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Hello from a new BiPAP user
#21
RE: Hello from a new BiPAP user
(05-08-2017, 08:13 AM)Sleeprider Wrote: I think the results are encouraging in that there is very little CA to worry about, so we have more flexibility in our options to address obstructive events and the RERA.  Generally for obstruction we increase EPAP.   In your case, I think increasing EPAP by 0.5 cm may have some positive effects, but the clustering of events still has me thinking you could benefit from a soft cervical collar or ergonomic pillow.  Due to the hypopnea and RERA being high, I think increase PS min by 1 to 3.0.  Overall, your settings are pretty good, but increasing EPAP by a .5 and PS min by 1 should address those specific issues, at least partially.

Thank you very much. I will make those changes this evening and post more data in a couple of days. 

I'm looking into the collar or ergonomic pillow and will make that change soon. Thanks again!
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#22
RE: Hello from a new BiPAP user
I've just got my BiPAP and am going to use it for the first time tonight. I had my APAP set at 13 min (to try and lower RERAs) and with the comfort of both pressure support and BiFlex I have set my EPAP min at 12. My pressure support range is from 2 to 5 so I could have an expiration pressure as low as 7. The information I was given was to set the EPAP min as close to the 95% level as possible. I'll know after tonight how this is going to work so I'll post results and also look at yours with interest.
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#23
RE: Hello from a new BiPAP user
So last evening I changed my settings - thank you to this forum for the instructions on how to do that! - based on what was recommended by Sleeprider. I raised my EPAP from 10.0 to 10.5 and my PS Min from 2.0 to 3.0. 

My AHI for Sunday night (before the settings were changed) was a 2.3 according to DreamMapper (I have not downloaded the info to SleepyHead yet but will tonight). Last night (Monday) after the settings were changed it dropped to a 2.0 which is the lowest AHI I've received since starting the therapy. 

I will download the data into SleepyHead this evening and post the graphs tonight or tomorrow morning.

Thanks everyone!
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#24
RE: Hello from a new BiPAP user
So I have downloaded some more data from SleepyHead (and, I got rid of the pie chart thanks to Sleeprider's excellent instructions!). 

This first chart below is from Sunday night (May 7) and was before I changed the settings (set min EPAP to 10.5 (from 10.0) and PS Min to 3.0 (from 2.0).

[Image: cnB51Dwl.jpg]

This chart below is from Monday night, the first night after making the settings changes:

[Image: Rk8bAF5l.jpg]

And, the chart below if from last night (no new changes to settings were made):

[Image: PXKCiNNl.jpg]

I do not yet have a cervical collar or ergonomic pillow but will probably pick one up this weekend. I have had to tighten my mask a bit tighter to stop the leaks on the inhale side, most likely due to the higher PS setting? 

Any advice or suggestions will be greatly appreciated!
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#25
RE: Hello from a new BiPAP user
No changes based on these charts, at least for now. The increased PS min had exactly the effect I was looking for, which was to reduce hypopnea. If you continue to see elevated OA, then increases in minimum EPAP pressure of about 0.5 cm can fine-tune that out of the picture. I'll leave it to you if that should be done sooner or later. I like to give changes in settings time to settle in, but in this case we do have a specific objective in changing the EPAP.
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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#26
RE: Hello from a new BiPAP user
(05-10-2017, 08:41 AM)Sleeprider Wrote: No changes based on these charts, at least for now.  The increased PS min had exactly the effect I was looking for, which was to reduce hypopnea.  If you continue to see elevated OA, then increases in minimum EPAP pressure of about 0.5 cm can fine-tune that out of the picture.   I'll leave it to you if that should be done sooner or later.  I like to give changes in settings time to settle in, but in this case we do have a specific objective in changing the EPAP.

Thank you Sleeprider! 

I'm not sure if the increased OA may be a result of a stuffy nose the last few days? I've been tested for allergies three times and the results are always the same but every year in the early spring and especially in the late fall, I battle watery eyes and some sinus congestion. It eventually settles down but this week it seems to have picked up a bit as it usually does. Would that possibly have an impact on the OA?

I think I'll leave things as they are for a few days - maybe until Friday or so - and then download some more data before I make any changes just to allow me time to adjust to the new settings. 

Thank you again for your advice!
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#27
RE: Hello from a new BiPAP user
Hello all. Well, it seems things are getting better as well as steadying out for me with my BIPAP. I am definitely sleeping much better and feel so much more rested in the mornings than I have for a long, long time. 

Here is the data from this past Thursday, Friday and Saturday nights. I was thrilled to see the Saturday night had an AHI of even less than 1. I have not changed anything since the last time and am still wondering if I should increase the EPAP minimum another .5 but with the results I'm seeing would it be worth doing that? I noticed that Friday spiked up to nearly a 4 AHI so that's why I'm asking.

As always your comments and suggestions are invaluable and greatly appreciated!

[Image: Pic3YFBl.jpg]

[Image: 1ahH9Dnl.jpg]

[Image: zVknTh9l.jpg]
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#28
RE: Hello from a new BiPAP user
As long as you have an adequate baseline of how you feel, and your results with the current pressure, there is no problem with a trial at 0.5 higher on EPAP. This change is reversible if it does not have the desired effect. Things look very good, and getting nicely stabilized for you. Well done.
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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#29
RE: Hello from a new BiPAP user
(05-15-2017, 07:51 AM)Sleeprider Wrote: As long as you have an adequate baseline of how you feel, and your results with the current pressure, there is no problem with a trial at 0.5 higher on EPAP.  This change is reversible if it does not have the desired effect.  Things look very good, and getting nicely stabilized for you.  Well done.

Thank you Sleeprider. I will adjust the EPAP min upward another .5 and see how it goes for a few days. 

Thanks again!
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#30
RE: Hello from a new BiPAP user
Hello all. First, let me say that I can understand why the Dreamstation has the name it does - I am having so many more dreams and feel so much more relaxed and rested as a result of using my BiPAP Auto it is hard to explain. It just simply has changed my life in a very good way.

When I last posted data, Sleeprider recommended I up my EPAP Min by .5 so I did that Monday night. Here is a shot from Sunday night as a reference from before the change:

[Image: FIyxaMpl.png]

Here is the data from Monday night after making the change. I did not feel that I slept as well that night and I'm sure it was from adjusting to the higher Min pressure. 

[Image: oJNpUDIl.png]

Tuesday night:

[Image: 47F9hQol.jpg]

And the data below is from last night (Wednesday, May 17). I slept really well and it felt like my best night's sleep so far even though I have had a night (or 2?) of less than 1.0 AHI. However, why am I now seeing more of the saw tooth pattern (in red) on the 'Pressure' chart below? Is that good or bad?

[Image: nGy4tMhl.png]

Any and all comments and suggestions will be greatly appreciated. Thank you!
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