Started BiPaP treatment, makes things worse. Struggling with the settings.

[ldinks]

I realised that looking at the FL and determining when they happened, relative to the mask pressure, would be difficult. In the name of science, I noted the mask pressure at each of the 15 FLs.

Pressure of : 6 to 6.88 - 7/15 Flow limitations at this level.
                 : 8 to 9.25 - 7/15
                 : 10.25      - 1/15

With an EPAP of 6.0 and PS of 2.5, does it still seem like raising EPAP is a good idea given the above data?

The 8 to 9.25 should really be 6, as the final flow limitation was after my alarm went off. I don't really count data after I've woken up (or before I sleep but that tends to be clear anyway). 2 of the "8 to 9.25 Mask Pressure" FL's were during CA's where the flow rate is almost a straight line, so I'm not sure if they "count" either.

[Sleeprider]

I think I had suggested trying PS 3 before.

[ldinks]

Thanks Sleeprider. I changed PS min/max to 3, and max pressure up 0.5 accordingly.

I had a vivid dream turned nightmare-lite (wasn't bad). I woke up in the middle of the night because of it, and did end up going back to sleep pretty quickly. I struggled to get out of bed like on my bad days, and dosed off lightly a few times (without any therapy, but not properly asleep).

Now that I'm up a few hours later, I feel better and don't have my typical brainfog, low energy/motivation, struggle processing things etc that I do on my bad days. Weird! I expected horrible data, but it's actually slightly better, going to build a trend again.

Anyway, attached is the overview and two zooms. First is the clear block from 00:30 to 1:30, looks very good to me. There's a single area with a more erratic flow-rate followed by it being relatively flat, with two pressure pulses. 

1) Are these pulses events that should have been tagged..? 

2) Second zoom shows all the flow limitations - for the majority of them (3/5), there's no issues with flow rate that I can see. What does that mean?

3) Is there any link between having more vivid dreams and PAP therapy? I can imagine either poor therapy results in nightmares/waking up, or perhaps good therapy means actually hitting REM for dreaming properly for a change, which takes some getting used to..? 

I realise that's a lot but I'm just looking to learn!

[Sleeprider]

This therapy looks better, and certainly didn't trigger the CA we have seen with more variable pressure and higher PS previously. Pressure pulses are just tests by the machine to check for airway openness. You would have to zoom in on the flow rate to determine why one was used. Flow limit determination on a Philips machine is different from Resmed, and I honestly don't understand it. You would need to zoom in closer to see the respiratory flow wave in the period flagged as flow limited. Most people experiencing dreams feel therapy is better when that happens. Thee is no metric I can use from Oscar or how you feel to actually know an answer to that question.

[ldinks]

I appreciate all of the explanation! 

Last night I woke once or twice, and was tired again when I woke up but it wasn't as bad as yesterday. My partner said I looked really bad this morning though. Still feel relatively good when I'm actually up and such though.

I noticed a 10 minute period (1.25 to 1.35) in the night that was filled with issues, I wouldn't be surprised if this is when I woke up.