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UPDATE: Back to the same original 3 clusters at approx the same time as first report I sent in (REM?) but not as
Ugly. Will cont to try the same continuous pressure over the weekend and see if the pattern sticks

Sleepysuz wrote:UPDATE: Back to the same original 3 clusters at approx the same time as first report I sent in (REM?) but not as Ugly. Will cont to try the same continuous pressure over the weekend and see if the pattern sticks

OKey, Dokey.
(acknowledging your post)


Den

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UPDATE again:
Pretty much the same pattern with the same 3 clusters spaced though the nite at intervals and some random OAs
Clusters not as ugly as when at 4-20 level.
How many more days would you suggest one needs to confirm a pattern?
Then is there a benefit to increasing to a higher constant vs increasing the max slightly?
Thanks!

You could try a little higher maximum but if the same thing happens as the other night and the machine doesn't respond to the clusters like we would think they would...won't matter what the max is. Of course that could maybe have been a fluke too.
We don't know if that was a one off weird thing because you only did the apap mode with 8 to 12 one night and then you went to fixed pressure at 9.
Don't know what would have happened if you had done 9 to 12.

Personally, 3 nights with the same thing showing up is enough pattern for me.

If the machine isn't going to respond to the clusters...like that one time....you are going to have to use a little more pressure again (either in fixed or apap)...but I would go slow and in 0.5 cm increments and watch for the aerophagia monster.
Since you are using sort of fixed pressures with minimum to equal maximum I would suggest sticking with that mode for now and maybe try 9.5 or maybe 10.0.
Or if you wish to see if the machine will try to respond...maybe a tight range of 1 cm just to see if there is movement.

Will try 10 for a couple of nights then will try 10-11

Sleepysuz wrote:Will try 10 for a couple of nights then will try 10-11

How's the tummy? I'm also in agreement for a 10-10 setting to see what happens.......clusters and tummy.

What was the AHI for last night?


Den

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An old "rule of thumb" around here is at least three nights per setting (unless there are significant problems).


Den

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Tummy is not bad- a little more bloat than pre cpap no where like last week when I thought I'd be on the ceiling a couple of nights

5.7 now (Not that much different than when 4-20 range when averaging about 6.3 but all over the place up to 10)

Here's the graph from the other night when i had a constant pressure. Pretty much similar for previous 3 nights with similar clusters (Less than a when I first posted an issue, but consistent)



Here's last night when I went up to 10 At 4 AM I the belly pain hit and woke me up. It's amazing how a small increase in pressure make a difference.

I switched the machine to a range 9-15 to see if it would control the next cluster when I got back to sleep. Picked the 9 as the minimum as it had not been a problem before and had helped make the clusters less ugly. The range of 9-15 didn't seem to help that cluster as I only went up to a max of 12. Guess I'll try this a few night more unless there are other suggestions. Really want to see those clusters go away!

I can't see the image. Don't know if is just me or not. Sometimes I have problems with images.

Well, now you know where the trigger for belly pain at constant pressure is. You might try 9.5 and see what happens with it.

You may want to reconsider the bilevel pressure machine option. If the apap won't temporarily increase the pressure (temporarily so that it won't cause the belly pain) to break up the clusters and increasing the minimum causes belly pain then you may need to try bilevel pressure machine. The combination of EPAP and IPAP should deal with the clusters better and decrease the aerophagia issues. I would recommend the auto adjusting bilevel pressure machine though.
To try to use the fixed bilevel pressures is going to require higher fixed pressures all the time and you don't need higher all the time....you just need it part of the time.

I would also recommend sticking with the PR S1 BiPap because the model 760 (the Auto) also has a variable Pressure Support (PS which is the difference between inhale (IPAP) and exhale (EPAP)) which is something that might come in handy in your situation.

trying to attach

attachment not working

trying again w/o the lpng

The links are formatted wrong... Was like: http://i.imgur.com/xln8E40.lpng when it should have been http://i.imgur.com/xln8E40.png

Krevilin Thank you! didn't realize I copied the wrong code sorry for the confusion
Trying once more

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