Shnorky's therapy thread / BiPAP Settings

[Shnorky]

Hi everyone!

Does anyone know what kind of event those are? Those whole night was pretty much a mess full of periodic breathing with or without apneas in the middle.
These somehow look half like centrals and half like obstructive to me, but... still learning. What is the correct way to go about those?
Basically: Dr urges me to lower the pressure as she thinks I have trouble breathing out against the pressure. As I lower the pressure, flow limitations and then obstructive apneas increase. As I increase the pressure, centrals and aerophagia increase. EPR/Flex/Bipap seem to wake me up unconsciously, bringing events to zero but still exhausted during the day. Should one get used to the pressure changes? After 6 years now I'd have thought that the brain would have had time to adjust...

[Sleeprider]

Your chart shows a classic cluster of RERA with increasing flow limitation leading to an abrupt arousal with recovery breathing, rinse and repeat. The root cause is positional, most likely chin-tucking. Your EPR/PS is turned off so you don't get any pressure support help for the flow limitations. You were previously using a Vauto with EPAP in 14 and PS 3 with much better results. Why the change? Your best option is probably a soft cervical collar. It could be your old collar has lost some of its resilience or height and this is starting to show up as increased events.

[Shnorky]

Oh, now I see it, thank you. 
You are right, this was without collar. Looking for alternatives to a soft collar, even in winter it makes me sweat, but with night time temperatures around 85F these past few weeks all the skin around my neck started to disintegrate from the sweat. Was hoping a pillow with a kind of wedge on each side would help, but that doesn't seem to be the case then.

And yes, pressure support helps remove the events, but I feel awful afterwards. Worse than if I had been sleeping without cpap.

[Shnorky]

Hi everyone!

So, after the local DME took away my defoamed dreamstation and gave me a gritty, stinky replacement with 17k hours as part of the philips recall program, I thought it was time to make the switch to resmed more permanent. Found a way to enable ASV mode (unemployed for the past few months, and hoping to convince my dr. for a new prescription once he sees how much better it is working, to buy a new device and support resmed). A kind sleep tech gave me the advice to take some antihistamine based sleeping pills for a few nights. That was a godsend. Cleared my swollen turbinates for a while, and helped me sleep through the pressure changes. Just in case someone else stumbles on this and it might help them.
Settings are now at min epap 11.4, max epap 15, min ps 2.2, max ps 17. Tried lowering the min epap more, but it then goes into hypopnea territory (with AHI > 1), even with higher min ps to compensate. Do you have any recommendations?