Feeling stuck. What would you recommend I do next?

[sleepy331]

So last night I raised the EPAP to 7.0 from 6.0 and seemed to have a much worse night. Strangely I feel a little better today. Also, right now I have it on a standard EPAP and IPAP. Why does it still say my pressure support is 3.0 when I'm at EPAP of 7.0 and IPAP of 8.0? Wouldn't that be pressure support of 1?

Thanks!

[OpalRose]

I went back to look at your sleep study and it does show some central apnea pAHIc, not a lot though.
Have you talked to your doctor about your results?  You may be headed for an ASV machine.

Let's see if SleepRider has any suggestions before making any changes.

[sleepy331]

I went back to look at your sleep study and it does show some central apnea pAHIc, not a lot though.
Have you talked to your doctor about your results?  You may be headed for an ASV machine.

Let's see if SleepRider has any suggestions before making any changes.

Hi Opal, I haven't spoken to a doctor yet. 

The other interesting thing I should note is that lately I've been feeling way more out of breath throughout the day, and my maximum breath hold time has gotten much worse since starting bipap therpay. I feel like the machine is almost making me hypocapnic.

[Sleeprider]

Hypocapnea is a good description when one becomes hyperventilated on a PAP machine. We have the option to just eliminate or reduce the pressure support, or add a little bit of enhanced expiratory rebreathing space (EERS). Both can help maintain a higher CO2 balance which should reduce the CA events. http://www.apneaboard.com/wiki/index.php...ace_(EERS)

I think the conservative thing to do is change pressure settings to EPAP 6.4 and IPAP 7.0 and see where that takes you. If we need to add some CO2 to the circuit we can discuss EERS after you have read the wiki above.

[sleepy331]

Last night was a little better, at least according to the OSCAR report. I'm still feeling tired though. I wonder if I need to try going back to the "Auto" mode rather than just the "S" mode that I have been using? I seem to be getting centrals regardless of what setting I'm on.

At this point, I'm basically using a CPAP and I'm pretty sure that I have UARS rather than just sleep apnea. I've attached my sleep from last night and will continue to update. Any advice is encouraged!

[Crimson Nape]

Look under the Events Tab > Clear Airway. What is the time range shown. They are the numbers in parentheses "(" and ")".

[sleepy331]

Look under the Events Tab > Clear Airway.  What is the time range shown.  They are the numbers in parentheses "(" and ")".

Between 10 and 14.

[Crimson Nape]

You are at or very near the minimal time on these. For me, I would rate them as insignificant. As your body adapts they may go away.

[sleepy331]

Hey everyone, 

I thought I would post a quick update and a quick question.

I've been slowly increasing my pressure lately and also got a new mask. Obstructive, hypopnea, and centrals have all but been eliminated. I still feel really tired throughout the day and imagine it's because of RERAs. 

Since I'm on "S" mode on the bipap it doesn't show flow limitations, but by looking at the flow rate it seems like there are several (every few minutes or so). Can someone please confirm that these indeed are flow limitations/RERAs? I've also included what appears to be a normal flow rate for comparison. 

If they are do I simply need to increase the pressure?

I've been on bipap for nearly a year now with very little improvement in symptoms. If anyone can help, I'd greatly appreciate it!

[sleepy331]

Here are a few more examples of flow rates that go haywire...