First Week on Bi-PAP, next steps?

[jkexbx]

I've had a CPAP for some time, and struggled to increase pressure without waking up due to aerophagia. I use a nasal mask with mouth tape

I just purchased a AirCurve 10 VAuto and need some assistance in getting it setup to start with.

I set it to 16 and 8, to give an average pressure of 12. I could never get above 13 when I was using the CPAP previously.

I'm currently experiencing medium aerophagia where I will wake up uncomfortable, but can sleep through the night.

I see some events are getting awfully close to 16, so I may bump max up to 17. I'm always trying to increase pressure, but aerophagia makes it quickly unbearable.

Not sure what I should do with the min, and response.

Appreciate the expertise!

[kwhenrykerr]

I was having same condition being uncomfortable. I reduced my pressures and gave myself time to adjust. With your AHI number it would not bother me at all. Give your self time to adjust to the new settings.

[super7pilot]

With those groupings of OA's. I bet you are having some positional issues.
So some questions.
1, do you use a pillow that is as flat as you can sleep with? If not get a flatish pillow and sleep on your side
2, Do you tend to curl up into a fetal position? This creates chin tucking. And no amount of pap pressure will fix this. Again, A flat pillow can help as well as a soft cervical collar to keep your chin off your chest.

[jkexbx]

Appreciate the suggestion! I will definitely invest in a good pillow now. Here's that spot zoomed in, is there anything else you can gleam from these events?

   

[CPAPfriend]

As someone who works with patients from across the world, that's a very high PS, and I would be curious to know how you arrived at those numbers. I'm not saying this is the case for you, but a majority of bilevel users have a bias towards 4+ PS, which I think is partly due to Resmed's clinical guidelines suggesting a starting PS of 4cm if the user has already trialed CPAP. Keep in mind that EPAP is more important than IPAP for maintaining airway patency, and then IPAP can be viewed as assisting in the work-of-breathing.

[super7pilot]

Those grouped OA’s with not much in between them. That sure is the text book look of positional apnea’s.

So look at the mechanical bits like sleep position, pillow, device to prevent chin tucking.

[jkexbx]

As someone who works with patients from across the world, that's a very high PS, and I would be curious to know how you arrived at those numbers. I'm not saying this is the case for you, but a majority of bilevel users have a bias towards 4+ PS, which I think is partly due to Resmed's clinical guidelines suggesting a starting PS of 4cm if the user has already trialed CPAP. Keep in mind that EPAP is more important than IPAP for maintaining airway patency, and then IPAP can be viewed as assisting in the work-of-breathing.

I experience aerophagia very badly. With my CPAP on a EPR of 3 I could only tolerate a max of 13. Everyone recommended higher pressure, because I'm still experiencing poor sleep, but I could never increase it. I purchased a BiPap and was expercing medium aerophagiaon with PS of 4 and max pressure of 16.

The machine was maxing out, so I bumped max to 17 and PS to 5 to keep average pressure down. My aerophagia actually got better when I did that so that's why I keep PS high

[Crimson Nape]

jkexbx - I noticed that you are using OSCAR version 1.4.0.  If you upgrade to the latest OSCAR release, version 1.6.0, you will be able to display additional parameters of the VAuto.

Also, please use the F12 key to take the screenshot.  I will remove the calendar and right side display, and allow more pertinent data to be displayed.

Here is the OSCAR Guide example of the layout we are looking for:

- Red