Bipap analysis

[CpapGee]

I have started using a bipap vauto aircurve after it was recommended in previous posts that a fixed pressure cpap would not help my flow limitations.
I have started using the bipap over the past 5 days and dont feel any more refreshed in the mornings

I have had to rent this machine as i am still in discussions with my sleep treatment clinic about providing me with a bipap machine.

can anything be tweaked to help me further 
attached are last nights oscar data

Thanks

[SarcasticDave94]

While you are at 0 AHI, meaning technically you're getting good therapy, you may want to try VAuto mode to allow a range of pressures. For me when I'd recently tried VAuto, this mode was much more comfortable than S. Then again S mode reminded me of ST which also is static exhale to inhale.

Consider using VAuto mode with EPAP a bit less than your current 13, maybe 10. PS of 4 and IPAP 18 can remain. Only reason I suggest this is attempting to maximize your comfort.

[CpapGee]

Thanks for replying, I will try VAuto tonight, on S mode do feel some bloating.
Will post the results of VAuto tomorrow

[CpapGee]

see my results with the changed settings
till think there could be improvements, please check my oscar data
feel little better than previous night but there were some arousals where i was awake around midnight and 0130

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some zoomed in screenshots from the event time

[Sleeprider]

Your last settings change implemented Vauto mode and reduced minimum pressure to 14/10 compared to fixed 18/13 in S-mode. Definitely an improvement. Note your original settings resulted in PS 5.0 and pressures were simply too high as shown by the 700 mL tidal volume. That has dropped back to a more normal 540 mL, so we can see you were over-ventilated. The Vauto is working well at current settings, but there may be room to move EPAP min down to 9.0. The events at midnight were probably positional with some chin-tuck that resulted in airway restriction (flow limitation), and even with bilevel, that can result in events and arousals. I think additional time at Vauto mode with these effective settings should be continued before you pass judgement on the comfort. I don't know if "perfection" exists, but this looks like a great start to "better".

[CpapGee]

Thanks I will try this for a week and see how I get on, for my understanding how do you know /interpret if eap can be reduced further?

[Sleeprider]

EPAP controls obstructive events, while PS will work on flow limits, hypopnea snores and ventilation. Think of EPAP as being the "CPAP" in your therapy. As long as obstructive event rates are low, the EPAP is adequate. The PS is where you are really getting better rest by making respiration easier and more normal compared to the flow limited condition that causes respiratory effort related arousals and more hypopnea events. That is in a nutshell how I'm looking at your progress and the effectiveness of your pressure range.

[CpapGee]

Thanks for clear explanation, will post a update during the week after a few nights with these settings

[CpapGee]

see past two nights results

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another set of screenshots

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another set of screenshots

[Sleeprider]

There is no significant difference in the pressure reduction from 10.0 to 9.0. In my opinion, you could probably continue lowering your EPAP min and maximum pressure without consequences. The objective is comfort as your efficacy is not in question.