UARS and CPAP

palerider · Post by **palerider** » Fri Mar 29, 2019 10:56 am

> Do I need higher pressure.
Yes

werther · Post by **werther** » Wed Apr 03, 2019 11:43 pm

Increased EPAP to 7 and max pressure to 12. Yesterday was great (and my longest night yet), today, not soo much. I think I couldn't keep the air out of my mouth, which woke up me a few times and after about 6 hours I was not able to get back to sleep.
I am confused why I have MORE events marked as OA now at the higher pressure.

: Bildschirmfoto 2019-04-04 um 07.35.24.png (256.6 KiB) Viewed 9511 times

: Bildschirmfoto 2019-04-04 um 07.34.51.png (252.29 KiB) Viewed 9511 times

werther · Post by **werther** » Fri Apr 05, 2019 11:07 am

Slept very poorly last night, even though I had not a single Apnea.

Do you have an explanation for attached flow rate curve patterns? I had a lot of them in the last two hours, in which I was constantly waking up. No flagged FL, leaks or snoring.

tyrone747 · Post by **tyrone747** » Fri Apr 05, 2019 2:54 pm

Do you guys feel EPR should be maxed with UARS?

dogsarelife · Post by **dogsarelife** » Sat Apr 06, 2019 5:04 pm

Pale responded.

palerider · Post by **palerider** » Sat Apr 06, 2019 5:39 pm

dogsarelife wrote: ↑
Sat Apr 06, 2019 5:04 pm

Of course, I leave myself open to be corrected by the experts/people with more expertise and experience, but the first flow rate to me (between 5:18:30 and 5:18:40), it looks like you were trying to take a breath but the machine wasn't catching it?

I wouldn't want to guess at that without also seeing the mask pressure trace.

dogsarelife wrote: ↑
Sat Apr 06, 2019 5:04 pm
and the 2nd and third flow rate graphs look like...you are maybe having mouth exhalations??

Where are you getting that?

The middle one is a big inhalation, hold then exhale...

The bottom one is normal breathing except for the burble.

werther · Post by **werther** » Sun Apr 07, 2019 1:11 am

palerider wrote: ↑
Sat Apr 06, 2019 5:39 pm

I wouldn't want to guess at that without also seeing the mask pressure trace.

Here it is:

: Bildschirmfoto 2019-04-07 um 08.58.20.png (54.38 KiB) Viewed 9384 times

Thank you, really appreciate any input.

Had changed EPAP to 8/PS 2 last night, slept very well. Had much less of these kinds of "events", which, of course, might just be a coincidence.

: Bildschirmfoto 2019-04-07 um 09.27.20.png (239.21 KiB) Viewed 9383 times

werther · Post by **werther** » Sun Apr 07, 2019 1:15 am

tyrone747 wrote: ↑
Fri Apr 05, 2019 2:54 pm
Do you guys feel EPR should be maxed with UARS?

At least some people think so: http://www.apneaboard.com/wiki/index.ph ... _and_BiPAP
It was the whole reason why I bought the much more expensive VAuto (even though insurance will have to pay, at least if I do have some kind of SBD).

palerider · Post by **palerider** » Sun Apr 07, 2019 2:31 am

werther wrote: ↑
Sun Apr 07, 2019 1:11 am

palerider wrote: ↑
Sat Apr 06, 2019 5:39 pm

I wouldn't want to guess at that without also seeing the mask pressure trace.

Here it is: Bildschirmfoto 2019-04-07 um 08.58.20.png

You *might* benefit from raising the trigger setting. That could have been an attempt at a breath right about where the FOT vibrations started up.

werther · Post by **werther** » Sun Apr 07, 2019 3:17 am

Ok, I will try that. Do you think that could help because the pressure might be too low at the beginning of the inhale?

palerider · Post by **palerider** » Sun Apr 07, 2019 3:29 am

werther wrote: ↑
Sun Apr 07, 2019 3:17 am
Ok, I will try that. Do you think that could help because the pressure might be too low at the beginning of the inhale?

When you start to inhale, it 'triggers' the machine to switch to IPAP, (then when you start to exhale, it "cycles" back to EPAP. by increasing the trigger sensitivity to high, or very high, it make the machine more sensitive to the start of a breath.

If your airway is starting to close, and you're not able to get much of a breath, then it's *possible* that if the machine catches that small attempt at breathing, and switches to IPAP pressure, it may help you get that breath, instead of having an apnea.

If you're just asking 'is my pressure too low", then the answer is "yes, at that moment, it was", but probably not over all.

werther · Post by **werther** » Sun Apr 07, 2019 4:00 am

I try to stay disciplined and leave it at EPAP 8 with PS 2, trigger high for at least four days. Thank you for the explanation.

werther · Post by **werther** » Tue Apr 16, 2019 5:20 am

I have a lot less of these events now. I am generally feeling much better, however, not great yet. I would like to stay at EPAP 8 with PS 2 for another week and then maybe increase Epap a bit.

Two last nights:

werther · Post by **werther** » Wed Apr 17, 2019 2:08 am

Think these two episodes are interesting.

dogsarelife · Post by **dogsarelife** » Fri Apr 19, 2019 12:10 pm

the first one you posted kind of looks like the 2nd inspiratory flow shape in this paper - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688581/

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