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Trying Bilevel for first time - need help! - Printable Version

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Trying Bilevel for first time - need help! - sleepquality - 08-15-2024

I just tried a PAP machine for the first time (AirCurve 11 VAuto) and was playing around with the pressure to see what felt comfortable. I´m currently trying an Airfit P10 mask.

I tried CPAP mode on 6, 7, 8, 9 and it was abundantly clear right off the bat that I felt asphyxiated while exhaling and needed PS. Then it got interesting - basically I tried PS 1-7, the last one being EPAP 4 and IPAP 11, and it seemed to get progressively more comfortable to breathe the higher the PS. My original plan was to do EPAP 5, IPAP 9 for a few days, and then raise EPAP one at a time and check data to see how I´m doing, but now I´m wondering what to do given that it seems to feel so much more comfortable to have a higher PS.

Any recommendation on how to proceed? Should I try to fall asleep with PS 4? Alternatively, is it a safe thing to do to start with a PS of 5 or 6 (or more) on the first full night of sleeping with PAP? I had read about TECA and definitely don´t want to feel like I´m doing something dangerous/a terrible idea.

Edit: I´m a UARS case.


RE: Trying Bilevel for first time - need help! - staceyburke - 08-15-2024

Welcome to the board.  You need to download OSCAR and use it.  In your left hand column you said you use OSCAR, so you need to post a days set of charts.  I have the WIKI of using charts in my signature.  When you take a screenshot use f12 button - it formats the screenshot for this site.

First I would suggest you use the VAUTO mode. with the following settings.

PS 4 over 4-20

That means your starting inhale pressure is 8
Your starting exhale pressure is 4
Your max is 20.

Try it for a night then post the OSCAR from that night.


RE: Trying Bilevel for first time - need help! - Phaleronic - 08-15-2024

We need the clinical data from the SD card that you need to please install asap! Also, welcome aboard sleepquality!

Please read through our guide here:

https://www.apneaboard.com/wiki/index.php/OSCAR_-_The_Guide

Pressure support is added to EPAP and not subtracted from IPAP so set your vauto to this:

Epap min: 5cm

Ipap max: 18cm

PS: 4

Too low of EPAP pressure is what causes airway collapse and why PS is needed when EPAP is set low.


RE: Trying Bilevel for first time - need help! - sleepquality - 08-16-2024

Thanks both, appreciate it. My issue right now is just trying to fall asleep while using the device.

I´ll have to wait to use OSCAR as per another thread on this forum, OSCAR doesn´t yet support the AirCurve 11. But planning to use another tool in the meantime like SleepHQ.


RE: Trying Bilevel for first time - need help! - sleepquality - 08-18-2024

I was able to fall asleep for the first time while using my device and it looks like OSCAR is working with my AirCurve 11, which is great. Note - I used fixed pressure settings of EPAP 4 IPAP 8 because I was stressed out about pressure changing during the night and wanted to feel like how the machine felt while awake would be how it would feel while asleep.

What do you make of the attached numbers? I´m a newbie, but is this a worrying amount of central apneas (not sure if some might have been while awake)? Or is this likely to get better with use?

Are the leak rates good/bad/so-so?

I zoomed into the flow rate and some of the breaths looked a bit flat, but didn´t look that bad from what I had read/seen in videos - but again, just a newbie.