[Treatment] Am I on the right track?

[ajack]

What is your awake o2 level sitting quietly in a chair for an hour? I wouldn't try and improve on that as an average.

First, I'd run it past your doctor, What does he say, is there some COPD, asthma etc, that impact on your lung function. You need testing and a diagnosis.

Given..
your breath rate is bumping 16. Which is still in the normal range by the way. But you have a bilevel now.
your 95% and max TV is about 580 and 760
You could target 450-500 as a median.
These can be done for just 90 minutes, to see the results and set the alarm clock if you want to.
I'd have min epap10 max epap 11 for o2 and see. min ps6 for tidal and see. Then I would raise to min ps8, if it wasn't 450, 400-450 would be my first step.
I would bring in the tidal volume chart and ignore anything where there is a leak.

[Sleeprider]

I think the "theory" that pressure support can increase tidal volume is appealing, but in my experience, it rarely works in non-invasive PAP therapy. Even if we get a response in the tidal volume, a decrease in respiration rate often results in the same minute vent being recorded, or an increase in CA events. Pressure support seems to help with flow limitation and tidal volume, especially where expiratory resistance is a factor. Where low O2 is a problem, increases in PEEP (EPAP) can improve oxygen saturation. Given the chronic nature of your low SpO2, I still think your doctor should propose a solution, and I really think an oxygen bleed is a more reliable means of accomplishing your objectives. This forum is at its best in suggesting solutions to apnea problems, rather than desaturation or respiratory deficiencies unrelated to sleep disordered breathing. We can suggest approaches that may help, including increased PEEP and PS, but where those don't achieve the desired result, is a pretty good indicator that it is time to talk with your doctor.

[ajack]

I'm sorry Sleeprider, I try not to directly correct you, but it's only a google to show that it does. I also have direct experience that it does. Whether he really needs to, at RR16 and TV 400 is probably the point. My advice was to see his doctor in the first instance.

https://www.sciencedirect.com/topics/med...y-pressure
Bilevel Positive Airway Pressure Ventilation
Bilevel positive airway pressure devices (e.g., BiPAP) can provide different pressures during inspiration and expiration. Expired positive airway pressure (EPAP) helps maintain end-expiratory lung volume and airway patency, similar to CPAP. The pressure difference between EPAP and inspired positive airway pressure (IPAP) serves to increase tidal volume and hence minute ventilation

[alshayed]

I will be seeing two of my doctors in the next week and a half, and pretty sure at this point I will be adding another one to the mix shortly. So I think today my main objective should be to minimize hypoxemia and CA's both as much as possible so my sleep is as good as can be expected until they can figure out official diagnosis and treatment ideas.

Between both of you I think I know the ballpark of pressures I need to fine tune for the short term, again thank you. I'll post an update when I get it finalized or other news. Unfortunately I don't nap very well so I don't think that's a reliable way to gauge new settings for me. I really wish that wasn't the case.

I really had no idea just a couple of weeks ago that there was something else going on beyond OSA/UARS. However it kind of makes sense looking back and I may have had this other issue possibly since I was a teenager. So yay me for being stubborn and suffering needlessly all these years.