Struggling with BiPAP AutoCurve VAUTO--Central Apneas

[Paul Massie]

Thanks. We'll see how this goes for a week or so and then I may have to go look for a new sleep doctor.

[Paul Massie]

Latest results attached.  Lower pressure seems to have helped and I am now averaging <5 AHI events per hour.  However, I can't seem to get to sleep long-term with my BiPAP.  Taking it off (consciously and subconsciously) and then putting it back on several times throughout the night.  Initially, airflow seems restrictive and I stay awake fighting it, then take it off so I can doze off.  Ramp has never helped in the past, and now Ramp does not show as an option I'm assuming due to lower pressures???  Later in night around 4-6am I seem to be able to put it on and keep it on, but since I didn't sleep good until then I am not waking up until 10-11am.  Fortunately, I am not working now (retired), but can't imagine going back to work (which I would like to at least part time) until I can get up around 6-7am like I used to.

I have another Dr. Appt. this Tuesday and am thinking of cancelling it.  Not sure there is more they will do as I am averaging <5 events/hr.  Is there anything specific I should pursue with him?  Is it realistic to think I should be able to have one sold 8 hour block of sleep (I was up 3-6X's per night before using CPAP and BiPAP).  Is it worth pursuing any more improvement than current results?

Although I do feel like the CPAP and BiPAP have reduced the headaches I used to wake up with and the direct injection humidity has reduced my sinus/respiration issues I do not feel as though I am waking up with more energy, in fact just the opposite.

[ajack]

You may not wake up with a lot of energy. It wasn't may experience either. I first noticed that I didn't need an afternoon sleep. It takes a while for you body to adjust to the machine. My sleep was very broken. Your's is still broken, but improved over time. There is also a marked improvement of the CA, which you would expect the pressure induced ones to resolve over the time.

If it was my chart, I'd lift the min epep to 8 and keep PS3 max ipap 11. This won't affect the high end of the pressure, but it may clear up some SDB. It may not make much difference in how you feel either, but it may stop a few micro arousals an hour.

It may take another month or so. Next would be to increase the ipap 1cm at a time. To allow the machine to move

[Sleeprider]

Ajack's suggested settings in Vauto mode with EPAP min 8.0 and IPAP max 11.0 with PS 3, results in fixed pressure. I agree this will be less disruptive. I actually think EPAP min 7.0, IPAP max 10.0 PS 3 would be better. Just slightly lower pressure but the same fixed pressure.