BiPAP new therapy

[DanEm]

After more than a year with the CPAP, I had my first night with the new BiPAP machine (Resmed AirCurve 10 vAuto).

My night sleep consisted of 2 sessions.
The new headgear did not feel right after the first session and I changed it for the older one for the second session.

I think my results could improve with some settings change but I am not certain what should be changed.

I know this is the first run with the new machine and I should probably wait a few more nights before making changes.
Nonetheless, I am here to share my results and get your comments.

There is one thing not as usual with the results, it seems I have been snoring during the second session.
That is a first since the beginning of my therapy about a year ago.

After the night, I feel good. Is it psychological or for real, the long run should tell me 

[Sleeprider]

There is quite a bit of OA and clustered events, so we need to watch for positional issues here. Let's increase EPAP to 9.0 and PS to 4.6.

[DanEm]

Sleeprider
Let's increase EPAP to 9.0 and PS to 4.6.

I made the changes.
Will be back tomorrow with the results.

[DanEm]

Please tell me what I am doing wrong!!!

The screenshot for last night is the worst ever night I have had.

I just hope I did not spend +$2000 for no improvement.

[Sleeprider]

DanEm, you have moved full-on into positional sleep apnea. What are you doing differently with your sleep position, pillows or mask? I don't see this as having anything to do with settings or the type of PAP device you are using. What experience have you had with a soft cervical collar?

[DanEm]

When I started the BiPAP therapy, I thought I should start fresh.
So I did not use the collar nor the MAD.
I was hoping to be able to get rid of those :-(

My sleep position, pillow and mask are the same as before with the CPAP.

I will use the MAD first and come back tomorrow with the results.
The MAD is the device that yielded the most improvement in the past.

Any other suggestions???

[Sleeprider]

Just because you are using bilevel, does not remove the need for the aids that enabled you to get less than 1 AHI with your Airsense 11. The positional apnea has gone nowhere! All the bilevel does is enable you further optimize therapy, and is additive to what you had done before. Just as with CPAP, there is not enough pressure to open your airway when it gets clamped shut by positional apnea. We are not starting over, we are continuing onward.

[DanEm]

All the bilevel does is enable you further optimize therapy, and is additive to what you had done before.

OK Got it.

I will use both the collar and the MAD for my next sleep.

Hopefully there will be better results than those I had with the CPAP.
Remembering the discussions, I think that what needed improvement was the Flow Limitation as the rest was good.

I am including the screenshot for my last night with the CPAP.  We can compare tomorrow with the one with the BiPAP.

[Sleeprider]

You were still showing a lot of flow limitation with the positional apnea with the CPAP, but the EPAP at 16 just barely kept your airway open. If that's the game you want to play, then we need an EPAP min of 16, Max pressure 25 and PS 4 with the Vauto.

[DanEm]

You were still showing a lot of flow limitation with the positional apnea with the CPAP, but the EPAP at 16 just barely kept your airway open.  If that's the game you want to play, then we need an EPAP min of 16, Max pressure 25 and PS 4 with the Vauto.

I was asking what could reduce the flow limitation when I was here previously and the answer was to get a Resmed Aircurve 10 vAuto.

RE: Flow limitation
I'm impressed with the improvement from earlier threads I saw. It seems you still have some positional related flow limitation that drives your pressures higher and in this case increased events at the onset. Your pressure remains high for the remainder of the night. Looks good, and I don't know that you could do more without transitioning to an Aircurve Vauto.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

I suppose the settings you are suggesting are to reduce the flow limitation and keep the other indexes as good as they were with the CPAP.

I will set the BiPAP with your last recommendations and show you the results tomorrow.

Knock on wood..