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Switched from APAP to BIPAP
RE: Switched from APAP to BIPAP
I don't have any specific cause in mind, but it just seems that any pressure he tries kinda gives disappointing results. An opposing conflicting thing, seems to need sometimes more pressure or PS to treat but as more pressure applied then it blocks and gets worse. Just a supposition though.
Dave

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RE: Switched from APAP to BIPAP
Amir,
It seems like these two are the best so far as regards flow restrictions:
PS 1 over 9.0 to 10.0
PS 3 over 8.0 to 11.0
assuming you don't stay at one setting for multiple (3 or more) nights as generally recommended, you might want to try -
PS 2 over 9.0 to 11.0
which ought to have the best parts of those settings.

QAL

p.s. if you do go to PS 4 or 5, make sure it is EPAP of 8, preferably 9, or split the difference at 8.5 ish.
PS 4 over 9.0 to 13.0 for example
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RE: Switched from APAP to BIPAP
QAL both nights using PS 1 he had high/higher flow limitations 0.45 95% when using EPAP of 8, 0.24 when using EPAP of 9. This agrees with when he tried low PS/EPR months ago (may not have seen that data).

In terms of flow limitations EPAP of 11 was best. EPAP of 8 was pretty good but one night had a couple elevated points. EPAP of 9 is my recommendation as 8 appears to be on the edge.

So far the best indication is that EPAP between 9 and 11 with PS of 3 appears best. Lower pressure has too much restriction and higher pressure has too much aerophagia and doesn't appear to improve restriction further. PS of 4 test is next, probably need to try it for a few nights then try PS of 3 again to compare and see which feels best.
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RE: Switched from APAP to BIPAP
Regarding the poor PAP therapy:

If an untreatable (by PAP) airway constriction is possible, how would I go about testing that? (CT scan / X-ray?) and what kind of doctor would I go to see about that?

Regarding last night:

Being super exhausted last night, I forgot to use a PS of 4 and used a PS of 1 again. I can confirm that I feel worse than I did at a higher PS of 3. I will try a PS of 4 again tonight, with an EPAP of 9 (unless 8 is recommended), if results improve, would it be worthwhile testing even higher pressure supports (5 <).

Here are the results from last night at 10/9:

   
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RE: Switched from APAP to BIPAP
It seems the team believes EPAP 9 is good start.   Smile
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RE: Switched from APAP to BIPAP
Last night's results were great (I believe the best I've seen). Let me know if going back to a PS of 3 is recommended, or if I should continue to use these settings for a few more days.

Last nights results:

   
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RE: Switched from APAP to BIPAP
Stick with this for a while.
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RE: Switched from APAP to BIPAP
Last night wasn't great. I ended up having to take an additional 2 and a half hour nap today because I was so extremely exhausted - and still woke up consequently exhausted. 

Here are the results from last night:

   
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RE: Switched from APAP to BIPAP
Keep using it for a while and then try PS of 3 again to compare and decide which is best.
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RE: Switched from APAP to BIPAP
Sorry for being offline for so long, have had many things to deal with so I've been relatively busy. 

I haven't been able to find a good setting with any PS so far (Max PS used is 4) in which I feel better. Some days I feel better not using the CPAP machine at all. 

I haven't switched over to a nasal mask yet but will do so today or tomorrow. I have a chin strap that I can use and am wondering if that's a better option than using mouth tape.
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