[Pressure] Recently diagnosed with UARS and prescribed Bilevel. Need help with settings.

[cloudwalker]

Hello folks! I was diagnosed with upper airway resistance syndrome by a sleep specialist after suffering for years with fatigue, daytime sleepiness, insomnia, overactive nervous system (I have POTS), chronic pain and cold extremities. On the sleep study there were lots of arousals and limb movement. Oxygen went down to 85%. I was on APAP for a while but my symptoms didn't improve so my doctor prescribed me Auto bipap. I had to pay out of pocket because the insurance wasn't covering anything for UARS. I have been using fixed pressure on auto mode for a few weeks so I can track flow limitations. I think I feel a bit better but still having symptoms. I was wondering how long does take to feel better and if I need to change any settings. I have been using the N30i Mask.

[PeaceLoveAndPizza]

My suggestion is to self-titrate starting from a good baseline. Once you have a few nights in we can help tweak things from there.

Mode VPAPauto
EPAP min 8
IPAP max 15
PS 4
No ramp

Also, please read the link in my signature “Formatting OSCAR charts”.

[cloudwalker]

Thank you for the suggestion and the link. I'll try these settings tonight. Do you think auto mode has more advantages over fixed mode?

[PeaceLoveAndPizza]

Is auto better than fixed? That depends on many things. 

For fixed (CPAP) mode to work, you have to be at least in the 95%-99% percentile of pressure needed, which means you are using a higher pressure for a significant portion of usage time than you actually need. Plus, if there are events that need higher pressure the machine cannot respond to it, so your sleep will likely be disturbed.

With auto (APAP) mode the machine can respond as required to events. If you are hyper-sensitive to pressure changes you can manage it with the response setting on APAP or trigger/cycle on bilevel. 

Basically do what feels right for you, but understand the rules before breaking them.

[cloudwalker]

I've spend 4 nights with these settings:
Mode
VPAPauto
Min EPAP
8.00 cmH2O
Max IPAP
15.00 cmH2O
PS
4.00 cmH2O
Mask
Nasal
Ramp
Off
TiMax
2.00 Seconds
TiMin
0.30 Seconds
Trigger
Med


I am dealing with a bad sinus infection right now so the tiredness might be increased due to that (I was given antibiotics for it). I also wear my bipap in bed while awake before falling asleep. I did have some issues with it leaking so I try to adjust it to the best of my ability.

[jkossis]

cloudwalker, any luck with nailing down your settings as well as you feeling better?

[cloudwalker]

Yes. I’m on 12.6/8.2 right now and I was able to get rid of most of the flow limitations. I do have chronic sinus issues and tend to take off the mask while sleeping when I’m congested. I still have some issues with the mask leaking and hurting the septum. But overall I feel like my nervous system stays relaxed during sleep. I am also getting treated for iron deficiency, which was playing a big role in the fatigue. I am accepting the fact that I won’t be as energized as I hoped due to other health concerns, but something is better than nothing. Thank you for asking.

[Jlcdsc]

I hope to get a bilevel I have a CPAP currently and Im struggling with flow  and exhale . You said you found success , what Bilevel setting gave you success? What steps got you there please?