[CPAP] Newbie ready for guru input

[SarcasticDave94]

Here's my findings upon entering Configuration: Therapy: BiLevel, IPAP 15, EPAP 10 then under Comfort: humidifier Fixed, humidifier setting 4, tube temp 3, SmartRamp Off, Ramp Time 45 min, Ramp Start 4.0, Flex BiFlex, Flex setting 3, Tube type 15, tube lock Off, Mask type x1, Mask lock Off, Check mask fit On

[Gideon]

Flow limit for you shows as an event (FL), on ResMed it is a graph.
You will shortly run into a limit on attachments. Copy to IMGUR and link the posts.

From IMGUR.com Just left click on the image, then click on the large thumbnail, and finally "Copy" for the Link for BBCode. Past that into your post

[Sleeprider]

Here's my findings upon entering Configuration: Therapy: BiLevel, IPAP 15, EPAP 10 then under Comfort: humidifier Fixed, humidifier setting 4, tube temp 3, SmartRamp Off, Ramp Time 45 min, Ramp Start 4.0, Flex BiFlex, Flex setting 3, Tube type 15, tube lock Off, Mask type x1, Mask lock Off, Check mask fit On

Dave, I'm going to make you sleep better tonight, ready?
Therapy mode: BAuto
EPAP min 9.0
IPAP max 17.0 (doesn't matter, you won't touch it)
PS min 2.0
PS max 5.0
Humidifier and tube temp as you like it.
Smartramp ON (no other options will show)
Ramp Start 6.0
BiFlex 3 or for comfort
You're using a heated tube the setting is overridden, but will show 15
Mask stuff as-is.

Good luck and enjoy not having all those centrals and other apnea.  Your results go from 36 AHI to less than 6 tonight. You are way over pressurized and we may drop the EPAP depending on what we see tomorrow.

[SarcasticDave94]

Sleeprider and others: here's today's 3-31 report after Configuration edit...my take is even though I still didn't get to use a full night, I'm still trying to stop the bad habit of not turning BiPap back on after nightly bathroom break, but hours of use is up and events and AHI are going down...we're on right track is my feeling.   Thanks to all thus far, and sleeprider if you're in fact on vacation, if I may say so, take time to enjoy it as you deserve it. special thanks on the settings info...

thanks to bonjour for sleepyhead tip on my version of report showing flow limit on left side instead of as a graph and for tip on image.
thanks to all others, not that I don't appreciate each individually, there's so much help I can't keep track of all users who's input is of great value

[Sleeprider]

Well, if we can go from 36 AHI to 10 in one session, it's an improvement for sure. Did you notice what happened to tidal volume? Pretty amazing huh?

We need to review your diagnosis. How much central was involved? I think we can address that aspect, but we've also got an equal amount of obstructive here. I need you to consider whether you might need to improve your neck and head alignment a bit. The OA are in clusters suggesting you might be getting into a position where your chin tucks towards your chest. If not that's fine, but it makes a big difference in some people.

Let's increase EPAP min by 1 to 10.0. If you can find the setting for Ti, record the reading (probably 1.8) and let's go to 2.3. Other than that, I think we leave other things alone.

[SarcasticDave94]

Well, if we can go from 36 AHI to 10 in one session, it's an improvement for sure.  Did you notice what happened to tidal volume?  Pretty amazing huh?

We need to review your diagnosis.  How much central was involved?  I think we can address that aspect, but we've also got an equal amount of obstructive here.  I need you to consider whether you might need to improve your neck and head alignment a bit.  The OA are in clusters suggesting you might be getting into a position where your chin tucks towards your chest.  If not that's fine, but it makes a big difference in some people.

Let's increase EPAP min by 1 to 10.0.  If you can find the setting for Ti, record the reading (probably 1.8) and let's go to 2.3.  Other than that, I think we leave other things alone.

Yeah I'm already happier with results. Regarding alignment of neck and head, it is possible that I create the issue due to switching from left and right side sleeping to back sleeping. I'll blame my bad back mostly here. The pillow is a curved not flat topped to be better for side sleeping I guess. I will see if I can adjust something...

OK setting EPAP min adjusted up to 10.0, Ti specifically not found anywhere in configuration settings or info.

BTW last night's setting adjust made the BiPap less intrusive feeling to me, helpful as I still get used to the device in my opinion.

 again

[Melman]

I need you to consider whether you might need to improve your neck and head alignment a bit.  The OA are in clusters suggesting you might be getting into a position where your chin tucks towards your chest.  If not that's fine, but it makes a big difference in some people.

We are all different, but thanks to a similar observation from Sleeprider, I experienced significant and immediate decrease in OAs by stabilizing my head position. In my case, what worked was a buckwheat chaff pillow which can be configured to stabilize your head position and support your neck. Mine is the CPAPfit which can be purchased from amazon for $50. If you google buckwheat chaff pillow you will find lots of info. It sounds strange but it's the most comfortable pillow I have ever used. I have it configured for side sleeping which worked well for me initially. Like you, I move around some and I have noticed an increase in flow limitations which associate with rolling onto my back. To control that I have been using a soft cervical collar, also from Amazon for $10, which seems to be working well. I thought it might be uncomfortable but I'm generally not aware I have it on.

I hope you find these suggestions helpful.

[Sleeprider]

Quick note on your last session, your PSmin was 2.0 and max was 2.5. Move that PSmax to 5.0 so it's there if you need it.

Also note that the session prior to 20:00 was from the old fixed settings...I think I got my AHI of 8 prediction if that is not included.

Tom

[SarcasticDave94]

Copy that. Changed settings as advised.

[SarcasticDave94]

New report from Sleepyhead will have to wait a day. I didn't sleep hardly at all last night. It was not a BiPAP machine issue nor was it coffee. I just couldn't sleep. I'll have something tomorrow though. Thanks everyone for tips thus far.