In need of some BiPAP settings help please

[elocin71]

Going into my fourth year of CPAP/Bi-PAP journey and still don't feel fully treated.  I am a faithful machine user because I am way more tired without it but I am still chasing the "waking up refreshed" feeling.  The SleepyHead Wiki suggested that I screenshot the following so I am hoping this will get the ball rolling.

Here is my most recently downloaded night:




and here is the worst night in the last month:


Sleep therapist said I actually could go up to 18, if it weren't for the darned burping that I get at anything above 15.

I am using an AirTouch mask and a chinstrap.

Thank you for any insights

[Crimson Nape]

elocin71,
Unless you wish to pay the $200 per year for a public photobucket account, I'd strongly suggest that you consider using imgur to host your images. . . it's free.

[Walla Walla]

Well the bad night could be fixed with a soft cervical. Your tucking your chin in during sleep and that cuts off your airway. Better than a chin strap it also takes care of mouth leaks.

You also have a lot of flow limitations driving the pressure high. I think with a collar you could cap the IPAP at a lower pressure.

[Sleeprider]

I agree a cervical collar looks like a winner. You don't have any central apnea going on, and with the narrow range of EPAP min and IPAP max, and a range of pressure support from 2-4, you get very inconsistent treatment. I think I'd close the range of PS fto 3-4 or just set it to 4.0, and open up IPAP max to 18. That will allow EPAP pressure to rise to treat the OA as needed, and should keep the hypopnea at bay and improve flow limitation. On your best night, the EPAP stayed at 11 cm and your IPSP moved between 13 and 15 cm. On your worst night, the EPAP fluctuated from 11 to 13. We could look for a pattern with more data, but it appears you do better when pressure support is maintained, and EPAP stays more stable.

At the end of your other thread you mentioned that you previously used CPAP at a pressure of 7. If that was able to treat most of your OA events, then reducing EPAP minimum pressure may be okay. The thing is, we don't know whether a lower pressure would increase your obstructive events. It appears that pressure support is important to better results for you, so I'll focus on that while keeping your current EPAP min pressure the same for now.

EPAP min 11, IPAP max 17 or 18 and PS min 4 ps max 4 would accomplish a stable pressure support and allow EPAP to move from 11 to 13 or 14. That is a pretty wide variation in results, and there may be something going on that a close-up of your flow rate chart could clarify because your exhale time is quite a bit shorter than inhale, and that's not normal for most of us.

[ajack]

I can't see any chart. You may be able to work around the gas, there is some stuff you can do. also it may just settle down. get some imgur images up.

[Sleeprider]

I can't see any chart. You may be able to work around the gas, there is some stuff you can do. also it may just settle down. get some imgur images up.

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