Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

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aspen
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Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Sun May 29, 2022 7:28 am

What do I need to change/adapt to let the machine drop to an EPAP of 3? I see it's possible.

I'm a bit of a wreck right now, but appear to be sleeping well. Just in case this is part of my issue, I have to explore. My "centrals" are much higher than obstructive so i do wonder.

I have a feeling I should know how to do this, but can't appear to access the part of my brain that knows how. :lol:

Thank you for helping me walk through this! I do have an official sleep study booked in June; it's been delayed TWICE now since last fall due to other health junk, and I can't wait for them to figure this out.

EDIT: Resmed Aircurve 10S

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 7:36 am

aspen wrote:
Sun May 29, 2022 7:28 am
. My "centrals" are much higher than obstructive so i do wonder.
So how much of a difference is there? What is the AHI and category breakdown of that AHI?
What are your current settings? Did you know that sometimes the difference between inhale and exhale can actually make centrals more numerous and reducing that difference might reduce the centrals?

You can go here and request the provider/clinical manual for your machine and it explains how to get to the clinical setup menu area where you can change your settings.

https://www.apneaboard.com/adjust-cpap- ... tup-manual

The short version is this below but I strongly urge everyone to take the time to get the full manual and read it so they understand their machine better.
ResMed A10 Series (AirSense 10 AutoSet, AutoSet for Her, Elite, CPAP, AirCurve 10 VAuto, S, ST, ASV, & CS PaceWave): For Setup Instructions with pictures, click here. The "dial" can be turned or pushed. The button below the screen with the house icon is called the "home" button. To access the clinician menu, press the dial and the home buttons simultaneously for 3 seconds. The clinician menu will appear. Select parameter(s) you wish to modify with the dial (push down to select, turn to modify). When done, press the dial and home buttons for 3 seconds again, or find the "exit clinical menu" option in the menus. (complete manual available via email, below)

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 7:38 am


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aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Sun May 29, 2022 7:50 am

Thank you Pugsy! I'm a pro at changing settings but lowest setting on the machine is 4.

I will attempt figure out screenshots but my cognitive stills are toast. the one graph in particular that makes me wonder I will screen shot below, then will try to figure out how to do the whole thing.

I figure it has something to do with the PS value ... maybe ... ugh. Yes I have the manual. Just don't get it right now.

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 7:55 am

I thought that S mode on the AirCurve 10 S offered a minimum of 3. Or rather I thought I read that somewhere.
Maybe I dreamed it. Let me check on it.

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 8:04 am

So....according to the manual I have (which is a combination manual for various AirCurve 10 models)
it should go below 4 in S mode...but I have heard people say that depending on where they live they don't always see the same options on their machines as what the manual says. I don't know why this happens.
pressure range S mode.PNG
pressure range S mode.PNG (20.08 KiB) Viewed 501 times
pressure range S mode.PNG
pressure range S mode.PNG (20.08 KiB) Viewed 501 times
SMode.PNG
SMode.PNG (58.74 KiB) Viewed 501 times

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 8:15 am

Okay I just check my AirCurve 10 VAuto and S mode does indeed offer EPAP minimum of 3.

If you can't manage screen shots just tell us what you are seeing on your sleep report in terms of AHI and the breakdown (you have to scroll to get more details be it is available).

When you say "more" centrals than obstructives that could mean anything...if OAs were 1 and centrals were 2 that is more but insignificant more. If OAs were one and centrals were 10 or 20 or 30 now that is significantly "more".
We need to know the reference.

What are your current settings?

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aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Sun May 29, 2022 8:21 am

WOW OSCAR is an improvement. Now have to figure out how to lin. Let's see if this worked?
update oscar screenshot basic mary 29 2022.png
update oscar screenshot basic mary 29 2022.png (67.29 KiB) Viewed 496 times
GRRRR that makes sense that in S mode it would go to 3. I'm using as a vauto. I moved Time at Pressure up - this is why I'm wondering. Basically my nice what should be normal curves "end" at 4, so I feel like having a lower EPAP option would help. Perhaps I could reset to S and give it a try.

aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Sun May 29, 2022 8:52 am

Presently 4-16, PS 2.8. I’ve dropped min EPAP slowly from (I think 8 at one time?), PS is down (I was trying to at least minimize my IPAP min setting if possible.

Thank you so much for your help, Pugsy!!

Pugsy wrote:
Sun May 29, 2022 8:15 am
Okay I just check my AirCurve 10 VAuto and S mode does indeed offer EPAP minimum of 3.

If you can't manage screen shots just tell us what you are seeing on your sleep report in terms of AHI and the breakdown (you have to scroll to get more details be it is available).

When you say "more" centrals than obstructives that could mean anything...if OAs were 1 and centrals were 2 that is more but insignificant more. If OAs were one and centrals were 10 or 20 or 30 now that is significantly "more".
We need to know the reference.

What are your current settings?

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Pugsy
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Pugsy » Sun May 29, 2022 9:02 am

First thing you need to do is check your mask and long hose and short hose (if your mask uses one) for a hole somewhere or incomplete attachment of the mask components.
Your leak line in its baseline is no where near 0.0 and it should be.
Not too long ago I had a similar issue with my hose and I couldn't feel it but I filled the long hose with water to see if it leaked or not and sure enough...it did leak but I could never feel the air leaking.

I don't understand what symptom you are having that makes you think you need lower EPAP. Can you explain in more detail please?

As for those centrals...that's really not a lot of centrals and I would bet some of them are arousal/awake related.
Go here and watch the videos and learn how to spot awake/arousal breathing being different from asleep breathing.
If you aren't asleep when something is flagged then it doesn't count except to make us wonder why someone isn't sleeping so great.
http://freecpapadvice.com/sleepyhead-free-software

By all means...give S mode a try and see if it does whatever it is you are wanting. You don't seem to need much pressure anyway.
Maybe try EPAP 3 and IPAP 7 and see what happens.

Next time you post your OSCAR report...omit the time at pressure graph and include the flow limitation graph instead which is a lot more useful.

First thing though.....take a close look at all your mask connections AND take the hose off and do the water in the hose test to check for leaks. That baseline leak is way to high at the pressures you are using. I would bet my last dollar there is a leak somewhere.

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aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Mon May 30, 2022 8:13 am

I included the time at pressure because of the way it's truncated at 4 - I feel like that suggests i could use a pressure below four to see an appropriate bell curve. We don't tend to respond in straight lines (I actually moved it up - I'm blown away by how well they are doing with OSCAR over SH!!!) I have been having some throat issues and I'm wondering if constant, slightly too high pressures could be contributing.

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Julie
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by Julie » Mon May 30, 2022 8:28 am

Or GERD (acid reflux) which is too common in apnea. You might want to look into it.

aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Mon May 30, 2022 11:55 am

One of the many things that has been ruled out. After a disasterous experience with a PPI. I’m running out of ideas at this point, hence the question. Just not sure.

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palerider
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by palerider » Mon May 30, 2022 1:37 pm

aspen wrote:
Mon May 30, 2022 8:13 am
I included the time at pressure because of the way it's truncated at 4 - I feel like that suggests i could use a pressure below four to see an appropriate bell curve. We don't tend to respond in straight lines (I actually moved it up - I'm blown away by how well they are doing with OSCAR over SH!!!) I have been having some throat issues and I'm wondering if constant, slightly too high pressures could be contributing.
You're mis-interpreting what the TAP chart is (supposed) to be telling you.

A bell curve on that would be bad.

Yours suggests that your min pressure should be a little *higher*, not lower.

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aspen
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Re: Significant weight loss; still require BiPap but my EPAP of 4 is looking too high

Post by aspen » Mon May 30, 2022 2:24 pm

OHHHHHHHHH. Tell me more. My addled brain is not comprehending. I do expect that if I dig into the links above from OSCAR, it will explain that somewhere?

Egads, I've had a bunch of medical issues and my sleep study should have happened last fall. Really wish I could just go there and have the sleep neuro figure it out.

My numbers are so good though, and the higher I put the minEPAP, the higher the clear airway drama goes - at my previous settings I was starting to wake up bamboozled and confused, and it was those events that were high. My AHI was running 6-8.


palerider wrote:
Mon May 30, 2022 1:37 pm

You're mis-interpreting what the TAP chart is (supposed) to be telling you.

A bell curve on that would be bad.

Yours suggests that your min pressure should be a little *higher*, not lower.