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manders513's therapy thread (UARS)
manders513's therapy thread (UARS)
Hi folks,

I apologize for not following the protocol of starting just one therapy thread--I wasn't aware of that expectation initially. So, here I am! Mods, feel free to consolidate my other threads into this one. 

My current question--is it reasonable to assume I may need a Bipap? In early May, I was diagnosed with mild apnea from a WatchPAT test through Lofta based on my RDI (7.5) and many heart rate spikes, and prescribed APAP. My WatchPAT AHI was like .2 or something. From February to May of this year, I was using a borrowed Dreamstation, but never really feeling relief. Since the Lofta diagnosis, I started renting a ResMed Airsense 11 AutoSet, which I've been using since 5/15/23. I've had it on For Her mode and EPR at 3. I've been slowly trying to increase my min pressure because I'm still seeing flow limitations/arousals, but I think I'm at my limit. When I go past 11cm minimum, I have terrible aerophagia. I've dealt with this before when I originally started PAP therapy back in February. I do have a small hiatal hernia, which I've read can be a cause. But with a chin strap, mouth tape, and an elevated head, above 11cm I am awake often and burping/etc full of air. I can't sleep more than 4-5 hours like that, and I think I'm starting to go backwards. That said, I'm still seeing flow limitations (mostly in my flow rate--most aren't marked in the flow limitation graph) and having mini sigh breaths/arousals every 5-10 minutes in addition to larger ones throughout the night. I'm not having any OAs with the ResMed machine, just a few CAs each night, so from what I understand, my EPAP is sufficient. A higher IPAP with sufficient EPAP would treat my flow limitations without causing aerophagia, correct? 

I'm still waiting for my in-lab PSG, which is scheduled for July 2nd. I'm assuming the only way to switch to a bipap is after the PSG/my ENT gets the result and I can tell her about my issues with APAP? I'm not entirely sure what it takes to get prescribed a bipap machine. I would love to be able to rent one to try it out before I commit the $$. 

Thanks for any and all insight!

I'll attach a few recent screenshots of different pressure ranges on my Airsense 11.

Last night (bad night, everything after 2:30am was half awake/light sleep):

A night with a range of 9.8-13:

My first night with the ResMed, testing it out wide open 5min-20max:
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