Tweeking Bipap Settings

I received a Respironics Auto Bipap machine about 5 days ago. I am operating in the Bipap Auto with biflex mode: Ipap is 16, epap is 7, biflex is 3 and max pressure support is 8. I average about 2 to 3 apneas per night, from 30 to 50 hypopneas, and the AHI averages from 4 to 7.

I would appreciate some suggestions as to how I can tweek the settings to lower the number of hypopneas.

Rooter

I'm not a doctor or anything in the health care field, but if it were me, I'd give these settings a try for awhile:

auto bilevel mode

EPAP 9
IPAP 20

Max Press Sup 8

BiFlex 3

Thanks for the suggestion RG.

Rooter

Hi Rested Gal:

I know you´re not a doctor. I´ve read that in several of your posts. But I feel from reading them that you know a lot as a patient. I´ve been meaning to ask you for advice.

I´ve had two titrations already. One showed 4 and the second showed 16.

With 4 I felt like nothing happened. Later I learned this and not using CPAP at all was the same. My first doctor never told me this. She wouldn´t believe I wasn´t sleeping better, so I changed doctor.

With 16, I felt like I can´t exhale well and end up sofocating. My new doctor won´t believe this either. Now that I read the posts I feel like with this high preassure I should probably be on a different, better machine, like a BIPAP or a BIPAP auto.

The thing is, after my experience, which I just explained a little, here in Colombia, South America, I feel like doctors and sleep labs don´t seem to be very prepared for treating sleep apnea, specially severe cases like mine (I feel like crap!).

I am slim, and I´ve been told by several otorrynus I have no structural problems in my whole airway passage. The only pattern I´ve seen in my sleep studies/titration is I have a lot ot hypopneas.

I´m using right now the Respironics Auto PAP with C-Flex with the full preassure range (20-4). Since I feel like I don´t know my preassure still, this is the only way I feel I can tolerate PAP therapy and get some sleep, not listening to my doctor.

If it was up to him I´d still be sofocating with that 16 preassure on a straight CPAP machine. I sleep somewhat better than with no PAP therapy at all, but I´m still not feeling rested. Last night I recorded myself with my video camera and I could see I still jerk waking up, as if I still have apneas/hypopneas.

Could this be an indication that I need more preassure? The results from the auto PAP smart card show that I spend most time on preassure 8. I also used to have mouth air leaks, which I now controll by taping my mouth shut. Sometimes I get aerophagia from this. By the way I use a nasal mask, the ResMed Mirage Activa.

So, I just made the appointment for another titration. One doubt I have right now is, I´ve seen when I´ve had them done they use a BIPAP Auto with B-Flex. If this machine is more specialized for finding your IPAP and EPAP preassures, how come they´ve come up with just one number as your air preassure, prescribing you a straight CPAP machine?

Aren´t they forgetting things like easying your exhalation (Bi-Flex), or the change in the AHI number from the different sleeping positions through the night (Auto PAPs)?

Do sleep studies/titrations in the US/Canada show the patients´ IPAP and EPAP preassures for doctors to prescribe them? If not, like here, how do you know how to set these preassures if you wanna get a BIPAP or a BIPAP auto?

So while I wait for my next titration, should I buy me a full face mask to solve my mouth air leaks, or could this problem be solved by getting a BIPAP/BIPAP auto. I´ve read here that air leaks can be caused ´cause you can´t exhale properly.

I´m sorry for dumping so much information on you like if you were a doctor. Like I said, I know you´re not. So, please feel free to comment anything, if you want. Don´t feel compromised to do it.

I just feel like I can´t talk to doctors here anymore ´cause they won´t listen or they don´t seem to know much. I believe more in this forum, and it shouldn´t be that way ´cause you´re not supposed to treat yourself right?, but what can you do?

Everyone else´s help is also welcome. Thanks.

John.