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Recently got onto Bi-Level therapy as I found that increasing EPR on my CPAP helped with my flow limitations and overall sleep quality, so decided to nuke my flow limits with Bi-Level.
I've been struggling to get the settings dialed in, also the new options such as trigger and cycle time don't make things easier.
I've attached two nights below. Let me know your thoughts!
Note that for the second night I set trigger to high.
The first night was nearly event-free, so the changes you made on the second night seem to not be working. Most people do fine with the default inspiratory timing and trigger defaults. Notably, you changed too many factors to attribute the problems to any specific setting. On the first session you use BiPAP S mode at 14/10 pressure and machine defaults, resulting in an excellent AHI of 0.22. On the second night you made setting changes after starting at 15/11 and changed to 14/9 (PS 5.0). I think the higher CA rate is due to the increase in pressure support which scavenged CO2, and the high trigger made no difference.
I don't care if you use S-mode or Vauto mode, but your limit is PS 4.0. In Vauto mode EPAP min 9.0 Max IPAP 15, and PS 4.0 would probably be fine. In S-mode I don't know why you would mess with the perfection of 14/10.
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Just to clarify, first night is the one with all the CAs and the second night is one with 0.22 AHI. The reason I want to mess with the settings is that I'm still getting enough arousals during the night that its making me tired the next day.
Because you're concerned about flow limitations, I recommend that you get out of S mode and into VPAP Auto mode. The reason is that in S mode, FLs are not reported.
You can emulate a steady 14/10 in VPAP Auto mode this way:
Oh my goodness, I had no idea that FLs were not reported in S mode! I shall switch to vAUTO tonight with the settings described and try again. Thank you
