Difficulties with BiPAP

[cpapnewbie18]

Hi, 

Hope all is well. I recently switched to a BiPAP machine (Aircurve 10) to help with flow limitations to some success (my diagnosis was high RDI, low AHI). My flow rate looks much less choppy, and for the first time in my year of CPAP usage, I actually have long stretches of fairly normal looking breathing. 

I am still have stretches of sleep that are heavily punctuated by events of some kind (not sure what is going on). I've attached a bunch of screenshots of these events below from the flow rate chart. 

For the record, I'm at 16 IPAP, 11 EPAP. 

Thanks!

[OpalRose]

It's always best if you include a full daily chart.

[cpapnewbie18]

Here's the full chart, thanks!

[Gideon]

Thanks

What is the status of your Trigger and Cycle settings?

[Sleeprider]

You are using fixed VPAP-S mode on your Vauto with a pressure support of 5.0, IPAP 16, EPAP 11. You have certainly eliminated the flow limitations, but we don't get that data in VPAP S mode. I want you to switch to Vauto mode so we can get that data. To reduce the CA events, we need to to reduce PS to 4.0. If you want to use fixed pressure, please set EPAP 10, IPAP 14, PS 4. If you don't mind using variable pressure lets start with EPAP min 9.0, IPAP max 16.0, PS 4.0.

Gideon asked about your trigger settings. We often use a high trigger sensitivity, or very-high trigger sensitivity to mitigate CA events; however, I think that is premature at this point until we dial in your appropriate pressure settings, and especially try a lower PS and see where that leaves us in terms of flow limitation and efficacy. Keep trigger and cycle at Medium for now.

[cpapnewbie18]

Hi, 

So I've tried a handful of different settings: IPAP 15, EPAP 11; IPAP 16, EPAP 12; IPAP 13, EPAP 10. I'm going to attach another comment with zoomed-in screenshots of the events I'm seeing. What do you think?

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Here are some of the events that have been arising.

[Sleeprider]

16/12 seemed to have the fewest arousals and irregularities, but 15/11 looks similar. The fixed 13/10 had the poorest looking results. You are the person on the other end, so you are the one that needs to say what works best.