Still Struggling with BiPap and Anxiety

Dallaslady51 wrote: Is it better to have a higher PS to give the machine more range?

Actually with your machine there is no "range" of PS. You get what you select. PS doesn't vary at all with your machine.

PS doesn't affect the overall pressure ranges either unless someone is using a really high PS and they also are using maximum pressure settings such that the machine simply has no room to roam around. So it could actually limit pressure movement depending on the settings involved.

PS is nothing more than the difference between inhale and exhale. It's like EPR on the AutoSet...but with more customization available.
Now there are some people who have lung issues and the doctors will really elevate the PS in an effort to help with lung ventilation but those are separate issues and special circumstances and don't really pertain to you and your OSA issues. If you had lung issues of some sort you would already know about it and you would also most likely be on a different machine than what you have.

You were given this type of bilevel machine simply because it offered greater exhale relief (that what was available on the AutoSet) and since your pressure needs are relatively high they wanted to help you out with more exhale relief.
Unfortunately you used the AutoSet for so long that your body grew quite accustomed to the exhale relief you were using in the form of EPR and when they changed the exhale relief to more of a drop your body didn't like the change because it was new and different.
Most people would appreciate that larger drop available than what EPR offers...but your body and your mind didn't and in fact the change caused you stress and worry and all that stuff.

You need to quit worrying about which PS to use in terms of therapy and just use what is comfortable for you.
This bilevel device is nothing more than the AutoSet that you were using but it has more options available just in case you need them or want them.
It is a bit more customizable in terms of what can be offered to make your inhale/exhale experience comfortable to you. That's all it does.
Otherwise it works the same way except it can go higher than 20 cm which doesn't appear to be needed in your situation.
Just pretend that this machine is the AutoSet and EPR is replaced with PS.

EPAP minimum is nothing more than the minimum you used on the AutoSet. The minimum needs to be at sufficient levels where the machine can go higher if needed. Doesn't mean that it will go higher but it can...just like with the AutoSet.
PS is just added for comfort in your situation. It's like EPR was on your AutoSet.

Most commonly a PS of 4 or 5 is used when people are put on a bilevel machine for situations like yours...that's probably where they came up with the setting of 5 PS initially suggested. Most people do very well with it but you didn't because it was such a big change from what you were using.
The brain and body gets kinda funny about change....some people don't adapt well to any change and I think it sounds like you are one of those people.
The change was harder for your brain and body to adjust to than the breathing in and out against the higher pressures was.
The PS in your situation is simply a comfort setting...doesn't really impact the therapy itself because the machine is going to auto adjust the pressures as it thinks it needs to. Only the minimum EPAP needs to be worried about and I think you are probably good with the EPAP being 11 or so.
For the PS...just pick the one that is simply the most comfortable for you and your body and your mind to deal with.
Any of the PS settings offered will work well to treat your OSA...the only difference is your comfort.
You can get just as effective therapy with a PS of 1 as with a PS of 5 so it doesn't matter which you choose just as long as you are comfortable with it.

My wife and I both use the same machine. When I first started, my machine was set for very high pressure, with a pressure support of 5 cm. I have found I do quite well with much lower pressure and a pressure support of 4 cm. My wife's machine has always be set with a pressure support of 4. I took about six months to get her pressure optimized. When she first started, the high pressure caused her to have a lot of CAs. They started her at a low pressure, and brought it up slowly over the six month period. Her sleep apnea is now controlled as well as mine (AHI averages less than 2 every night). We both have nights where out AHI will spike much higher, but these are the nights were other medical problems are interfering with our sleep. I wish you well in your quest to find restful sleep.

Thank you so much, Pugsy - That eases my mind - I will continue to use it each night and just try to get used to it over time. It makes me feel better knowing that it is really not out to hurt me (just kidding - sort of). You have been So Helpful, Calm, and Supportive - I love all you explanations of how these things work. Thank you!

Also, thank you, Okie, it helps to know that I'm not a lost cause just because I haven't settled in with the Bipap right away. I know a lot of my anxiety is coming from other places, but maybe I can just relax about this "issue" and allow myself time to get used to my new "friend" without being afraid of it! It also makes me feel better knowing you have "not great" nights with higher numbers and that it is normal.

I could never get my wife to get a sleep study, so I told our doctor that she would stop breathing while she slept. Our doctor scheduled her for her sleep study. Now, she has adjusted to the machine and puts on the mask every night. She told me she doesn't feel right if the mask isn't on when she lays down. I took to the treatment easier than she did. I was originally diagnosed around 1996, but opted for surgery hoping to not need the machine. The surgery stopped many of my symptoms for several years, but I ended up with a machine over two years ago.

Well unfortunately still struggling. My appt with the good CPAP mask person was postponed to this week. Still having so much trouble with the Stupid Stupid humidity - ResMed masks are way too dry (manual or auto climate), F&P are the Great Flood, etc. Maybe she can help me.

My nose is definitely closing at night and I am still waking up at all kinds of hours in a panic. Heart is pounding like crazy and I'm just shaking, but none of that really shows on the graphs in terms of a reason. Keep trying full face, but it almost seems to hold my mouth closed rather than allowing mouth breathing. Too many years of training myself to keep mouth closed. Trying saline spray to help dryness and Afrin to reduce swelling, but no real benefit. The nasal strips were a joke - pop off right after I put them on.

Still takes about 6 hours to get over the panic and trauma from each nights sleep - Lovely. Even set up the old S9Autoset - actually got AHIs in the 2s at 11-18 pressure with EPR of 1, but did nothing for reducing panic.

Each day I wonder how much more I can take, but I obviously just have to keep trying.

I think I understand a lot more about the Pressure Support on the Bipap, and lowering my PS from 5 to 2 or a little below improved my numbers from about 7-8 to 2-4. Somehow despite the panic I am feeling, I must be sleeping, because the graphs don't look bad and I am not overly tired during the day (but having panic attacks all day kind of keeps you awake).

When I wake up startled and scared I am trying to see how the breathing on the machine feels. It feels like it's hard to exhale but at the same time it feels like there's not enough air (but could be a function of stupid nose closing up).

I think the EPAP/IPAP range is fine because it covers what my pressures usually average.

Is PS only a reduction in the air flow from the machine so you can exhale easier or does it do something else on the Bipap? Thanks for any thoughts.

Seeing your chart zoomed in showing 5 minutes near the time of your arousal may help.

Ok will try to post a couple of those times tomorrow morning - thanks