bilevel iVAPS settings help

[subconscious]

historically used a resmed autosense 10 w pressure range of 4-7 and epap 3. Able to get my AHI from 5-6 to 1 or less. But still had periodic flow limitations exceeding 0.1 and feeling fatigued in the morning. Although part of that did improve w better sleep hygiene as sleeping 8hr would feel much better than 6.5. 

However after seeing this forum i am realizing that my flow limitations are significant. So i am trying a Aircurve 10 ST-A on iVAPS. I tried the settings on LEARN mode, and the pressure was too much as i developed chest soreness on the first night. I was afraid of volutrauma and noticed my median tidal volume on the airsense 10 apap was much lower than what aircurve ivaps set. So i adjusted my bilevel settings to be similar to the APAP. My min pressure is 4 with a pressure support of 0-1.8

I have not adjusted the trigger or cycle. I am posting my data and curious on your thoughts on my wave form and what your suggestions are for improvement.

   
   

[SarcasticDave94]

I've used an ST-A as an unofficial self trial, as it's likely a machine type I need.

What are all your time settings despite you not changing them, include trigger, cycle, Ti Min - Max, whatever the target value from learn? Specifically that learn value, I had to edit mine down to get the ST-A to not do unnecessary ventilation. It was wanting to step in a little too much. You'll probably want to get yourself off the ramp as well.

[Sleeprider]

I think resolving flow limitation is helpful to reducing physical respiratory effort and having more restorative sleep, but I don't usually send people to iVAPS unless there is a serious underlying pulmonary condition. If your apnea and flow limits were obstructive and you had no problems with centrals, a better choice would have teen the Aircurve 10 Vauto, and with central apnea the ASV. Why the ST-A? With this pressure range and PS 4.0 you should have done fine with the Vauto which has a more comfortable "Easybreathe" pressure transition.

[SarcasticDave94]

Yes, Sleeprider is correct, and I forgot to ask.

Why did you choose ST-A? If you don't have pulmonary disease like COPD, it's very likely ST-A is a big overkill.