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Newbie Looking to Lower AHI Below 5 on BiPAP
#1
Newbie Looking to Lower AHI Below 5 on BiPAP
Hello,

I am a new user on the Apneaboard, nice to meet everyone. Although I have been using the BiPAP for a while, I am a bit clueless on tweaking the settings myself. My AHI usually hovers around ~5, but I am still pretty tired throughout the day. I am looking to change the settings to see if I can lower the AHI to ~2 consistently. I'm attaching my latest OSCAR data for reference. Any help here would be sincerely appreciated! Thank you.


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#2
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
You are showing positional apnea (clustered Oa and H events).  It is also called chin tucking where the chin drops down to the sternum city of your airway. 

It happens many time sleeping on your back or it could be just to high of a pillow. If simple solutions don’t help you may need a collar ( link in signature). Please look at the difference a collar makes.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
You might be more comfortable using the VAUTO mode instead of the BIPAP-S mode.

Also, your leaks are not terrible but higher than they should be.  Does your nasal mask leak or does air seep out of your mouth?  If it's the mask you need to adjust it to fit you better.  Many folks attach the mask too tightly, thinking that will stop leaks.  The mask should sit lightly on the face.  As the air starts to flow it will fill the mask and cause it to adhere enough to prevent leaks.  Give it a try.

If it's your mouth leaking I find that mouth tape works the best.  Lots of us use Cover Roll Stretch tape.  I prefer Theraband kinesiology tape, even though it's more pricey.  You can get either from Amazon.

Best of luck with whatever you try to solve these issues! Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#4
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
Hello - thank you for all the replies. I will try lower pillow and loosening the mask a little bit. 

How are my settings looking? Should I be making any changes? Why do you recommend I use VAUTO mode instead of the BIPAP-S mode? Any guidance in terms of settings would be greatly appreciated!
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#5
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
This is from wiki - I have only worked with people using VAUTO

Modes of BPAP

S (Spontaneous) – In BiPAP-S or VPAP-S mode the device triggers IPAP when flow sensors detect spontaneous inspiratory effort and then cycles back to EPAP. BiPAP-S or VPAP-S refers to fixed pressure bilevel machines with no backup rate.Auto (Spontaneous) - The BiPAP Auto or Vauto bilevel uses a pressure range for EPAP and IPAP (or EPAP plus PS). Like Auto-CPAP, these machines can raise pressure within the set range to respond to flow limitation, snores, obstructive apnea and hypopnea.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
Thank you! Would love to hear - does anyone use BIPAP-S mode instead of VAUTO mode here on this forum? Any other input on settings would be appreciated.
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#7
RE: Newbie Looking to Lower AHI Below 5 on BiPAP
The use of S-mode is for individuals sensitive to changes in pressure or that are intolerant of higher pressure. In your case, the following settings would work:
Mode: Vauto
EPAP min 6.0
Max IPAP 13.0
PS 4.0
Trigger Sensitivity: High

This provides a range of 10/6 to 13/9 (inhale/exhale) and with high trigger sensitivity, you will have fewer CA events. We can fine-tune these Vauto settings after seeing data. Be sure to work on the positional apnea and leaks. https://www.apneaboard.com/wiki/index.ph...onal_Apnea
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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