS 4 (EPAP 3, IPAP 7) since the air felt a little thin with PS 3. A marked increase in arousals (all flagged as CAs for easy viewing, but those are all arousals). So it looked worse, data-wise, but subjectively I felt like I slept better. I didn't need to get up until much later, and when I was conscious of the arousals I felt relaxed and fell right back to sleep. I think I'm going to stick with the PS 4 and see if things improve, data-wise.

Screen Shot 2019-11-17 at 10.24.24 AM.png

[Tweety]

WOW! consider that stolen-

memestolen.jpg

Glad you liked it. My friends say I have a weird sense of humor.