[Treatment] RagingBull - Bi-Level Help

[OneShleepyBoi]

Hey, just wanted to add my own experience regarding the pressure thing when waking up. I can agree that it also sort of feels like there isn't much of a pressure/benefit anymore once you are getting used to it, but if you remove your mask, you will immediately notice how much worse your breathing is without it and give you immediate feedback that the pressure actually works - so yeah, I guess it's normal that we get used to it

[RagingBull]

Oh man, i didnt see the replies until now! Thanks @Sleeprider and @OneShleepyBoi.

Ive been having more nasal congestion and then fatigue during the day. I found another section of my OSCAR data from last night that looks suspicious to me. @Sleeprider, does this look like a potential RERA, where the waveform gets shallow/boxy then leads to a sharper inhale? Still trying to figure out if this is normal or not, so i appreciate the help.

And @OneShleepyBoi, I'll have to try that, thanks for the idea!

[Sleeprider]

Possible RERA at 07:21:50, but it's mild.

[RagingBull]

Possible RERA at 07:21:50, but it's mild.

Okay, good to know. Might it make sense to raise my pressure while keeping PS consistent?

[Sleeprider]

Your device did not even pick up this event or any flow limitation. In fact no flow limits are detected across the board and your AHI is roughly one event in two hours. Your EPAP is already high in my opinion, and I do not recommend raising it or changing anything else other than not to obsess over the flow rate graph. What are you trying to accomplish?

[bertchintus]

I believe the reason there is no flow limitation on your OSCAR data is because your Bi-PAP is in S-Mode. Flow limitation only appears when using V-Auto.

[RagingBull]

I was debating using an old thread or starting a new one. On my previous thread here, I appreciated everyone weighing in.

The main consensus was that my data looked fine, no flow limitations (now i realize there were no flow limitations because i was in "S" mode - but regardless, switching to VAuto barely showed any flow limitations either, so back to "S" mode).

However, i've continued to feel worse and worse. Waking up exhausted, overheated and sweaty (despite room temp of 70 degrees), sometimes with head throbbing / pain. My Lofta sleep study shows an RDI of 10, but i suspect it's higher than that some nights.

Anyways, I decided to buy a Wellvue O2 monitor. My O2 levels sometimes drop to 93%, which I guess isn't too low. However, my heart rate rises between 15-30 bpm during moments of erratic breathing.

I attached 3 screenshots:
1). Entire night
2). Breathing looks erratic, heart rate spikes, O2 drops
3). Breathing looks erratic, heart rate spikes, O2 stays about the same



Leak rate during those screenshots was pretty low. Leak rate overall had some high moments, which is strange considering im using mouth tape + bandage to prevent mouth leaks along with a dreamwear nasal pillow. Maybe the nasal pillows fell out of my nostrils a bit at some moments.

I could really use some advice here. Maybe everything looks fine, but given the heart rate spikes, breathing, and feeling unwell, I don't think my current settings are helping much. Thanks in advance.

[G. Szabo]

I had a similar HR spike problem & chest pain, which I posted too. Does abnormal breathing trigger an elevated heart rate? Or vice versa.  

Later, I suspected that my position could be the culprit. Hence, I purchased a  MedCline Shoulder Relief Wedge and Body Pillow System. It locks your shoulder in so you can not change your position too much. Then, I slept 50% of the night on my right and 50% on my left. 

The HR spikes and the chest pain have been gone.

[RagingBull]

G. Szabo, That is an interesting point about position. I mainly sleep on my side and stomach so I'm not sure that is affecting me, but maybe my chin tucks a bit at night. I was thinking of trying a cervical collar but I don't suspect I chin tuck all that much.

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@Sleeprider (not sure if this will "page" you ), I'd appreciate any insight from you, since you weighed in on my previous post.

Personally, I think my breathing is still problematic, and even more so now given the heart rate data. But im curious what you think.

[RagingBull]

I'm hoping someone might be able to suggest changes to Bipap settings, because I haven't played around with a lot of them (mostly trigger, PS, IPAP, EPAP).

My PS is almost 7 now, but doesn't seem to make a difference.