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Is a BIPAP needed for me? BIPAP at lower pressure works better
#1
For over two weeks, been trying out a BIPAP given to me by my doctor. I am trying to find out, how a BIPAP is helping have LESS OA events, but most of the night it is at lowest pressure of EPAP5, IPAP8. It rarely goes up high.

My APAP was all over the place, always jumping up high, then back down, and I was having a lot more events on the APAP. But then some nights, my APAP was doing good at low pressures too. But the BIPAP seems more consistent at keeping my airway open, even while using low pressures.

Can anyone provide an explanation?

My leaks though, are all over the place, and it appears when i wake up, they stop. And when I wake up and leak stops, look at the flow rate....It appears more jagged for some reason. See second screenshot....Why is that?
[Image: q7hBggX.png][Image: tRevxFn.png]
ResMed AirCurve 10 vAuto
Pressure EPAP min 5.6, IPAP Max 16, PS 3.

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#2
The more defined flow rate during periods of low leak is because the machine can better detect your respiration and events in the absence of leaks. I think you have given this mask a fair trial and you are failing to achieve a satisfactory fit that avoids large leaks. Others have suggested your event data may be less than reliable with the extent of leaks present, and I have to agree. I guess as long as we see some definition to the respiratory wave form there are probably no apnea occurring, but that is about all that can be discerned. I think the machine is keeping a low pressure in the presence of all those leaks because it really cannot detect cues like flow limitation and hypopnea that might be a cause for pressure increases. There is some odd behavior in the mask pressure chart which is just out of sight in the screenshot. Maybe move that up and let's see what is going on there. It may confirm the machine is losing control with all the leaks.

I think it's time to try a different mask.
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#3
Wow, with a medium leak rate of 50 and 95% leak rate of 90, I can't see it doing any thing for you, need a new mask or major adjustments.
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#4
Unfortunately, the only thing the BiPap is doing right now for you, is spraying your face with air all night. As noted, with the leaks as bad as they are, it can barely detect what it thinks is your breathing, but it really isn't sure. And certainly its not providing any therapy.

If i had to guess, i would say you are opening your mouth in your sleep, which is breaking the seal, and letting the leaks get out of hand. When you wake up, you close up, and it can fit again. Have you tried a chin strap at all?
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#5
I know you've probably already read it. But go back and review Mask Primer in the link below. You might want to try a ResMed P10 pillow mask.
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