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Yet another newbie - I'm clueless...
(05-03-2017, 10:41 AM)Sleeprider Wrote: We can keep working to bring that down a bit.   What were your results at 12 CPAP and what kind of events?


I didn't even try 12 CPAP, knowing that that was not the same setting as what worked for me in the past.  Current setting (as of yesterday evening) is:  vAuto 12/8 PS 0.0
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It's always a bit more difficult to fine-tune apnea with a lot of CA.  Your initial results had me thinking you would end up using ASV.  Anyway, that is the reason pressure support does not work well, unless it is intelligent and able to overcome central apnea.  When you talk to your sleep doctor, it would be nice if he leveled with you as to his strategy.  To me, the fact you got a BiPAP pointed to central or complex apnea.  I just wonder if your doctor expected that you would fail BiPAP and end up needing the ASV.  The initial results you posted sure pointed that direction.  His reaction to your simplified settings is irrational.  He prescribed 20/8 over PS 4.0.  For someone with central events this was bound to fail.  In his defense, a fixed CPAP pressure that prevents OA can also minimize central events, and a lower pressure is usually better for that, so his recommendation of 12 is a bit surprising.

In your first graph, your OA events overwhelmingly occurred at high pressure when IPAP was >18 cm.  After we changed pressure to exclude pressure support and limit maximum IPAP pressure to 12, you eliminated nearly all CA, and had some OA events at the maximum pressure of 12.  If you look at what is going on here, it's very possible we will end up at fixed pressure of 9.0, but it will take some trial an error to narrow it down.

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