New AVAPS User Problems (Try Again)

[jmayer180]

After a follow-up sleep study I finally got my new PR System One BiPAP AVAPS. With my previous BiPAP Auto I had been getting CA's about double my OA's with total AHI's in the twenties, and with IPAP 25, EPAP 20 (or as close as could be tolerated) with restless nights and sleepy days. My new prescription is for AVAPS, PC mode, tidal volume 800 (I'm 6ft 3in, and weigh far, far more than ideal weight), back-up rate 12, IPAP max 25, IPAP min 10, EPAP 10. I used the new AVAPS machine for the first time 4 Oct 2016. Subjectively I felt great, with comfortable breathing all night. Imagine my surprise when I ran the data and found my total AHI was 45! Last night, 5 Oct 16, was the same.
I think I have learned how to provide screenshots. Let's see:





Hoping the images come through, one question concerns my tidal volume. I see some are as low as 300-400. I thought the whole idea of AVAPS was to guarantee a minimum tidal volume, 800 in my case?

It'll be some time before I can get a follow-up with my sleep doc. Meanwhile does anyone have suggestions?

[palerider]

there's very little to go on with those screenshots.

I'm not familiar with what data is displayed from the avaps, or how accurate sleepyhead is with it.

if you want to upload a zip of your entire sd card, I'll take a look at it and see if I can figure anything out.
https://www.dropbox.com/request/0LalWvEsijRIgX8sdM7H

[jmayer180]

Thanks Palerider. I sent the zip file to you (I think) via pm. As far as I can tell, the data from Encore matches SleepyHead pretty well (although less detail, I believe.)

[palerider]

I wanted to see if there was a flow strip, (it's rudimentary on the 1160, unfortunately), I don't know what it's supposed to be, maybe average breath size or something.

unfortunately, I'm not getting much helpful out of the chart, other than it looks like your EPAP is too low, too low to prevent both the obstructives and hypopneas you're having.

if you feel comfortable trying it, raising the epap *should* help cut down on the OA and H count.