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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Jun 11, 2019 7:24 am
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Back off on that minimum EPAP for a while then since you had significant aerophagia issues.
Not good to trade one problem for another.

Give yourself a week or two with the minimum EPAP of 8.
Revisit the higher minimum EPAP later. Maybe give your body more time to adjust and might get lucky and the AHI will reduce on it's own a bit anyway.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Jun 13, 2019 8:08 am

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This is just an update after moving min EPAP back down to 8. Will keep tracking for a week. Thank you.

20 Pres
10 EPAP up
8 EPAP down
6 PS up
5 PS down
3 Humidification

OFF OptiStart
14 BPM
1 Ti
OFF Mask Type
3 FLEX
15 Tube Type


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Jun 20, 2019 6:37 am

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I'm still experiencing aerophagia, but not so badly that I wake up in pain in the middle of the night. Attached are the most recent screenshots.

20 Pres
10 EPAP up
8 EPAP down
6 PS up
5 PS down
3 Humidification

OFF OptiStart
14 BPM
1 Ti
OFF Mask Type
3 FLEX
15 Tube Type


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Jun 20, 2019 7:13 am
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You need more EPAP but more EPAP very well will increase the aerophagia issues.

Might try letting EPAP go a little higher than the 10 max EPAP you are now using and see just how much it needs to go higher and see how much aerophagia you get. Start slow with the increases in max EPAP though...I know you probably need a lot more EPAP but it doesn't help you much if you kill all those OAs with more EPAP and you are miserable and can't sleep from the belly issues.
Maybe try 12 max EPAP and see what happens....just a guess. If too much aerophagia happens back off to 11.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Jun 20, 2019 8:08 am

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Thank you. I really want to get these apneas under control so will begin upping the EPAP per your recommendations.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Fri Jun 28, 2019 6:48 am

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I started the first night with:
20 Pres
12 EPAP up
8 EPAP down
6 PS up
5 PS down
3 Humidification

The next 4 nights I went up to:
20 Pres
14 EPAP up
8 EPAP down
6 PS up
5 PS down
3 Humidification

I experienced little to no aerophagia. Oddly the aerophagia does not seem to directly correlate to max pressure and appears to be more random or based on other factors at the moment. I'm prepared to raise the PRES to 22 and EPAP up to 16 if that is what you recommend next.


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Fri Jun 28, 2019 10:24 am
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It doesn't look like minimum EPAP is set to 8 from the pressure graphs.

Could you do me a big favor and use the commonly correct terminology as to which settings you are using?
Like minimum and maximum instead of up and down.
You go into the clinical menu and you see minimum and maximum...not up and down.

I can't tell if those hyponeas are central in nature or obstructive in nature.

Try minimum EPAP set to 10...your minimum EPAP is the most critical setting...not the maximum (what you are calling "up" I think anyway).
Don't change anything else except minimum EPAP...


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Fri Jun 28, 2019 12:38 pm

Joined: Wed Jun 05, 2019 10:35 am
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In my menu it is listed as up/down with an up/down icon, but I fully understand what you are saying and can easily adapt my terminology. Please let me know if additional changes in my terminology would be helpful. These are the actual settings in my machine, but do not accurately reflect in Oscar. I have misunderstood and thought we were raising Max EPAP. If I am now understanding correctly you are suggesting raising Min EPAP to 8. I checked again and Min EPAP is already set at 8.

20 Pressure
14 Max EPAP
8 Min EPAP
6 Max PS
5 Min PS


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Fri Jun 28, 2019 12:46 pm
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Pressure Setting: Depends on the machine as I actually have more than one

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Up/down is for directional change.
Bear with me...I have used ResMed and Respironics ASV machines but not the latest DreamStation model.

I understand that OSCAR may be messing with the reported settings but the graphs also look "off"...which might be OSCAR.

Didn't you have central apnea or complex apnea?
Wonder if those hyponeas are central in nature?
Need to increase PS max and see if the machine wants to do anything about them....
PS max of 10...maybe more but I don't want to open the door too wide for the aerophagia monster to sneak in.

So leave EPAP minimum at 8 but increase PS max to 10 and see what happens.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Mon Jul 01, 2019 6:49 pm

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I have both central and obstructive sleep apnea with obstructive making up the majority of apneas. Just got back into town tonight and will be raising PS to 10 for tonight. Thank you, Ric


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Aug 01, 2019 10:10 am

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20 Pressure
14 Max EPAP
8 Min EPAP
8 Max PS
5 Min PS

Can't believe it has already been a month since I last posted. I've definitely experienced better #s by increasing the Min EPAP. I tried increasing it to 10, but couldn't handle the amount of aerophagia. Still have problems at 8, but I've been tolerating it. I'm excited by the lower average AHI :)


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Aug 01, 2019 3:04 pm

Joined: Wed Jun 05, 2019 10:35 am
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I meant to say I experienced better #s by increasing the Max PS. I tried increasing it to 10, but couldn't handle the amount of aerophagia. Still have problems at 8, but I've been tolerating it. I'm excited by the lower average AHI :)


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Aug 01, 2019 5:51 pm
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Think you could handle maybe 0.5 cm more minimum EPAP??


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Thu Aug 01, 2019 7:21 pm

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I'll absolutely try it. I'm in it to win it, so always open to trying. Thank you for helping me.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 6:06 am

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20 Pressure
14 Max EPAP
8.5 Min EPAP
8 Max PS
5 Min PS

I've been using the new setting for over a month now. It's unpleasant, but tolerable (meaning the aerophagia is unpleasant, but it's not keeping me up at night). It seems like my AHI is all over the place, but still much lower than where I originally started.


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 6:41 am
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Your minimum PS is 4 and not 5.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 8:02 am

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Just checked the setting on the machine and minimum PS is set to 5.


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 10:25 am
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Pressure Setting: Depends on the machine as I actually have more than one

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Okay....must be a software bug in the reporting of the settings.
Known issue. Ignore what I said.

You are caught between a bad rock and an ugly hard place.
You need more EPAP or IPAP but more of either is going to make the aerophagia monster grow up bigger and uglier.


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Bart
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 11:46 am

Joined: Wed Jun 05, 2019 10:35 am
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Okay, let me make sure I understand before I decide what to do. EPAP is my 14 Max EPAP & 8.5 Min EPAP settings. IPAP is my 8 Max PS & 5 Min PS settings. Pressure is currently set at 20, but it would in theory be 14 Max EPAP + 8 Max PS if I had it set to 22 or above.

Your suggestion is I need to raise Min EPAP or Min PS. I'm open to it and will continue to raise either one by .5 until I can't handle it.

20 Pressure
14 Max EPAP
8.5 Min EPAP
8 Max PS
5 Min PS


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Pugsy
Unread post  Post subject: Re: Dreamstation BiPAP autoSV Therapy settings  |  Posted: Tue Sep 10, 2019 3:03 pm
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I am torn between minimum EPAP and/or minimum PS increase.

If you were already at say 3 minimum PS I would suggest that one but you are already at 5 minimum PS.

I think if it were me I would still try to sneak minimum EPAP up a little.
If you were pegging out max PS at 8 a lot I would say maybe try increasing max PS but it's hanging around 6 ish so just letting it go higher won't make it go higher.
Plus...the numbers have reduced a little with the already slight increasing in minimum EPAP...means we are at least tweaking a working setting.


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