Switched from APAP to BIPAP

[Geer1]

I am still leaning towards this being a mouth breathing issue. Hopefully the congestion will subside as things continue to heal and then I would be interested to see how you do with a nasal mask.

I am not sold that higher pressure helps you. I would try a test of low fixed pressures, minEPAP = 4, maxIPAP = 8, PS = 4.

[AmirKas]

My titration study did confirm that my sleep was better at min EPAP of 10, Max IPAP of 14 so I'm not sure if lower pressures is necessarily great. However, to try it out, should I put some kind of range instead of IPAP of 8 to give myself more room to see what settings work best for me?

[SarcasticDave94]

My opinion, I think bouncing settings about without letting the dust settle isn't a well planned out approach. Yes, if some setting is giving drastically bad results, then don't hesitate to change it. However, you're supposed to be attempting to build a trend over time to see how the settings will work longer term than a day or so. And it should be limited to one or two settings at most, not scrapping the setup and starting over every few days.

I'm not at all against what Geer1 is mentioning BTW. My comments are because as I see it you're straining at your bit like a horse, just waiting to spin the dial to try something else without pausing to see how it goes a few days.

[Geer1]

I could be wrong but I don't believe you have posted titration study results, you should post up a redacted version of them as that information would be helpful.

The reason I was curious to try a low pressure is because imo these new settings do not look like an improvement although potentially that is due to congestion etc from surgery still (If I remember correctly around 4 weeks I was starting to feel better than pre surgery though). Compared to your previous data this last data has a higher EPAP, higher average pressure, higher PS but also higher AHI, lower tidal volume (were taking smaller breaths), lower minute ventilation (less overall air breathed) and just in general your flow rate chart looks worse to me. 

If a restricted airway is your main then lower pressure with higher PS is likely to be the best solution. High pressure and high PS creates issues with noise, leaks, aerophagia, breathing out against pressure etc making it hard to tolerate so should only use higher pressure if it proves to reduce obstructive apnea/flow limitations which I don't know that it does. 

The reason I recommended fixed pressure is so we can see what your results are without APAP muddying them. It makes it a more definitive test and things should be obviously worse if pressure is indeed helpful. If the pressure isn't obviously helpful then results will be inconclusive or show improvement. Learning how you do at lower pressure with PS of 4 teaches us a fair bit imo and helps decide where to start making micro adjustments from (at that lower pressure or by returning back to higher pressures).

[AmirKas]

Here are my titration results:

[attachment=36197]

[attachment=36198]

[Geer1]

Should ask for more details if you don't have them. Want to see the time and number of events at each setting tried.

[SarcasticDave94]

Looks like a summary and not a detailed report. There's some items missing as Geer1 points out.

[Sleeprider]

Not much useful information in these screenshots. More details needed. There should be a page showing the pressures trialed and events at pressure. If this is the best your get, you should ask for a refund...worthless.

[SarcasticDave94]

Probably not even a cup of coffee with that one. Sad.

[AmirKas]

I’ll ask medical records for the more detailed report. I’m the meantime, what settings should I try tonight?