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[Treatment] Need help titrating BiPAP
#11
RE: Need help titrating BiPAP
Hello, I put my BiPAP in AutoMode last night with the settings you recommended. These were the results. Curious what you think.


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#12
RE: Need help titrating BiPAP
If I understand this data correctly it looks like there's still some central apneas, hypopneas, and RERA/flow limits.


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#13
RE: Need help titrating BiPAP
Most (all but 3) were centrals. With a VAUTO we have had good luck using the trigger setting. You have yours set at medium raise it to high. That should help eliminate the centrals. Let’s see what OSCAR shows tomorrow. 

On the other note how was the night, how do you feel?  Was the settings better, worse or about the same?  That is the question you need to keep asking yourself.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#14
RE: Need help titrating BiPAP
I agree that one way to go is to try putting the trigger up to high, making no other changes. Let's see what that looks like.

Other options include reducing pressure support and waiting a while to give your body a chance to adapt, which may bring the centrals down. But trigger to high is fine.

I want to underscore what staceyburke says about reporting how the night was and how you feel the next day. These are really important clues.

I'm also curious about the timing of your sleep on the two nights you posted, and the long breaks between sleep segments. It's good, if possible, to avoid naps and go to bed at about the same time every night. This is part of how you can help yourself sleep better.
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#15
RE: Need help titrating BiPAP
Thank you! I will bring Trigger up tonight. I felt pretty awful today admittedly, and it was definitely one of the worst nights of sleep. I'm working on taking notes everyday about what my settings are and how I feel to better identify the ideal settings. I think I'm also going to bring PS support down from 5 to 4. 

As for the timing, it is because I usually fall asleep in the early morning (I have delayed sleep phase), so I'll usually fall asleep around 4 am and wake up a little after noon.
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#16
RE: Need help titrating BiPAP
It's OK to change both trigger and PS, though you'll learn more if you make one change at a time. Your call.

Decades ago, I would sleep from 4 to noon, and for a while I shifted even further: 6 a.m. to 2 p.m. So I get that. Still, you'll benefit from going to bed at the same time every night, be it 4 a.m. or some other time.

I'm glad you're keeping track of settings and your experiences. And I'll be curious to see your next chart.
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#17
RE: Need help titrating BiPAP
One thing that causes centrals is the difference between inhale and e xhale pressure, the larger the difference between the more centrals. So going down on the ps might not do you any good. I would suggest you just do the trigger high tonight and see what that does. If the centrals go down we won’t know why
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#18
RE: Need help titrating BiPAP
(05-02-2021, 07:13 PM)staceyburke Wrote: One thing that causes centrals is the difference between inhale and e xhale pressure, the larger the difference between the more centrals. So going down on the ps might not do you any good. I would suggest you just do the trigger high tonight and see what that does. If the centrals go down we won’t know why

Ok I'll just bump the trigger up but not adjust PS, then tomorrow we will see the chart.
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#19
RE: Need help titrating BiPAP
My quality of sleep was slightly better than yesterday but I still woke up totalled. These were the results in Oscar:


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#20
RE: Need help titrating BiPAP
Some improvement is better than none, but this is still not where we hope it will be.

Please leave the trigger where it is and try reducing the PS tonight to 4, with a minimum EPAP of 6. The lower PS may reduce CAs, and the higher minimum EPAP may reduce obstructive events.
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