ejbpesca wrote: ↑Fri Sep 30, 2022 8:32 am
I went ahead and did a drastic pressure change on my machine. I woke with less aerophagia today. AHI went from 0 to near 5. I had found my pressure min and max was set WAY too high and I wonder if the AUTOSET function of my machine is very accurate.
So the good news is less aerophagia. The bad news is too big of an increase in AHI. Although it's worth asking: What was the CAI? the HI? and the OAI?
Also, to help us help you:
What were the old settings---as in both the maximum and minimum pressure settings and the EPR setting?
What are the new settings---as in both the maximum and minimum pressure settings and the EPR setting?
Because if you lowered both the max and min pressures, you may have lowered them a bit too much. But it's going to take some time to sort out the compromise you are looking for in terms of the pressure settings needed to minimize the aerophagia and the pressure you need to prevent the obstructive events.
As for how accurate the AUTOSET function is:
It's reasonably accurate in detecting (and responding) to breathing patterns that meet its definition of OA, H, and CA. It's lousy at telling when you're actually asleep. As for how the AUTOSET
responds to events: The Resmed machines are pretty aggressive in increasing pressure rather rapidly in response to OAs, Hs, snoring, and flow limitations. As soon as the Resmed determines that the bad breathing pattern seems to have stabilized into a nice regular sleep breathing pattern, it starts to gradually reduce the pressure---until the next set of events, snoring, or flow limitations are detected. And then it raises the pressure again. This gives a Resmed Autoset pressure curve it's characteristic "wave" shape where the fronts of the waves are steep and the back sides are much less steep.
With aerophagia, you may also do better with a tighter pressure range than a lot of people use: It could be the pressure
increases that are triggering the aerophagia. But it could also simply be that a higher minimum pressure than you need is enough to create the aerophagia problems.
Did you ever use a fixed pressure mode---i.e. straight CPAP instead of Auto? If so, did you have the same problems with aerophagia?
I have never once, in over 10 years of CPAP therapy, have had anyone give any examination to my therapy. There are NO technicians available in my area and the doctors, I have seen, have 0 knowledge of sleep therapy. Each yearly visit, I am asked if I use my machine 4+ hours a night and that's it. The sleep lab people do zero follow-up. I have to get my supplies online via Verus, which does not offer any analysis services nor advice, just sales.
They're doing exactly what they need to be paid by your insurer. And not one bit more.
It's a shame they don't care enough about their patients to learn something that would help people like you actually benefit from seeing them.
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