EP?IP settings?

[christinepi]

In Dec 2010 I was diagnosed with mild sleep apnea (4.4 OSA's/hour and 14.4 RERA's/hour). I was put on CPAP (Resmed 9) at a setting of 9-13. I never made it past 6cm because the aerophagia problems were insurmountable. After 4 months of suffering, I've been switched to Resmed VPAP Auto, at a setting of EP 7 and IP 14. Last night was the first night, and I promptly got aerophagia again, enough to keep me from sleeping. The doctor had eye balled the pressure setting, because during my sleep study I hadn't been put on Bilevel, so my current pressure may indeed be too high (or, CPAP just isn't an option for me, due to aerophagia).

My question is: let's say I play around and go down experimentally to IP 12. Note that I'm clueless about this. SHould the EP setting follow suit and be set to be always 7 cm's apart, so that I would set it at IP 12 and EP 5? Or should I leave EP at 7?

[jnk]

In Dec 2010 I was diagnosed with mild sleep apnea (4.4 OSA's/hour and 14.4 RERA's/hour). I was put on CPAP (Resmed 9) at a setting of 9-13. I never made it past 6cm because the aerophagia problems were insurmountable. After 4 months of suffering, I've been switched to Resmed VPAP Auto, at a setting of EP 7 and IP 14. Last night was the first night, and I promptly got aerophagia again, enough to keep me from sleeping. The doctor had eye balled the pressure setting, because during my sleep study I hadn't been put on Bilevel, so my current pressure may indeed be too high (or, CPAP just isn't an option for me, due to aerophagia).

My question is: let's say I play around and go down experimentally to IP 12. Note that I'm clueless about this. SHould the EP setting follow suit and be set to be always 7 cm's apart, so that I would set it at IP 12 and EP 5? Or should I leave EP at 7?

"PS" is the setting for how far apart breathe-in pressure is from breathe-out pressure at any given time. The setting for how high your pressure is allowed to go is called "Max IPAP" and the setting for how low your pressure is allowed to go is called "Min EPAP."

It is always good to keep a doc in the loop whenever you think about playing with pressure settings, especially if you aren't sure what the settings do or why you were prescribed the settings you were prescribed.

[Otter]

What was your titrated pressure for straight CPAP? If I had to guess without knowing that, I'd say leave EP at 7 cm H2O the first night. Assuming you're not running the bilevel in timed mode, it waits for you to inhale before increasing the pressure, and you don't want EP set so low that you have trouble inhaling, and hence switching over to IP.

Keeping your doctor in the loop is a good idea, as is keeping track of both your data and your aerophagia as you make changes.

[christinepi]

I was titrated for 9-13 for CPAP. I'm trying to figure out how to go about lowering the pressure to avoid this darned aerophagia. Any suggestions?

[Otter]

I was titrated for 9-13 for CPAP. I'm trying to figure out how to go about lowering the pressure to avoid this darned aerophagia. Any suggestions?

Do you mean 9-13 cm H2O on APAP? Was that with any sort of exhalation relief? If you sometimes need 13cm CPAP to prevent apnea, I'm afraid it's going to be difficult to prevent aerophagia by lowering your pressures without allowing more OAs. I hope you can thread that needle, though. Keep a close eye on your data as you experiment. You should probably also keep a log of how you feel during the day. This will help if you have to trade obstructive apneas for cc's of swallowed air.

Do you usually sleep on your back? If so, switching to your side or stomach may lower your therapeutic pressure and make the eye of the needle a bit larger.

I don't know much about aerophagia because my body figured it out on its own after the first few nights. But, bump. Maybe someone who has been down this road will see this thread.

Don't give up, and keep posting.

[Slinky]

Bi-levels are usually set, or at least started, w/a Pressure Support (in auto mode) or IPAP/EPAP range of 4 or 5 cms.

My understanding of Pressure Support in Resmed's VPAP auto mode is that IPAP and EPAP can never get closer or further apart than the PS setting.
My understanding of Pressure Support in PR's BPAP Auto mode is that IPAP and EPAP can not get closer than the PS setting, but can ranger further apart than the PS setting as long as it never ranges higher than the IPAP setting or lower than the EPAP setting.

So w/your IPAP and CPAP settings left the same, in VAuto mode you could just reset your Pressure Support to 4 or 5 and see how that works out for you.

Keep in mind that excessive Leaks will inspire your VPAP Auto to increase the pressure delivered in order to compensate for the leaks. It is important to get and keep your leaks under control

jnk can correct me if I'm wrong.