New sleep study coming... some questions about moving to bi-level

[Miss Emerita]

vandownbytheriver, I'm puzzled by why you want to use a bilevel machine when you are also trying to do without EPR.

Both EPR and pressure support provide a differential between inhalation and exhalation pressure. EPR is limited to a differential of 1, 2, or 3; PS can provide a much greater differential. EPR subtracts 1, 2, or 3 from your inhalation pressure; PS adds however much to your exhalation pressure.

[vandownbytheriver]

Now that I look at the horns on my waveforms I'm seeing that I might be fighting EPR.

Now that WHO looked at your waveforms?

And are you awake or asleep (cause if you're awake analysis would be an exercise in futility)...

I wouldn't make any major life decisions based on 16 breaths when there are 5184 other breaths that need a look-see, so you could load that file to SleepHQ for a better assessment;

Look, I know you're all proud and stuff... take it easy please.

I ran straight APAP 14-20 last night... same waveforms. Your EPR hypothesis is wrong, sorry to say. Who looked at the other 5000 breaths? Me.

Fighting is a function of wake.
Fighting is a function of wake.
Fighting is a function of wake.

Yes... I'm awake when I'm reading my plots and adjusting my pressures etc.

Perhaps you misunderstood.
Perhaps you misunderstood.
Perhaps you misunderstood.

Anyway, sleep study tonight. More later.

[Rubicon]

Look, I know you're all proud and stuff...

Not really. I'm technically a misanthrope. Ya got 2 choices. Live with it or press the foe button up there.

Your EPR hypothesis is wrong...

My hypothesis is you have palatal prolapse.

Perhaps you misunderstood.

Yeah we'll get to that.

Let me clean up the lines in our 16 breath sample:

[Rubicon]

EPR only exists during exhalation, in the light blue columns.

There are significant pressure changes in this snippet, but let's look at the area in the purple column, where pressure is about 16.8/14.8.

Green and blue lines in the pressure waveform are drawn to help in the analysis.

The problem of EPR as discovered The Great and Powerful DeltaDave as previously noted (and realized by others a decade later) is represented by the orange circle-- inspiration at significantly lower pressures that would otherwise be needed.

"Fighting" is a vague layman's term, but for laymen's purposes, may be used to refer to the struggle of trying to inhale at the sub-therapeutic pressure and/or resuscitative breathing post-arousal due to the EPR generated event (including that supra-pressure spike-- again, if that period is wake, it can't be scored as an FL).

[vandownbytheriver]

(snip)
"Fighting" is a vague layman's term, but for laymen's purposes, may be used to refer to the struggle of trying to inhale at the sub-therapeutic pressure and/or resuscitative breathing post-arousal due to the EPR generated event (including that supra-pressure spike-- again, if that period is wake, it can't be scored as an FL).

“When I use a word, it means just what I choose it to mean — neither more nor less.” I meant 'fighting' how I clarified it... I think you understand now.

Removing EPR did not change the flat-topping. Flog at will if you wish.

See y'all after the study.

[vandownbytheriver]

Failed the study, of course... ludicrous to think that taking 3 Benadryl would be enough for me to survive that torture. I'll create a whole 'nother thread on that ordeal... it's all insurance-driven, of course. Nobody with initial AHI > 100, who has gained significant weight and aged over a decade to over 65, should be forced to endure that trauma.