Appreciate help adjusting settings (UARS)

[cmcphee]

No, those CAs were when I was asleep - I only slept a few hours last night, and it was from around 11:30p-1:45a

[Gideon]

The charts are daying to set your PS=3, maybe lower.

[cmcphee]

Ok will do @bonjour. So I can learn, what from my charts lead you to that conclusion? I think I’m getting IPAP, PS and EPR all confused and don’t understand how they impact my curves. Thank you.

[Gideon]

Your obstructive events are well managed, your CA events are not.

That says to get a better "balance" reduce the CA events.  This is by reducing PS and reducing pressure.  These action over time should reduce central events and increase obstructive events.  I doubt that obstructive events will increase immediately.

Thus we start down the road of reducing your CA events.  Set EPR PS=3 then reevaluate.

edit EPR changed to PS

[slowriter]

Thus we start down the road of reducing your CA events.  Set EPR PS=3 then reevaluate.

Is the hope that this tames the CAs, and then can slowly raise PS to help with the other issues (FL, aerophagia)?

[Gideon]

The OP offered no indication of any issues that required addressing at this time.
The OAHI is 0.42 which is beyond excellent the Hypopnea Index is zero and no RERAs are flagged, either currently or in history.
At this time I am not expecting an issue with either FL or obstructive events.

With a non-ASV machine, and since CPAP, APAP, BiLevel machines are not designed to treat centrals and in general, cannot treat central events, the goal is to achieve a balance between obstructive and central events.  This means that in general and to a point, you would allow obstructive events to rise with the balance being a loss in central events.

The future here calls for further evaluation and very likely further changes.

I will add that I love my BiLevel and I want to keep it, so I make sure that I am demonstrating my efficacy at settings only my VAuto can produce.  Since My pressure is significantly down from the 18-20 I was at when I got mt VAuto so I do that with PS being 4 or greater.  I do not lower PS on a bilevel below 4 unless I see a very clear reason to do so.

[mper6794]

Hi, all
As I sometimes say as “a new duck, I have been refrain from diving deep in this blog”, yet in this case, I am afraid I will take a little bit of more risk, and maybe disagree a little bit of Master Fred’s ponderations, which always bring learnings. I am aware though that in this CPAP world of uncertainties; it is going to be just an opinion more; apologies if sounds non-pertinent anyway!
I would not have backed off to PS:3.0, and rather maintained PS:4.0, and keep exploring cmcphee’s ideal number on PS. Why?:  
(1) CA’s, as I have been following closely in my 191 day with Oscar, as well so many other examples in this blog, appears to be in the absolute majority of cases just awakeness/quasi-awakeness artefacts (this case too). The user alexp have been pointing here and there very interesting analyses on CA’s meanings (actually, reasons for stopping breathing in general);
(2) that cmcphee’s last posted events would be eventually far from being representative, given the short period of time involved and light sleep. It appeared quite similar to some stretches of his full night sept 13th, which appeared did not scare anybody;
(3) taking my case as an example (I am aware that everybody may be different, but not so much, randomly !), I would like to share how I intuitively, and semi-quantitatively, got my ideal PS of 5.6, while cross-plotting PS x CA’s (recounted values outside awakeness spots) x RR (it is divided by two the picture attached): it appears clear that CA’s do increase with PS, yet living a broad range of possibilities to work with (4.0 to 6.5 in my case); it also clear that RR, anomalously increases with lowering PS, so that once you know your adequate RR (in my case 14 to 15; lab studies, etc) you can use it, among other correlations, to fine tuning your PS.
Good luck

[Gideon]

I am missing what RR is?

[Crimson Nape]

Respiration Rate ???

[mper6794]

Sorry.... RR respiratory rate , yes