ppluissz - BiLevel Journey

[ppluissz]

Increase in Central Apneas BIPAP - EPR

Hello,

I have been diagnosed with sleep apnea for over 7 years now. I had never been able to say that cpap was helping me feel better , hence did not use it much.

My first study showed a 8.0 AHI without titration , lately I had been more tired than usual and dediced to do a second study , I have put some weight since then and my AHI got to 20+ . It was an split study , after two hours , they put me in a CPAP , not working , after that they tried a BIPAP and my AHI was 0.0 . I was very optimistic since I thought all this time I needed BIPAP and now I had a prescription for it.

They put me in AUTO BIPAP with with max IPAP 20 , Min IPAP 7 with a PS 5 . First days where Ok , did not feel too much o of a difference  ( 2-4 AHI) but last week my AHI went to 48.20!! , with 45 being from CA.

Kind of desperate since I am always tired , hope you could help me out. I am also attaching my sleepstudy if you wanted to take a look.

   
   

[OpalRose]

If you could post your sleep study, that would be helpful.

Also, check in the clinicians menu and let us know the Trigger setting.

[ppluissz]

Thanks! My trigger is set to MED , Ti Max 2.0s Ti Min 0.3s.

I have attached my sleep test. 

Note: I did not start sleeping until 1 AM , eventhough the test started around 9pm , Hypopneas is the main culprit , and they did not disappeared after started on BiPAP.

Thanks!

[OpalRose]

Try setting the trigger to high for tonight. This may help bring down the CA's.

Repost tomorrow if able.

[Bhante]

Maybe the result of the treatment device overenthusiasticly ramping up too much pressure? Runaway pressure increases can cause increases in apneas. My reaction would be to aim to reduce the maximum pressure the device is allowed to reach, to keep it within whatever pressure range you have found to be adequate in the past. Try this: estimate the maximum therapy pressure used on 95% of days during the last 6 months of treatment on your old device (assume the top 5% to be outliers), and set the maximum pressure on your new device to that. See whether the results are better or worse over a few days. If better, then gradually fine tune the maximum pressure to optimise the results. Be sure to make allowance for individual differences on different nights!

[Sleeprider]

ppluissz, in addition to setting your Trigger Sensitivity to High or Very High, let's also reduce PS from 5.0 to 4.0 and see if this resolved the centrals. I'm pretty sure it will drastically improve.

[ppluissz]

Hello all, thanks for your help!

CA completely dissappeared after changing the trigger sensitivity to high. 

I do not feel well rested though. My Ti Max is 2.0, hack when I was using cpap my 95% was around 3 and something. Not sure if the current Ti Max is forcing my inspiration to less than 2s and that's why I haven't been feeling that great.

I have been waking up kind of anxious and a bit lightheaded. 

Again thanks for helping me out I am new with Bipap and really hope for it to work. 

Thanks

[Sleeprider]

time for an Oscar chart.

[ppluissz]

Yesterday with BIPAP

   

Old CPAP chart 95% inspiration over 3s

   

[Sleeprider]

You have very high expectations for feeling rested with less than 6 hours of sleep. Keep trying, and improve your sleep hygiene to get to bed before 4:00 AM, and you might feel a lot better.