Switched from APAP to BIPAP

[AmirKas]

Geer1. Considering that you've noticed that higher PS exacerbates my awake periods, would the reason my sleep study didn't notice the issue (and why I genuinely felt a lot more well-rested after a few hours of the study) be that no PS was used during the CPAP portion, which made up the majority of the night? 

Testing that would obviously need to be done, but the hypothesis doesn't seem too far off from what could be reality. Besides that I'm willing to do anything to try and resolve these symptoms. 

I will continue using the same settings as last night tonight. But would a CPAP trial at 8 with no PS be the next step?

[Geer1]

I am torn about PS. It seems to make some things better and some things worse. The question is if it improves or worsens symptoms which can only be determined from how you feel because the data doesn't tell us anything about your symptoms.

Assuming these current settings appear to be a good baseline for EPAP (want to see that they are fairly consistent) then my next thought was to test PS of either 1 or 4. Trying PS of 1 first would be a more noticeable difference from current settings and then if you determine that seems worse than current settings could try PS of 4 and then slowly narrow in from there what seems best.

[AmirKas]

Sounds good, 

Here are the results from last night in case it provides /confirms any information:

   

[AmirKas]

So I changed PS to 1 last night, and so far it already seems like PS should be raised again. What's interesting is that Central apneas went up significantly.

Here are my results last night + I felt worse after waking up today than yesterday:

   

[Geer1]

Try EPAP 9 with PS 1 for one night then try PS 4.

The other night at EPAP 8 you had some higher flow limitation as well so it seems like 8 is on the edge of being adequate.

[AmirKas]

Here are the settings from last night:

   

Will use PS 4 tonight unless PS 5 is recommended instead.

[cathyf]

AK -- I continue to be amazed that you can produce such runs of high and extended flow limits while on the vauto. My autoset nights look like that, but the vauto just fixes it for me. I wonder what's different between us that prevents the vauto from just fixing yours?

[SarcasticDave94]

Just curiosity, if applicable, would a physical airway restriction cause some of these kind of ongoing issues? A restriction that PAP cannot resolve that is.

Maybe this was discussed earlier but I don't remember about it...

[quiescence at last]

Just curiosity, if applicable, would a physical airway restriction cause some of these kind of ongoing issues? A restriction that PAP cannot resolve that is.

Maybe this was discussed earlier but I don't remember about it...

What, like a scarred or non-pliable mass that partially blocks or restricts airway?  QAL

[cathyf]

As someone with a significant goiter (that used to be bigger!) I have wondered about the thyroid pressing on the airway.