Data check

[Mersim85]

Hi all
A little background info. I used a CPAP machine for 3 years because subjectively it made me feel quite a bit better. I never had a sleep study done due to many reasons (read: No INSURANCE). I finally had a study done and to my surprise I was diagnosed with UARS and sent home packing. During the study I spontaneously aroused 28/hour and had an AHI of 1.2.  Doc explained i'll never get insurance to pay for treatment, which honestly I don't care because I have a Bipap and CPAP already and just get supplies through a drug dealer ( I kidd).  
Anyway, I was told by doc that bipap is better than the cpap that i've been using and was wondering if I can dial down my settings to where I wake up and actually want to attack the world. I'm a 34 year old guy, used to be extremely active before having my symptoms begin about 5 years ago. 
Appreciate all the help from you all.            

[Gideon]

Welcome to the Apnea Board

Congrats on a diagnosis of UARS, well at least you definitively know.

You need to be looking at 2 - minute views of the flow rate to see flow limits.  The other word for UARS is Flow Limits and your friend for treating that is Pressure Support.
The stats that indicate that you have a problem are RERAs and Flow Limits.  What says you are good is how you feel and a detailed 2-minute view of the flow rate to identify any flow limits that are causing a disturbance,  sorry, there is no stat for that.

[Mersim85]

Thanks for your reply Bonjour. 
Just for clarification, what exactly am I looking for in a 2 min flow rate view. Are there any sources to educate me on this. 
Also, I’ve used the bipap for a good while before and never once was flagged with an Rera. I was hoping I could learn what settings will be ideal for me. 
Thank you so much for helping me and the countless others you’ve already helped. 
Side note: Sweet beard my man

[Gideon]

OK, let's start with your charts.  Post a 2-minute view centered on 1 or 2 of your Flow Limits (FL) your machine chose to identify.  On those segments set the y-axis scale to +/- 75 so the wave form will better show and shoew the zero dotted-line as that separates inhale (top) from exhale (bottom).

See the OSCAR logo, within the O is an ideal waveform, smooth and sinusoidal with exhale longer than inhale, basically we are looking for differences from that.

The fact that the RERA shows in the events says you have a history of them and it fits strongly with a UARS diagnosis.  RERA is a series of Flow Limits ending in arousal.

[Mersim85]

Here are two different shots with the parameters you mentioned. I can see that there is something funky going on there.

[Gideon]

   
   

That help you understand

[Mersim85]

Wow ok, thank you. That’s relatively simple to understand. On to the next question, how do I adjust bipap settings to limit the poor flow rates? Is there a standard method of adjusting pressure for this?

[Gideon]

1 titrate EPAP first to eliminate obstructive Apnea.
2. Titrate IPAP or PS to treat flow limits, RERAs, hypopneas, and snores
Keep PS fixed, no range for this step.

Did you really mean you want to adjust flow rate? That's a lot more complicated.

[Mersim85]

So generally speaking increasing EPAP will reduce obstructive apneas and increasing IPAP will treat flow limits?
I didn't mean I wanted to adjust flow rate as I didn't even know that it was something that can be done. I will attach last nights chart, it is the worst I've ever had in terms of the amount of hypopnea and clear airway events. Any thoughts?

[Mersim85]

Can I have some help here. It seems this setting gave me the lowest AHI but i had a lot of RERA and FL. Should I increase IPAP, EPAP or increase the pressure support? I just want to know the method of how to slowly titrate to maximum comfort.
Thank you