Finding optimum settings for Respironics System One (60 Series) RemStar BiPAP Auto

[vinitwins]

Sleep data for last night.

AHI is finally down (for a layman like me, this seems to be the easiest measurement metric to track?)

Would appreciate any feedback regarding any critical issues that need addressing, otherwise will stick to these settings for now.
EPAP: 8
IPAP: 18
PS: 5-8

Thanks!
V

[ajack]

I think you are getting there. The last cluster at the end may be positional, I wouldn't go down that road yet. See if your dads chin is close to his chest, head propped up on a pillow. Now think the opposite, like CPR with the head back. A pillow change may help?

See what the forum thinks, there may be other opinions to consider.
I'd have the following for now, it may clean up the first half of the night on the above chart, The tidal volume and minute vent also indicates a higher min epap would help.
EPAP: 9 (you may need 10 next)
IPAP: 20
PS: 5-8

Does your dad have COPD or other lung issues? He may need an bit more min PS than 5 later. see how it goes once the obstructive stuff is sorted.

[vinitwins]

I think you are getting there. The last cluster at the end may be positional, I wouldn't go down that road yet. See if your dads chin is close to his chest, head propped up on a pillow. Now think the opposite, like CPR with the head back. A pillow change may help?

See what the forum thinks, there may be other opinions to consider.
I'd have the following for now, it may clean up the first half of the night on the above chart, The tidal volume and minute vent also indicates a higher min epap would help.
EPAP: 9 (you may need 10 next)
IPAP: 20
PS: 5-8

Does your dad have COPD or other lung issues? He may need an bit more min PS than 5 later. see how it goes once the obstructive stuff is sorted.

Thank you.

Will follow your advise and change the settings. 

And will share the sleep data once again tomorrow morning. 

He's recovering from a cold and dry cough - it's much better now. Don't know if that can mess up the data. 

Best, 
V

[Sleeprider]

Things look pretty good here and the event rate is relatively low with most hypopnea and obstruction occurring during clusters that look like positional apnea and along with those BND periods. Snoring is greatly reduced. I see no problem in elevating EPAP min to 8.5. I'd like to get some feedback from dad about how he feels with the comfort of the therapy or what is not comfortable. I think we will eventually move EPAP higher to the 9 or 10 range to extinguish the obstruction we see in the latest graphs. This strategy is working, but only if he is comfortable.

[vinitwins]

Things look pretty good here and the event rate is relatively low with most hypopnea and obstruction occurring during clusters that look like positional apnea and along with those BND periods. Snoring is greatly reduced.  I see no problem in elevating EPAP min to 8.5.  I'd like to get some feedback from dad about how he feels with the comfort of the therapy or what is not comfortable.  I think we will eventually move EPAP higher to the 9 or 10 range to extinguish the obstruction we see in the latest graphs. This strategy is working, but only if he is comfortable.

Hi. Here are the results for last night.

NOTE: Min. EPAP is set at 9 (Dad started the machine without me, he's gotten a lot more comfortable with it) -- It was initially set to 8, but I move it to 9 after he had used it for 20 mins in the night...

[ajack]

That one looks even better.
I sent a message about the manual. To look at settings, because of the tidal volume spikes. All may not be obstructive related.

[Sleeprider]

I think dad is tucking his chin and that causes the clusters of obstruction. Other than that, he seems well ventilated and the fact he is getting comfortable is enough reason to leave the pressure alone for a while and let this settle out.

[vinitwins]

I think dad is tucking his chin and that causes the clusters of obstruction. Other than that, he seems well ventilated and the fact he is getting comfortable is enough reason to leave the pressure alone for a while and let this settle out.

You're quite right. 

I've tried getting him to use different memory foam cervical support pillows, but he still prefers his old regular foam pillow. 

He's definitely better, more attentive and coherent during the day.

He says he's feeling more energetic and only naps for 30mins during the afternoon.

I guess at his age that's excellent progress (from being drowsy 24/7).

Will keep the settings as they are for 1 week and report back. 

Thanks for all your help. 

Regards, 
V