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+--- Thread: [Treatment] UARS - BiPAP - just started treatment - need advice (/Thread-Treatment-UARS-BiPAP-just-started-treatment-need-advice--30988)
UARS - BiPAP - just started treatment - need advice - calebpng - 11-26-2020
Hi all,
New to this forum. Just did a watchpad sleep test last week. RDI (15.2), AHI (5.0) and % REM of sleep time (12.6%). This was my first time doing a sleep test, and understand that this qualifies as upper airway resistance syndrome, or some would say mild sleep apnea.
[attachment=28344]
Details: 25 male/Singapore
Symptoms: Brain fog, neck pains, fatigue, unrefreshed sleep, joint pains, low energy throughout the day. Issues with concentration/memory
Duration: 3 Months - brain fog is permanently there
What I did:
1. Purchased a DreamStation Auto BiPAP with Humidifier and Heated Tube
2. Started therapy for a full week (6 days)
[attachment=28345]
[attachment=28346]
Results: - posted in attachment
1. AHI averages around 8, with high amounts of clear airway apneas.
2. Notice that when i decrease the EPAP to 4.0, instead of above 6.0, my AHI falls (why is this so?)
3. Waking up still having brain fog - also, i get some headaches initially when i wake up
Questions:
1. How can i improve this situation? I adjusted the flex level to 3, and maxed the humidifier as i wake up with dry mouth.
2. How long will this take before the fogginess lifts - feeling like i'm living a sub-human life
RE: UARS - BiPAP - just started treatment - need advice - Sleeprider - 11-26-2020
Your test is not definitive for UARS but your BiPAP results show you need some help with those settings. Your CA events correspond to higher pressure support, and with a setting of 2.0 to 8.0, that's a lot. I don't like the variable pressure support algorithm on Philips BiPAP for most people, especially in the initial self-titration phase. Let's make some changes.
Mode: BiPAP auto
EPAP min 6.0
PS min 2.0
PS max 2.0
Max pressure 1.2
BiFlex: 2
RE: UARS - BiPAP - just started treatment - need advice - calebpng - 11-26-2020
Thank you for replying. How do i get confirmed for UARS? seeing a sleep specialist to interpret the results on Saturday.
Will try the setting - what is the reason for upping the EPAP min to 6, instead of 4? My AHI actually do pretty well at 4. Also BiFlex setting of 3 seems to be more comfortable for exhalation. Thanks! You meant max pressure 12 ya? Appreciate it.
RE: UARS - BiPAP - just started treatment - need advice - Sleeprider - 11-26-2020
The chart you posted has a minimum EPAP of 6.0, and that looks fine. I don't see any reason to reduce to 4.0. By lowering the pressure support, we are looking for a significant reduction of CA, and see if your hypopnea increases or not. At that point we can look at some close-ups of the respiratory flow and see whether flow limitation is as indicated by flattened inspiratory peaks.