UARS, bipap pressure, I or E

[Wcsleep]

It's been determined that I have UARS (working with LankyLefty).  My sleep doc is not interested as long as AHI is less than 5.
I have been experimenting with different pressures and PS but have not found the right one yet. It has occurred to me that the airway collapse (when I am aware of it-during nap or drifting off) occurs on the Exhale. I have been working with the Inspiration pressure being higher than the Exhalation. Does this suggest that I should increase or decrease my Exhalation pressure. I cannot get a handle on how to address this.
On a separate note, I have many leaks during the night even though I use mouth tape. Even when I double tape. Any thoughts?
My thanks in advance. This has been pretty awful.

[Sleeprider]

We generally mitigate UARS with pressure support, which by definition is a higher inspiration pressure and lower expiration pressure. the amount of difference is expressed as PS. Post some charts and maybe review what settings you have tried and how they failed. We have a few other tricks that can try. A collapse on exhale is an uncommon form of expiratory obstruction or flow limitation often associated with palatal prolapse. We can often recognize it's signature in the flow rate graphs. https://www.apneaboard.com/wiki/index.ph...l_Prolapse We have several threads by individuals affected by this, and the solution was to use a stent to prevent the collapse during expiration.

[Ynot]

One thing that confuses me though is that lankylefty is against the use of epr if I understood correctly, but this online apnea forums persistently recommend epr to help with flow limitations. Personally, epr reduced my flow limitations. Lmk if you ask him about this, because I think his vids are insightful but I'm puzzled about this take.

[Gideon]

We typically consider EPR and PS to be the same thing. The "Pro's" (They are really just very experienced users) here look at the specific inhale and exhale pressures you experience and suggest changes on that. Yes PS is additive to Exhale Pressure and EPR is subtractive from inhale pressure but we address all that in our suggestions.

Titration 101
Manage OA events with Exlale pressure, EPAP. (on a CPAP inhale = exhale until EPR is applied)
Then Keep EPAP constant and increase inhale pressure/ IPAP to manage Hypopneas, Fow Limitations, RERAS, and UARS.

Following these principles, we typically often achieve a nearly constant set of pressures simply because we have managed to prevent the formation of most events.