[Pressure] Can someone help me adjust my BPAP pressure settings?

[ApneaSufferer]

Dear apnea group,

I have been struggling over the years with CPAP and finally got a BPAP about a year ago. My AHI numbers used to be off the charts and for whatever reason I could not make it through the night with a CPAP. With my BPAP, my AHI numbers have come down from 30-40 range to now ranging from 7-12.

Here are my settings... any advise would be great. 

My doctor suggested:
Mode: AutoBiLevel
Min EPAP: 8.00
Max IPAP: 12.00

But to be honest, he didn't care to see my SleepHead data I brought in and spent all of 5 minutes with me.

Therefore since I know little about this, perhaps some experienced CPAP/BPAP users may be able to help me improve my scores getting the AHI numbers below 5.0?

As you suggested; here is a screenshot of my recent sleep data where I scored a 7.59 (this is pretty good score for me although I'd like to improve it).

The only other thing is I feel as if I'm not getting enough air when I inhale.

An off topic subject was my experience using the ozone cleaning device that I developed allergy to. (I spent a lot of time tracking that down, and just in case anyone else is having allergic reactions issues, I may be  able to help).  Thanks.

[Sleeprider]

There are a couple things going on here. The obstructive apnea suggest a need for higher EPAP, and the clusters of those apnea are an indication of chin-tucking or what we call positional apnea. Read the two wikis below with a focus on the "pattern" for positional apnea, and if you think the collar fits, wear it.
Positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft cervical collar: http://www.apneaboard.com/wiki/index.php...cal_Collar

I think we need to increase your EPAP min to 9.0 and even out the pressure support. A higher minimum pressure support will help prevent hypopnea, so use PS min of 3.0 rather than 2.0. I have a preference for fixed pressure support, but for now you can just narrow the range. Finally to make all this work we need to take the maximum pressure or IPAP to 16.0. Your doctor has you on autoBiPAP but with a minimum pressure of 8.0, and maximum PS of 4.0, it becomes fixed pressure. You really need to open up the top end (IPAP) for the pressure support to work and for the machine to respond to the obstructive events. Finally, roll the BiFlex back to 2. I always found BiFlex at 3 caused sync problems.

In summary"
mode: BiPAP auto
EPAP min: 9.0
IPAP max 16.0
PS min 3.0
PS max 4.0
BiFlex: 2

[ApneaSufferer]

Thank you very much Sleep Rider! I will try that tonight and keep the thread updated to any improvements... much appreciated for such a quick response!  
Mahalo!

[SarcasticDave94]

http://www.apneaboard.com/forums/Thread-...#pid254972

2 years ago in the post linked to I answered that you needed a ResMed AirCurve 10 ASV. I see you are on a Respironics BPAP still. It may be that an ASV is not needed, but the screenshot is only one night. Central apnea will change nightly when not treated by an ASV. Even so, you didn't change to a ResMed. So you know what they say about not changing things and expecting different results? You need a ResMed AirCurve 10 VAuto if you do not need CA treatment, and the ResMed AirCurve 10 ASV if you need to address CA. As it's been about 2 or more years on the prior suggestions, don't you think it is time to act on advice given?

[ApneaSufferer]

Oh and thank you for the link to the collar... I followed the instruction of sitting upright in a chair and this seems to apply to me. I'm going to order one of those as well. Thanks so much Sleeprider!!! Mahalo  

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Oh and thank you for the link to the collar... I followed the instruction of sitting upright in a chair and this seems to apply to me. I'm going to order one of those as well. Thanks so much Sleeprider!!! Mahalo    

[ApneaSufferer]

Thank you Dave... I was able to do a second sleep study and my doctor allowed me to change to the BPAP. It has helped a lot. He wouldn't let me get the more expensive machine and I wasn't able to choose brands (I wanted a RedMed). But thank you for reminding me, and switching from a CPAP to a BPAP has helped me a lot! Thank you!!!

[SarcasticDave94]

If the subject comes up about machines and therapy, I have found that the doctor cannot dictate brand without your consent. I don't accept machines that I don't accept. Try to work with doc but the bottom line it's on you to accept or reject the machine offered. I choose supplier based on whether or not they offer the machine I feel I need. That's what I had to do myself. Hopefully the advice helps.

[ApneaSufferer]

Thanks Sleeprider... 

I just ordered the:

Velpeau Neck Brace -Foam Cervical Collar - Soft Neck Support Relieves Pain & Pressure in Spine - Wraps Aligns Stabilizes Vertebrae - Can Be Used During Sleep (Comfort, Blue, Large, 3.3″)"

I will give it a try when it arrives on Dec 5th and will report any improvements!

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Thank you for that Dave.
My device is renewable in two more years (and I'll request ResMed then), but I may just instead get an out-of-pocket refurbished unit that you recommended from the link supplied.

[Sleeprider]

There is some clustering of the OA events, and we see that a lot. I really think the other adjustments are going to help as well.

[ApneaSufferer]

Again... much appreciated for your help. Looking forward to better sleep!