New BiPAP User - Assistance with Settings

[weepingwillow]

Here are the last 2 nights. On Nov. 23 I increased the min EPAP back up to 9 after Session 1. No issues with aerophagia these last 2 nights. 

I've had the slightest bit of congestion/cold-like symptoms. It's very, very mild, but I do wonder if that's factoring in at all. 

I'm tempted to increase the min a bit more to hopefully smooth out the swings and decrease OAs, but I'd love to hear your thoughts.

[weepingwillow]

Another thought: Might it be worth increasing Min EPAP while also increasing PS to improve comfort? (I'm still a total newb, but that's my initial thinking after reading the device manual.)

Thanks in advance for your input!

[SarcasticDave94]

You can edit both up 1, probably no negatives there. Another item? Have you trialed Trigger very high? Trigger is known and proven to assist in lowering CA. Maybe trial that a bit and see if it helps.

[Sleeprider]

Changing settings to find the most comfortable settings is something I fully endorse. The only caveat is you should change one variable at a time or it will get confusing what is helping or not.

[weepingwillow]

Haven't shared an update in a while, as I've been traveling and dealing with a pesky cold, so my sleep has been atypical. But I'm back home and almost over my cold so I wanted to check in again.

A while back I changed to trigger Very High and have been satisfied with that change, as it's greatly reduced CAs.

I've been fiddling around with min/max/PS to try and optimize my sleep, and I'm not sure where to go from here. I'm attaching the last 2 nights of sleep, Dec. 1 & 2. I increased max and PS after the first night and was surprised to see that events went up rather than down after making those changes. Shouldn't it be the opposite, or am I misunderstanding? Or perhaps I just need to give it more time. Would love to hear your thoughts.

[SarcasticDave94]

I think it may be an example of having a set of data bits where you had low to high settings, and having seen the results, you've probably sampled too low, too high, and Goldilocks just right (or close). AKA turn back PS to 6. Maybe then afterwards pressure itself.

This is assuming the first of these two OSCAR shots represent your middle ground just right ish. Since the higher settings were worse, you can likely consider just prior to be in the middle ground. Caveat is it's single day samples that we're seeing here.

[weepingwillow]

I went back to PS 6 and had no improvement. Not sure what to try next.

[Sleeprider]

Once flow limitations and hypopnea are resolved, that indicates further increases in PS or IPAP are unneeded.  We use EPAP to control OA and we use PS or higher IPAP to minimize flow limitation, hypopnea, snoring and similar inspiratory anomalies.  The typical titration approach is to start with a low pressure and titrate EPAP higher until OA disappears, then adjust PS higher if flow limitation remains.

[weepingwillow]

Thanks, Sleeprider! Seems that I misunderstood how to control OAs; I thought higher IPAP would take care of it. If I'm finally starting to catch on, then I'm thinking I should increase EPAP. Any thoughts on if I were to try PS 6 over 12.0-19.0?

[Sleeprider]

Dial back your PS to a comfortable level you previously found controlled flow limits, and increase EPAP. That will keep pressure lower and remain effective.