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Bipap Titration for Preliminary UARS Diagnosis
#1
Bipap Titration for Preliminary UARS Diagnosis
I would like some help for Bipap titration for my breathing related sleep disorder. My preliminary diagnosis is UARS with WatchPAT. However, will get full PSG very soon to confirm. 

Some Questions

1) I am not getting enough sleep on CPAP. How to find a best mask? I am using N30 nasal pillows. I am a stomach sleeper ( I am not able to fall asleep side or supine). My problem with nasal pillow is I need to adjust it constantly at night as it gets squeezed between my face and pillow. Is there any mask recommendation?

2) I am not too much obsessed with numbers. The most important predictor of response for me is how I feel when I wake up. If I can sleep with the mask on minimum 7 hours (happens very rare), I feel better. What are the tips for getting used to a mask? 

3) I attached some flow rates. Are you seeing any gross abnormality there? As per WatchPAT my RDI is 18 while AHI is 1.2 so I am very likely experiencing RERAs. 

I really appreciate any feedback and advice. Thanks


Attached Files
.pdf   Screen Shot 2021-02-21 at 2.23.15 PM.pdf (Size: 870.9 KB / Downloads: 8)
.pdf   Screen Shot 2021-02-21 at 2.24.45 PM.pdf (Size: 838.28 KB / Downloads: 5)
.pdf   Screen Shot 2021-02-21 at 2.25.20 PM.pdf (Size: 831.31 KB / Downloads: 5)
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#2
RE: Bipap Titration for Preliminary UARS Diagnosis
Your profile need to be modified to show that you're using a Resmed Aircurve 10 Vauto, same as me. Seeing ASV on the profile, I was expecting something else. In Vauto mode you are using EPAP min 6.0, max pressure 11.0 and PS 4.0, so your settings prevent pressure from changing more than 1-cm. Your first zoomed screenshot shows some variation in respiratory volume, but no flow limitation or issues that should be affecting sleep. The second screenshot you're awake. The full night screenshot has about 2-hours cropped out of it, and the monthly calendar needs to go so additional information is apparent on the left column statistics and settings, and most importantly you did not include flow limitations. You are asking to optimize for UARS and that means the flow limit graph is most important.

The complete lack of flow limitations in statistics suggests to me the PS 4 is dealing with that pretty effectively. You have over 7 hours of therapy time, but that is fragmented into two sessions separated by a 1-hour break. I am sure that if my sleep pattern looked like that, I would feel equally dissatisfied with how I feel. The therapy itself looks pretty good, what I can see of it. I think it's going to take a bit more information to form a working opinion or recommendation.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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