New BiPAP user! (UARS). Need serious help please! Data included, much appreciated

[Crimson Nape]

What does the Mask Pressure graph display for these time periods?

[CentralApneaUser909]

What does the Mask Pressure graph display for these time periods?

It's fixed pressure. IPAP 13, EPAP 8.2

[Sleeprider]

With pressure support at 6.0, it's no surprise we would see more centrals. You seem to be obsessed with treating flow limitations, and you have to remember your machine produces square-wave pressure support. Your respiration is somewhat a mirror of that, and I think might be better with the Vauto which uses Easybreathe. Anyway, you can either reduce pressure support or switch to ST mode and use a backup rate of 12 BPM. That will give you a kick to start breathing when you pause like this.

[CentralApneaUser909]

With pressure support at 6.0, it's no surprise we would see more centrals. You seem to be obsessed with treating flow limitations, and you have to remember your machine produces square-wave pressure support. Your respiration is somewhat a mirror of that, and I think might be better with the Vauto which uses Easybreathe. Anyway, you can either reduce pressure support or switch to ST mode and use a backup rate of 12 BPM. That will give you a kick to start breathing when you pause like this.

My PS was at 4.8 not 6

As to why I'm obsessed with FLs? Because I already had a low AHI during my sleep test. My AHI was 1.5, yet I still felt terrible and woke up many times. That was without a mask etc. 

My problem is UARS, and the issue in UARS is Flow Limitations rather than apnea. If I shouldn't target FLs, then what should I target? Because the vast majority of my breathing is flow limited.

So do you think my respiration looks bad in the screen Cap I posted? I could use ST. I am a bit scared of that but if it's safe to do I will do it.

[Sleeprider]

I don't see a flow limitation in your last screenshots, however if those are centrals, the backup would switch you to IPAP and might cause you to take a breath.

This is PS 4.8, but I had read it as PS 6.0 based on the settings summary.

[CentralApneaUser909]

I don't see a flow limitation in your last screenshots, however if those are centrals, the backup would switch you to IPAP and might cause you to take a breath.

This is PS 4.8, but I had read it as PS 6.0 based on the settings summary.  

I manually scanned through the whole night and most was flow limited, so I didn't even bother posting them..the screencap I posted along with the 2 part summary for 19th of feb was a brief hour or so where my breathing looked non flow limited (for the first time since starting BiPAP).

So really, I was looking for points where my breathing wasn't flow limited, and it looks like I found it at ipap 13.

Unfortunately I don't think buying another machine with easy breathe is in my cards atm. Could increasing rise time from the current setting of 550 perhaps help? It goes up to 900. Cycle setting is set to low. My inspiration peak looks good in the screen cap I posted, just that the top isn't flat (or round). I think a rounded top would be closer to normal breathing.

As for why it says Ps 6 in that pic, that's my bad. After I woke up, I just played around with the settings and tried ps 6. Then turned off the machine and left it sitting at that.

[Sleeprider]

I am supportive of you trying to optimize this machine, but with your AHI now approaching 7 events per hour, I have to ask, is your sleep or sense of health improved since starting this therapy? The last thing we want is for the therapy to be worse than the conditions you set out to treat.

[CentralApneaUser909]

I am supportive of you trying to optimize this machine, but with your AHI now approaching 7 events per hour, I have to ask, is your sleep or sense of health improved since starting this therapy?  The last thing we want is for the therapy to be worse than the conditions you set out to treat.

Yes it has improved, just not as much as I'd hoped. I think I haven't found my optimal settings yet.

If I were to sleep without the machine, I would have a lower AHI but feel far worse. So mentally I feel sharper since starting. I can't really say that I feel worse with AHI 6 than I did AHI 0.5 (which I had on one of the days this week). 

I think these treatment emergent centrals would dissipate. 

So, I do feel better, but my sleep is still fragmented and I have tired eyes.

[SarcasticDave94]

I'm thinking these are not your normal rather common treatment emergent centrals. It appears your settings are causing them.

[CentralApneaUser909]

I'm thinking these are not your normal rather common treatment emergent centrals. It appears your settings are causing them.

Yeah, I was expecting I'd get some centrals once I was approaching PS 5. 

PS 4 didn't have them, but 5 did. However one of the reasons I got a bipap was to get the benefit of the PS function. 

Shouldn't the centrals go away once I get used to this Ps? Because if not, then that means I'd never be able to go beyond pressure support 5, which is very disappointing.