+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: [Treatment] Low Events On BiPAP (and CPAP) But Debilitated (/Thread-Treatment-Low-Events-On-BiPAP-and-CPAP-But-Debilitated)
Low Events On BiPAP (and CPAP) But Debilitated - LBartek03 - 07-29-2024
Hi all, I got my first BiPAP machine last week after diligently using an Airsense 10 for the past year and a half and seldom getting restful sleep or feeling better. My original sleep study 2 years ago diagnosed me with mild obstructive sleep apnea at 6 AHI, and during my time on CPAP, my OSCAR charts have averaged around 1.5 AHI. This came about after tweaking my settings and trying many devices (chinstraps/mouth tape/collars/tongue devices/nasal dilators/etc.), however, my AHI no matter the settings usually doesn't break 5. What seemed to work best (but still not well whatsoever in terms of sleep quality and wakefulness energy) was a pressure of 6.2 with 3 EPR on full-time - older posts go into more description.
The problem is, I maybe could say I sleep well twice a month on average and am slowly losing my ability to function. Now, hopping on BiPAP, I'm a little lost at what to do as my data looks fine and has little events to correct. No matter the settings over the past year or two, I generally sleep all the way through till about the halfway mark of my night's rest, then, I start awakening in intervals from that point on. To note, I am very consistent with living a healthy lifestyle (nutrition, sleep hygiene, etc.) and strongly don't think it has anything to do with that. Also, for reference, I am a young, tall man. Also, I currently use the Knightsbridge dual strap and mouth tape but have experimented with earplugs and eye masks as well.
In short, is there anything from my data that you can tell could be helpful for me? How can I fix the awakenings in the ladder half of my sleep? Lastly, are there events or something OSCAR isn't picking up that I have been missing (say, smaller obstructive awakenings, CA's, etc.)? Attached is a night on BiPAP, a zoomed-in view of that night, and an average night on CPAP. Thanks so much for any help!
RE: Low Events On BiPAP (and CPAP) But Debilitated - Sleeptechmaster - 07-29-2024
What was the reason to change from. Cpap to Bilevel?
You can see on CPAP your inspiration and expiration times are about the same.
When you switched to Bilevel your inspiration is short and your expiration is now very long in comparison.
Your pressure support should be a minimum of 4 on bilevel.
Those random central events are not significant and you are having no obstructions.
AHI between 0 and 5 is considered normal so within margin of error you are very close to normal and not requiring PAP.
I would try these settings:
TiMin: 1.0, TiMax 1.3
IPAP 11
EPAP 5
(pressure support 6)
You are tall with larger lungs so the increased pressure will ease ventilation by easing inhale and the increased pressure support will aid comfort and ventilation by easing your exhale. This allows more CO2 to be expelled which it looks like it is building up in your bloodstream with your body having the short inhale with long exhale. You are also exerting less energy during sleep with easier breathing which affects daytime tiredness. I would try the ipap/epap change first and the Ti settings second.
With your BMI it's less likely you are experiencing major health risks from OSA.
RE: Low Events On BiPAP (and CPAP) But Debilitated - Crimson Nape - 07-30-2024
First, upgrade OSCAR to version 1.5.3. It reports additional parameter settings.
Try setting the Trigger to High. This should help to reduce the CAs. You may wish to lower your EPAP min to 4 cm. Doing this, and leaving the IPAP max set to 10, will show if you need the higher pressure.
A little tip; when you zoom in, please use a 3-minute widow. This allows us to see your flow rate waveform.
- Red