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How to optimize the setting of Auto BiPaP? (PR DreamStation 700) - Printable Version

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How to optimize the setting of Auto BiPaP? (PR DreamStation 700) - 0xDing - 04-18-2019

I confirmed OSA(RDI: 35) through PSG test. So I bought a PR DreamStation 700(Auto BiPaP). But it doesn't seem to work very well.

How to optimize the setting of Auto BiPaP? 


my settings:
Mode: Auto Bi Level with Bi Flex
Min EPAP: 6.0 
Max IPAP: 25.0 
PS: 4.0-4.0 (range)
A-Flex: On



[attachment=11415]

I would appreciate it if anyone could give me some advice. (and Sorry, my English is not very good.)




RE: How to optimize the setting of Auto BiPaP? (PR DreamStation 700) - Gideon - 04-18-2019

Welcome to the forum.

50% of your AHI is Central Apnea.  Your Auto BiPap is not designed to treat Centrals.  Your Obstructive is also too high.

Increasing Pressure will typically increase Central Apneas.  Increasing PS (Pressure Support) will typically increase Central Apneas.

Your PS is currently set to 4 (PS = 4) I'm going to suggest reducing PS to 1 (PS = 1) to try to minimize the CA.  This may increase your Obstructive elements.


RE: How to optimize the setting of Auto BiPaP? (PR DreamStation 700) - Sleeprider - 04-19-2019

I don't usually disagree with Fred, but I'm going a different direction. Please consider using the following settings:
EPAP min 8.0
PS min 2.0
PS max 3.0
IPAP max 14.0

The OA events in your current chart are from the exhale pressure being too low (4.0) and it seems to greatly improve in the range of 7-8 cm. I think most of your CA events are due to sleep disruption and not being accustomed to the therapy. I am suggesting a reduction of the pressure support (difference between IPAP and EPAP), but I think you will be more comfortable in the suggested range of 2-3. At this point I don't see any need for pressure above 14/11, so that is the basis for the maximum pressure. I assume you are using BiFlex, and I suspect at a setting of 3. Please turn it down to 1 or 2.