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Switched from APAP to BIPAP
RE: Switched from APAP to BIPAP
Amirkas,

Your symptoms could be caused by a thousand different things. Not all symptoms of tiredness, fatigue, brain fog are caused by breathing issues or stress/anxiety.

Your 2 cm of pressure did not create the difference in your symptoms the last two nights. That is the whole point I have been arguing for weeks/months yet. Your symptoms fluctuate without rhyme or reason and are not tied to breathing issue
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RE: Switched from APAP to BIPAP
A BiLevel on PS=4 will perform better on flow limits than a CPAP on EPR=3
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RE: Switched from APAP to BIPAP
Did I miss something important that would explain why it can't in part be stress related issues? You mention struggling to perform responsibilities on a very bad fatigue and other symptom day and the next day with what sounds like nearly no responsibilities you have a much better day. If I have this right, why can't it be stress adding to your symptoms and other issues?

Normal to high responsibility demands seems to equal high symptoms.

Low responsibility seems to equal low symptoms.
Dave

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RE: Switched from APAP to BIPAP
What I meant to say is that I didn't have any responsibilities that required me to jump out of bed and get ready. My level of stress stems from my debilitating brain fog and how it has become overwhelmingly difficult to manage my responsibilities. I'm very sure that stress is not the primary cause of my symptoms.
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RE: Switched from APAP to BIPAP
Hi everyone, 

Over the week I noticed a trend regarding Trigger settings, central apneas, and obstructive apneas. Even at a higher PS of 5 used for a few days, my central apneas were minimal (only 1 for each night). 

When switching my trigger settings from Very High back to High for one night (without changing any other settings), my obstructive apneas dropped from around 3 to <1 while my central apneas jumped from <0.5 (essentially 0) to 4.  

What has made me adamant that my cognitive symptoms could be quickly resolved by finding the right settings, is that when waking up today after only a few hours of sleep (to get water), I felt significantly more mentally clear than I normally do. I went back to sleep and woke up with the same feeling of brain fog that has plagued me for so long. 

I understand that it's not scientifically sound to say that my brain fog is rooted in poor sleep, but I've tried most other things. (Coeliac test, Vitamin D + B12 tests, Thyroid tests, Food allergy test, taking probiotics for improved gut health, Cognitive Behavioural Therapy.) I will try an elimination diet once my schedule is more stable, but due to my experience with the alleviation of my symptoms, I don't think it's a result of food sensitivity. I'm going to see a neurologist this coming week, but in the meantime, I'm spending as much energy as I can on dealing with a possible sleep-related cause for my symptoms. 

Here are the results since my last post:

10-10-21 (PS 4   Trigger - Very High):

[attachment=36450]

10-11-21  (PS 4   Trigger - Very High):

[attachment=36451]

10-12-21 (PS 4.6   Trigger - Very High):

   
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RE: Switched from APAP to BIPAP
More nights:


10-13-21   (PS 4.6    Trigger - Very High)

   

10-14-21    (PS 5       Trigger - Very High)

   

10-15-21    (PS 5       Trigger - High)  

   
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RE: Switched from APAP to BIPAP
Last Night    (PS 5     Trigger - Very High):

   
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RE: Switched from APAP to BIPAP
And again you noticed significant difference in how you feel even though breathing wasn't significantly different.

Maybe you felt better because you were waking up at a regular time and then felt off because your sleep was interrupted by 2 hours awake (long drink) and then slept until noon with a messed up sleep schedule?

How come breathing is the obvious issue when it never correlates with your symptoms?

I have given my opinion multiple times, seem like time to bow out. Good luck, I hope you find improvement.
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RE: Switched from APAP to BIPAP
I promise that I take your advice seriously Geer1. The 2 hour period last night was when I had unconsciously taken my mask off and still slept, only to wake up later feeling fine. I then proceeded to go back to sleep and felt awful upon waking up again.  

I'm still looking at other causes of my fatigue and cognitive dysfunction (booked an appointment with a nutritionist to plan an elimination diet). I've cut dairy and gluten out of my diet so far and have yet to see significant improvements but will continue to diet. 

As I've mentioned before, I am booked to see a neurologist this week. 

I'm trying to exhaust all treatment options to get back to normal functioning, which includes getting my sleep + breathing as optimal as possible. For someone of my age, my AHI numbers are still not optimal which is why I continue to ask for advice. I will transition from nightly changes to weekly changes of settings to improve my therapy. I would still appreciate your support.
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RE: Switched from APAP to BIPAP
Hi AmirKas,

You seem to be homing in on a best fix pressure setting.  If I were trying to adjust, I would accept less obstructive and key in on the October 12 night.  I would change my settings to increase the EPAP to no less than 9.5.  I would try EPAP min of 9.5, Trigger Very High, PS of 4.6, IPAP Max of 17.  Most of the OA in Oct 12 night occurred below EPAP of 10.0.

Would like to get the benefit of preventing OA without causing CA count.

I would probably increase the EPAP Min by 0.5 each step, and staying for at least 3 days at each setting, until I reached EPAP Min of 9.5.

QAL
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