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[Pressure] Reducing Pressure/Knowing When to be Retested
#1
Hello All!

First Background:
I was diagnosed with Sleep Apnea October 2016 (about 6 months ago). I was set up with a Bipap machine at levels of 16EPAP/20IPAP on 11/1.

This pressure was too high (frequently causing aerophasia) and at my follow-up appointment the doctor reduced the setting to 13/17.

My insurance bought the machine, and after losing some weight and starting to get aerophasia again in January, I started....adjusting...the settings myself. Specifically, i took it off of set EPAP/IPAP and let it switch to the VAUTO mode that my machine allows. 

I also started reducing the upper/lower limits a bit but after reading another post about how that can limit the machine's ability to operate causing it to 'miss' apnea events, I reverted the settings to a wide margin (currently 4-17 with a gap of 4 between IPAP/EPAP).

After the first few nights, it seems my machine is just hovering at 4EPAP/8IPAP even with the open range. This is with AHI of between 0-2. I can't seem to find out how to reduce the bottom # any lower (not sure if this is a machine limitation or what).

Now my Questions:
1-I know weight loss can reduce the need/eliminate OSA - I've lost 80lbs since my sleep study, which is why I believe the pressures aren't needed as high. Is it possible to resolve OSA and still be considered obese?
2-Is there any reason I should delay in pushing for a new sleep study to get off the machine given my numbers above?
3-Is there a way for me to manually reduce the lower pressure below 4? Some trick?



If you'd like any sleepy head screen shots, please let me know (and be specific, I'm new to the program   Smile )
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#2
Welcome to the board.

your questions

Now your Questions:
1-I know weight loss can reduce the need/eliminate OSA - I've lost 80lbs since my sleep study, which is why I believe the pressures aren't needed as high. Is it possible to resolve OSA and still be considered obese?
Yes
2-Is there any reason I should delay in pushing for a new sleep study to get off the machine given my numbers above?
No but you have a machine which sould be able to give perfectly valid information on which to base decisions on.
3-Is there a way for me to manually reduce the lower pressure below 4? Some trick?
No

Two things please,  You were given an advanced machine, a BiLevel, Why?  Could you please post copy of your sleep study.
and Please post your current SleepyHead data. 

This data allows us to advise you of what is happening.

Fred
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#3
I will post what I have when I get home - 

As for my original study - they said i was having 120AHI or so during the study, they actually interrupted it after 3 hours to shove a mask on my face because my blood oxygen was getting too low (around that time I was also getting headaches every AM from the low blood oxygen - not good!).

That's where they decided on those BIPAP levels.

As for why that machine - honestly I'm pretty sure the DME place was just trying to get the most $$$ from my insurance company possible - my insurance paid for the machine 100% after one month of compliance and no money out of my pocket.
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#4
Any mention of Central or Complex Apnea? in the study.
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#5
A bilevel was probably issued for two possible reasons:
1) At higher pressure, more EPR is often called for.
2) PS = 4 may have been necessary to get TV into proper range.

To answer one of the OP's questions: Yes, 4 cm-water is the lowest EPAP can be set to. And, you really would not want to reduce EPAP below 4.

BTW -- nice job on losing 80 pounds since October.
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#6
Why would you want to take EPAP below 4. You should've adjusted to it by now. And mask/machine manufacturers keep the min at 4 for the machine because it lets the co2 washout from the mask adequately so that you are not rebreathing it.

You have a pretty advanced machine. And if your AHI is ~ 2 and you feel fresh and good during the day, then you don't need a new sleep study. You can play with the setting on your bilevel with help from the bilevel gurus here at the forum.
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#7
Hi geijere,
WELCOME! to the forum.!
Hang in there for more answers to your questions about your Bilevel machine.
Good luck to you as you continue your CPAP therapy and CONGRATULLATIONS on your weight loss.
trish6hundred
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#8
Your pressure can be changed to reduce pressure support, but EPAP cannot be less than 4.0 cm. You could however use 8/4 at PS 4, 7/4 at PS 3, 6/4 at PS 2, etc. The lowest pressure would be 4/4 in CPAP mode and that sounds pretty uncomfortable. Congrats on the weight loss. One way to evaluate the need for your device would be to get an inexpensive wrist or finger recording oximeter on Ebay, and see if your oxygen levels drop at night. Remember to get one that records data and not just instant readings.
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