Switched from APAP to BIPAP

[Sleeprider]

Are you using EasyBreathe, or is that disabled?

[Geer1]

Easybreath is the waveform shape. It is optional in S mode and without it your breaths would be more square which might explain the image you posted (and also less comfort last night). If not on then try turning it on (or switch back to vauto with min EPAP 8, max IPAP 10, PS 2 which will effectively be S mode with easybreath).

[AmirKas]

EasyBreathe was already on at the time. I tried an IPAP of 10 with a PS of 2 for a 1-hour nap and still had flow limits in my flow graph. I wasn't very comfortable with a PS of 2 either.

[AmirKas]

So in a pit of pure impatience, I ended up changing my settings to 11 IPAP 7 EPAP with a PS 4. I also changed my trigger settings to Very High, and while I know this doesn't follow any valid scientific method of changing one variable at a time. I ended up sleeping an entire night with a CAI of 0. 

Considering that using a PS 4 at higher pressures usually resulted in a CAI of around 3.00, I do believe this to be a significant result. My Tidal Volume also jumped to 360 which higher pressures with a PS 4, failed to reach. I believe a trigger setting of very high will be very beneficial for me.

[SarcasticDave94]

See what happens after at least another night. We're after trends longer than one night to determine success. It's good though it worked as is.

[Geer1]

You really need to focus on how you feel after getting used to a new setting and not what your data shows. Trials of different settings should be for a week not a day. You will always be able to pull out bad looking breaths from data no matter what your settings are and you also don't have to treat all flow limited breaths.

The analogy for this is choosing to run around in circles or walk in a straight line. Walking is what will get you where you want to go.

That said I am not surprised you felt PS 2 not as comfortable. I still want to try lower pressure and PS though. Recommendation is 8/11 (PS 3). For at least 3 nights absolute minimum. I don't want you to look at your data until you are 100% sure these settings are better or worse than previous settings. Once you know they are better or worse then look at your data and see if there is anything that seems to possibly explain why you believe there was or wasn't improvement.

[AmirKas]

The thing is that yesterday was absolute hell. One of the worst days in my life in regards to Brain Fog and malaise. I was entirely dysfunctional and couldn't properly attend to any of my responsibilities. 

Today was significantly better than most days (things like actually getting out of bed within 5 minutes of waking up instead of 30-60 minutes. I didn't have anything to attend to either so it wasn't a matter of stress.

[AmirKas]

The thing is that yesterday was absolute hell. One of the worst days in my life in regards to Brain Fog and malaise. I was entirely dysfunctional and couldn't properly attend to any of my responsibilities. 

Today was significantly better than most days (things like actually getting out of bed within 5 minutes of waking up instead of 30-60 minutes. I didn't have anything to attend to either so it wasn't a matter of stress.

[cathyf]

AmirKas, I'm really puzzled by your 2:15-3:00 graphs. Those look like flow limits to me, and when my breaths look like that the vauto flags them as flow limits, boosts the pressure, and then they go away. Your vauto didn't seem to know it was happening, and didn't react.

[AmirKas]

@Cathy 

It's because my VAuto was actually on S mode that night despite what OSCAR said. It's still strange that no flow limitation was marked and makes me question whether flow limitation is essentially my norm. Otherwise, S mode might just ignore flow limitations as a whole.