Severe chest injury and CPAP?

[jennmary]

Pain killers? Did he take pain killers one night and not the next? Or use more pain killers? My ahi is always higher when I use painkillers or have too much wine.

[Pugsy]

For some reason or other the max pressure of 11.6 works decently some nights and not so great other nights.

I think I would just increase that max pressure and let the machine sort it out. At this point won't know if more minimum is also going to be needed.
I would start with more max and see what happens.

[kteague]

Yeah, I noticed it is not going to the max in spite of many events. Could this be a sign of a malfunctioning machine? His wife says on the nights the numbers are high the machine makes so much noise.

[Pugsy]

What makes you think it isn't going to the max of 11.6 on that ugly night?

When you look at the pressure graph (not the mask pressure graph) and you see something around 8.6 ish as the max line...that's EPAP...add EPR to it and you get IPAP max.
EPR appears to be 3....IPAP max is 11.6

On that ugly night he pegged that max of 11.6 out for the entire ugly time frame.

[kteague]

Thank you for clarifying that max pressure for me. DIdn't realize that was factoring in EPR. My plan tonight is to increase his max pressure. I may just increase it to 15 - he's already noting some discomfort in the area of his injuries and I don't want to be responsible for causing a problem. I am leaving town in a couple days, so I'm hoping this will get him to a tolerable point at least. His sleep study was 10 years ago, and he got his machine then, and it has 6800 hours on it. He plans to get a current sleep study and new machine when his mobility improves. That could very well be a couple months out. Thanks again.

[kteague]

Progress! Inching his upper limit up. Last night looked pretty good. Most of the events he had were in clusters and appeared to correspond with his pressure topping out. The way the clusters were spaced out over the night makes me think they could be REM related. If he has to go much higher, I'll probably go ahead and set up the bi-level (from a late family member) in the closet just in case he needs to switch. Leaving in a couple days so hoping he will be dialed in enough to benefit fully from his treatment.

[kteague]

Last night's data. Does he still need his upper limit increased? Last night they had one of those nights from hell between the leaks and the machine noise. Would like to set up the bilevel today but have no clue what settings to use. It's an S9 VPAP Auto. Anybody willing or got the time to make suggestions for its setup?