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UARS - bad first night switching from APAP to BPAP
#1
UARS - bad first night switching from APAP to BPAP
Hi folks,

I've been diagnosed with UARS (PSG results .2 AHI, RDI 27). Since May, I've been renting an Airsense 11 and my best settings have been on For Her mode at 9.6-10.6 with EPR at 3. With that machine and those settings, my AHI is nearly always less than .4 (predominately centrals) and I'm mostly able to sleep through the night without any insomnia. Many of my symptoms disappeared or improved EXCEPT that I don't wake feeling rested. I felt like I was 95% of the way there and just needed a little boost to feel rested and energetic during the day. When analyzing my OSCAR data, I noticed that a higher IPAP improves my flow limitations, but I can't go past 10.6 without severe aerophagia and gas pains. So, I did some research and found that bi-level might help me, given that I don't need a high EPAP, but IPAP may need to be higher. 

I just started renting an Aircurve 10 VAuto and first used it last night at EPAP min 5, IPAP max 11.6, and PS at 4. I went to bed at 10:30, woke around 3am to pee as usual, then woke again at 5 for seemingly no reason, tossed and turned a while, then woke at 6:30 very groggy and kinda stiff/sore as though I didn't sleep well. My AHI was still low, but much higher than it usually is (.7), and was all centrals.

I'm wondering how I should go about analyzing this data and trying to optimize BPAP treatment? Any thoughts? I had a handle on APAP but this bi-level stuff is a whole new world for me.

I've attached screenshots of the night before last (8/3, Airsense 11) and last night (8/4, VAuto). Note: I'm not sure what happened with the settings not importing...this is the first time I've seen that. It could be because I was messing with the settings a bunch this morning to see what was more comfortable, maybe? Anyway, I edited out the pressure settings on the 8/4 night because they displayed incorrectly.

8/3 (Airsense 11):
   

8/4 (Vauto):
   


Thank you!
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#2
RE: UARS - bad first night switching from APAP to BPAP
Updating to hopefully get a response--I really need help here. Sad Last night I only slept for 3 hours before waking up to pee and then was completely unable to sleep again (this is how I used to be before treatment). I messed around with the settings a ton from 4-6am, so I won't post a screenshot of last night...but here are two more comparison shots:

7/31 (Airsense 11):
   

8/5 (AirCurve 10 VAuto):
   

Any thoughts on why I'm not able to sleep with bilevel? Could it be the For Her mode/the Airsense algorithm is better for me, or is this just a transitory thing and I just need to acclimate to the VAuto? Please note the changes in tidal volume, minute vent, and insp/exp time--I can see that I react differently to the two machines, but I don't know enough to know what this means.

Thanks in advance to anyone who'll take some time to help me out--it will be SO appreciated!
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