Hi I am new! Need help understanding some stuff

[dnar82]

Your maxing out on your IPAP.  I'd increase the Max IPAP setting to 25cm.

Didn't check the forums last night so never see this but anyway I personally up the Max IPAP to 21.5 last night.
Following is last night result, should I increase it to 25cm? Since the pressure I am using is still very high. 
BTW how to post picture? Or I still need more post? Everytime I click on "insert an image" add in the url than click "insert" nothing display....


https://imgur.com/rEcTIBy

[Walla Walla]

I think I'd put the EPAP at 13cm and the IPAP at 25cm. I'd leave the PS alone. Your EPAP shoots up to above 13cm as soon as you start. Might as well give it a head start.

[Sleeprider]

I actually think the results are very very good. You are under AHI of 0.5, ore one event per 2-hours. If the flow limitations are impacting your comfort and sleep quality, I increase pressure support by 1.0 and leave everything else alone (PS 4-5). I see no rationale for increasing EPAP by 3 cm in response to these results. I'm open to why Walla thinks this is needed, but in bilevel, we don't attack flow limits with higher EPAP.

[Walla Walla]

Sleeprider,
I was looking at his Medium EPAP of 15cm. I figured 13cm would put it closer to the medium also raising the IPAP without having to increase pressure support. Less chance of CA's that way. But than you have more experience then me.

[Sleeprider]

It's pretty interesting in this case how dnar gets along pretty well, then suddenly has a couple OA events at what looks like REM onset (could be positional or sleep stage??).  Results are good, and the main problems are FL and H events, which I would work on with pressure support.  If the OA becomes more predominate, than I would go for the EPAP increase, but probably in 1-cm increments.  The onset of OA events is so rapid, and the machine is already at near maximum pressure, I'm not sure an overall pressure increase is the answer.  With AHI less than 2, I tend to work on comfort and let a few events go.

[dnar82]

Thanks for all the help!!! I have adjusted accordingly.
Below is my yesterday night result, AHI gone up again... i think it might be due to me having sore throat, I have been coughing in bed until eventually i zzzzz
Yes sleeprider, I think it is sleeping position as well... the night before where my AHI drop below one, I am using another pillow with neck support (i got 2 pillow one soft and comfy another with neck support). 


https://imgur.com/ghoMN7V

[trish6hundred]

Hi dnar82,
WELCOME! to the forum.!
Good luck with CPAP therapy and also with getting it fine-tuned to better meet your needs.

[dnar82]

Thank everyone for the help and so sorry I never post any update as I was pretty busy with work.
Btw I think for the time being I no longer need to change any more setting. The previous setting have worked well for me.

I have been getting a good range of 0.5 to 0.7 AHI for the past many days and I am feeling very refresh   
The next thing that I really need to change is to cut down on my weight

[ajack]

I was looking at your MED tidal volume, which seems a bit low, your higher breaths per minute and normal minute vent. If these numbers are right and you could zoom in to check, I'd talk to your doctor and see if he wants to increase your PS.

This is how these numbers can be adjusted. Resmed has PS:6 as default for healthy lungs and 6-8 for obstructive, resistant etc lungs. page 24, You can also see how they titrate a bpap if you scroll down.
https://www.scribd.com/document/35340282...-Titration