I need help on my machine settings

Hi everyone,
I sometimes do ok with below settings, but recently I've been struggling. I often gasp before falling asleep, that or wake up gasping, and the machine doesn't kick in enough for higher pressure. At 6 am I finally was able to fall back deep asleep only having to get up in an hour, and I check the machine that the pressure was at 11 and I was sleeping like a baby, for that one hour. Sometimes my lung feels bloated with air at a lower setting like around 9.0 already, what am I doing wrong? What should I do?

Here are my settings:

Mode: AutoSet
Max Pressure: 20.0
Min pressure: 9.0
Mask: Nasal
Comfort
Response: Standard
Ramp Time: 10 min.
Start Pressure 4.0
EPR: On
EPR Type: Full Time
EPR Level: 2
Tube Temp: 82F
Huminidy Level: 2
AB Filter: NO

Sleep Report
Usage hours 7:22
Events Per Hour: 1.3
Mask Seal:
Humidifier:
Ave. Usage: 6.9 hrs
Pressure 9.6
Leak 29L/min
AHI 1.4
Total AI 1.2
Central AI 0.5

Thanks in advance,

Based on the 1 night numbers you are showing, I would do nothing but continue at the present settings. Consider downloading the Oscar software and posting some data.

Since you are already using EPR and are still feeling the way you describe, that may not be enough - you may need a different mode that your current machine does not offer: bi-level. You may simply need higher flow, and although it is similar to pressure (directly proportional in the static case but certainly not in the dynamic case, which is what reality is), it often gets confused with it, but they are not interchangeable. The main purpose of a CPAP machine is to keep the airways open to avoid OSA, which is achieved by maintaining some minimum pressure, but that, in and of itself, is not always comfortable for many people. Morphology of the airways is one factor, such as narrow nasal passages. Another one is simply higher sensitivity to air resistance, as evidenced by higher RERA (respiratory effort-related sleep arousals), which makes you notice it more than other people. Raising the pressure somewhat alleviates your airflow problem, but also adds unnecessarily high levels of pressure, which is also uncomfortable. You need higher pressures at the right time (when you inhale) and lower - the rest of the time (when you exhale). That is what bi-levels do. ResMed machines also have ways to adjust the pressure rise time (rate), which further compensates for those airway restrictions. I'd feel exactly like you describe, if I wasn't using one of those machines. The good news is most sleep doctors would readily prescribe a bi-level CPAP, if you presented to them your symptoms and suggested the switch (my doctor, back in 2003, didn't even need me to suggest it). Good luck!

McSleepy

Hi Mac,

I also have a surgically corrected deviated septum and a BiPAP that's about a year old, abandoned. I'll open it back up, any suggestion on the settings?

Thank you,
Marq

Hi, Marq,

I'd be glad to help. What make/model is the machine? If it is truly BiPAP than it must be Respironics (it's their trademark). I got started on a Respironics BiPAP Pro and it was great - it had a quick pressure rise and excellent sensitivity; because not much on it was adjustable. However, the newer Respironics models are not only not programmed as that one was, but they are also not much more adjustable. I had an older System One and it was horrible for me, I had to switch to ResMed.

I'm also not very knowledgeable about the specific settings that Respironics machines have to offer, you may have to get some assistance from other members here; similarly for the pressures - someone with more time on their hands can guide you through it step by step, if you need to. The general rule is: try to keep your pressure support (IPAP - EPAP) to a reasonable value, typically between 4-7 cm H2O. The higher it gets, the more apneas you may get. I have mine at around 6 and it's a good compromise between comfort and effective therapy. If you can get a ResMed, I can give you all the details about all the settings that will affect your comfort.

McSleepy

marquisvns wrote: ↑

Thu Dec 02, 2021 9:30 pm

I also have a surgically corrected deviated septum and a BiPAP that's about a year old, abandoned. I'll open it back up, any suggestion on the settings?

Need to know exact brand and model name of the "bipap"....to give you settings comparable to your current settings.

Also need to know if you are having any problems or complaints with the ResMed APAP you are currently using...which BTW I see no need to change those settings unless you are having some problems.
Are you sleeping decently and feeling decent during the day?

I am so sorry to dropped the ball on my own post after almost a year. I don't remember, probably was going through some rough times for sure. Thank you all trying to help, you guys are awesome!

Marq

So how are you doing now, using what?

maybe they'll tell us next year?