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Bipap Pressure Suggestions
#1
Bipap Pressure Suggestions
I am still relatively new to Bipap. I posted some charts from the past couple days playing around with the pressure settings. I was prescribed IPAP of 9 and pressure support of 4 after and overnight sleep study. However, I didnt feel the best with that so I have been steadily adjusting my pressures.

Is there a negative to increasing the pressure support? Any suggestions on if I should bump/reduce the PS or IPAP based on these charts?

Any advice is welcomed!


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#2
RE: Bipap Pressure Suggestions
Your best results appear to be at PS 4.0 and those results seem to deteriorate with higher PS. I think it would help if you would open up Vauto mode by adding about 3-cm to the EPAP min plus PS and make that the max pressure. As it is, you are using fixed pressure VPAP. Events are low in all of these charts, so EPAP min does not seem to be affecting the obstructive apnea rate, and there does not seem to be a central apnea or hypopnea problem with PS between 4.0 and 4.6, although CA event rates rise with higher PS. Based on what I'm seeing here the obstructive events are minimized with EPAP min 6.0, and CA is minimized at PS 4.0. I would just set a IPAP max of 12.0 and let it ride for a couple nights..
Sleeprider
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#3
RE: Bipap Pressure Suggestions
supyasieve,

Unless you feel like a bad night, I would suggest a couple of nights at a setting. Sometimes there are small differences night from night even at the same settings.
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#4
RE: Bipap Pressure Suggestions
(11-01-2022, 05:45 PM)Sleeprider Wrote: Your best results appear to be at PS 4.0 and those results seem to deteriorate with higher PS. I think it would help if you would open up Vauto mode by adding about 3-cm to the EPAP min plus PS and make that the max pressure. As it is, you are using fixed pressure VPAP.   Events are low in all of these charts, so EPAP min does not seem to be affecting the obstructive apnea rate, and there does not seem to be a central apnea or hypopnea problem with PS between 4.0 and 4.6, although CA event rates rise with higher PS.  Based on what I'm seeing here the obstructive events are minimized with EPAP min 6.0, and CA is minimized at PS 4.0.  I would just set a IPAP max of 12.0 and let it ride for a couple nights..

Alright. I will try this for a few days and post results. Thanks for the reply!
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#5
RE: Bipap Pressure Suggestions
(11-01-2022, 05:03 PM)supyasieve Wrote: I am still relatively new to Bipap. I posted some charts from the past couple days playing around with the pressure settings. I was prescribed IPAP of 9 and pressure support of 4 after and overnight sleep study. However, I didnt feel the best with that so I have been steadily adjusting my pressures.

Is there a negative to increasing the pressure support? Any suggestions on if I should bump/reduce the PS or IPAP based on these charts?

Any advice is welcomed!

Here are my results over the past 3 nights. Note, last night I tried a F&P evora vs the normal f20. 

Let me know what you think. Still tired most days, but dont feel as much of the headaches and such as before.


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#6
RE: Bipap Pressure Suggestions
Pressure is very steady and events have disappeared. If you want to try fixed pressure to eliminate the possibility that pressure changes are disruptive to sleep, just keep EPAP min 6.0, IPAP max 10.0 and PS 4.0. This looks like excellent therapy and may just take some time to settle in. The big spikes in flow rate and minute vent all correspond to brief mask leaks, so they are not necessarily arousals, but the occasional leak spikes might be movement.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Bipap Pressure Suggestions
(11-01-2022, 05:45 PM)Sleeprider Wrote: Your best results appear to be at PS 4.0 and those results seem to deteriorate with higher PS. I think it would help if you would open up Vauto mode by adding about 3-cm to the EPAP min plus PS and make that the max pressure. As it is, you are using fixed pressure VPAP.   Events are low in all of these charts, so EPAP min does not seem to be affecting the obstructive apnea rate, and there does not seem to be a central apnea or hypopnea problem with PS between 4.0 and 4.6, although CA event rates rise with higher PS.  Based on what I'm seeing here the obstructive events are minimized with EPAP min 6.0, and CA is minimized at PS 4.0.  I would just set a IPAP max of 12.0 and let it ride for a couple nights..

Sleeprider,

I never noticed you had posted while I was posting.

Of course I always defer to you.
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#8
RE: Bipap Pressure Suggestions
SR,

I played around with my settings a bit over the past month as someone suggested I might need more pressure. My question is this. No matter what range I set my pressure at, I tend to rarely go above the lower end of that pressure because I tend to have low AHI , however I am still tired. It was suggested that I still had arousal that wernt tagged by the machine so I need to jump up pressure. 

Based on my breathing, would you concur that I have better breathing pattern at the 15-17 or the lower setting? To be honest, I am still tired with both, so I want to try and stick one out to see if my body adapts. Im assuming all these changes I am making are making it hard for my body to get used to anything and thus might contribute to my probelm. 


Thanks for the feedback as always. Hope you have a great Christmas! (or other!)


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#9
RE: Bipap Pressure Suggestions
With higher pressure you have significantly higher tidal volume and minute vent, with no changes to respiration rate. This suggests the higher pressure is successfully recruiting more lung volume that is not available with lower pressure. Whether that has the potential to improve sleep or health is somewhat complicated, but this appears to be an improvement in overall ventilation.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Bipap Pressure Suggestions
(12-25-2022, 03:09 PM)Sleeprider Wrote: With higher pressure you have significantly higher tidal volume and minute vent, with no changes to respiration rate. This suggests the higher pressure is successfully recruiting more lung volume that is not available with lower pressure.  Whether that has the potential to improve sleep or health is somewhat complicated, but this appears to be an improvement in overall ventilation.

Is improved tidal volume and min vent something I should strive to improve? 

When I have higher pressure I wake up with headaches and feel more cloudy. Maybe it is because I am not used to it being so high?

Would you recommend I stay 15 and above or drop back down to 10.

This is all very confusing. I had a titration that says I need 8 or 9. Then based on my oscar data I have had people say (not you specifically) more pressure is better for me. Do they even adjust the pressure during titration? They basically started me on 8 and said it controlled my apnea and didn't have to adjust it much. However, without CPAP my AHI is hardly 6, so I imagine a little pressure with squash that all together, but does it address the RDI?

Ive read some that lower pressure is better for UARS and some say higher. Either way I am just tired all day.
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