[Treatment] BiPAP: Great Numbers, Super Dizzy

[churras]

First, thank you guys! This forum is a gold mine. I'm learning a lot here. After reading many posts and making several adjustments, my therapy, at least in terms of the numbers, appears to be great.

But during the last two nights, when the great numbers finally appeared, I was extremely dizzy in the morning—about 7.5 on a 1-to-10 scale. On the other nights, I always felt like "I didn't sleep well," so I kept reading the forum and making adjustments. Now that I finally have great numbers, I feel so dizzy that I'm almost ready to quit PAP therapy.

Last two nights: (flow limitation does not show in OSCAR for Bipap S mode, but manualy zooming it's very low)

   

   


So, very low numbers.

For context:
In 2010, I did a sleep study when I was 23 years old:

• 0 AHI, RERA 10.8, and they had a different metric for "brief awakenings per hour": 33.4/h
  
• SpO2 min 97%, SpO2 max 98%, PML 13.5
  

No PAP therapy was given.
After 14 difficult years...

In 2024, I had another sleep study:

• 17.8 AHI, with 35.8 AHI during REM and 13 in non-REM
  
• SpO2 min 91%, SpO2 median 94%, PLMS 3.3, Bruxism 8.5/h (14.7/h in REM)
  

Current Settings:

• BiPAP-S mode
  
• EPAP: 3
  
• IPAP: 6.6
  
• PS: 3.6
  

I found that EPAP 3 just solves my apneas and hypopneas.

• With PS 4, I started having lots of Clear Airways events.
  
• With PS 3.6, using a medium trigger and cycle, I still had many clear airways.
  
• With PS 3.6, trigger set to "Very High" and cycle to "Medium," the clear airways seemed to be resolved.
  

I started with APAP and was experiencing lots of flow limitations. EPR 3 helped a lot, but didn't completely solve the problem, so I moved to BiPAP. PS levels of 2.2, 2.8, and 3 didn't resolve the flow limitations either.

I'm thinking I might be experiencing a mix of hyperventilation and hypoventilation at different times, and I'm unsure what else to do...


I'm posting a zoomed-in view of the last 30 minutes of my night:

   

Does anyone have any suggestions? I'm really feeling hopeless about what to do next. I actually feel better without any PAP device than with it. I would be very grateful for any help—I'm almost giving up.

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If you guys want, I can post more zoomed-in screenshots for 10 minutes and 40 seconds to show the waveform. I didn't do it before because I reached the maximum number of attachments.

[Deborah K.]

Most people find the Vauto mode better. Try that.

[churras]

Hi Deborah! Thanks for the reply! I'm clueless about what to do next.

I tried VAuto mode for a few nights, but as you can see, it produced a lot of clear airways, as shown in the two attachments.

I was waking up feeling bad too. =/

Any new ideas are welcome 


If you’d like me to post a zoomed-in pic, just let me know and I’ll upload it!