Help with Settings for Respironics System One (60 Series) RemStar BiPAP Auto

[wjblevins]

Hello,

I am new to the board and to using cpaps. I'm going to do research to understand things better but I was hoping I might get some help with jump starting things. I have a Respironics System One (60 Series) RemStar BiPAP Auto with a full face mask. 

My diagnosis is - Moderate Obstructive Sleep Apnea with minimal Central Apnea and an AHI of 23.1. Patient had

minimal hypoxia with an average saturation of 94% and one short episode of desaturation to 85%.
Patient had no Cheyne-Stokes respirations and an average heart rate of 76 bpm.

I've used the machine twice so far. I have attached a screenshot of the most recent night's data. The other night was similar. I would appreciate any suggestions for adjustments to the settings.

Thanks,
Jay

[Gideon]

Welcome to the forum.
Not a bad start. This machine is running "wide open" and Philips machines algorithm is somewhat slow to respond. This means we like to help the machine to respond to obstructive events. For that increase the min epap to 6 and the min ipap to 9.
You also have significant flow limits and RERAs. These are treated with increased pressure support. To manage this increase the min ps to 3. This also ties into the min ipap which is min epap plus min ps or 6 + 3 or 9.

Try this and keep an eye on your centrals. And see if further adjustment is needed.

[Sleeprider]

I agree with Fred but think you can go a bit further in light of the fact your median EPAP was nearly 8.5 cm on this chart. Revise EPAP min to 8.0 and PS min to 3.0. This is going to get you much closer to the "zone". On your charts, you can turn off VS2 which is not a very helpful metric at this point, and will help clean up the charts to see more of the important stuff.

[wjblevins]

Thank you!

[wjblevins]

I went to adjust the settings and am now a bit confused. I understood the posts above to suggest

Min IPAP 9
Min EPAP 6 or 8
Min PS 3

However my machine only lets me set MAX IPAP. Am I missing some way to set the MIN IPAP?


It also has a MAX PS. Should MAX PS be set at highest setting?

Thanks again for all of your help.

[Gideon]

Min IPAP was a setting shown in your chart it is min EPAP + PS so don't worry about it.

[wjblevins]

I see, that calculates automatically. 

Thanks again to both of you for the help. This is a bit challenging to get started with. I look forward to having time to do more research and understand things better.

[wjblevins]

I made the adjustments above. For 2 nights I skipped using the ramp feature and my AHI jumped from about 4 to over 10. I used the ramp last night and it went down to 4 again. My thought was why not use full pressure the full time but that logic didn't seem to hold up. My understanding was that the ramp feature was about comfort not efficacy. Does it actually play a role in making it work better the rest of the night?

[Sleeprider]

Can you help us out with a chart so we can see what's going on?

[wjblevins]

The good news is that I used the ram feature and did a better job of mask fitting and my AHI dropped to 2.13!

I've attached a chart in case anyone has more suggestions but honestly, I'm thrilled with this. Thanks for all of the help!