On a bipap trial, not sure about settings?

[Seiru]

Due to the problems I had with my previous CPAP usage (chronicled here: viewtopic.php?f=1&t=155320&st=0&sk=t&sd=a), my doctor had me go through another in-office sleep study. It once again found that I had OSA with an AHI of 20. This time they are trying to see if BiPAP works better than CPAP. To find this out, they gave me an old loaner BiPAP to evaluate for a month.

Anyways, the machine came with these settings (as reported by Sleepyhead):


And my first "night" looks like this:


My question is, I assumed that BiPAP had two different pressures, and that in auto mode it would find the two pressures that work best to combat apneas? From what I'm seeing here, it looks exactly the same as an auto CPAP (one pressure that's adjusting over time). Is there any difference? Is it set up wrong?

Thanks for any help.

[Holden4th]

I'm not an expert on this but just a few observations. If PS is not set then the machine is virtually acting as an APAP. You need to set a max and min PS. Maybe start with PS mIn 1 and PS max three. With this set I don't see the need for Ramp, turn it off.

Reading your previous thread you said you were starting to see results using APAP with a min pressure of 9.0 and a max of 20. So why not start here and set EPAP min to 9.0 and IPAP max to 20. This will now allow the pressure support system to do it's work. With a PS max of three your exhalation pressure could drop to as low as 6.0.

Once you've done that, show us some SH data so that people here can help you.

I'm sure that other members will come in here and make even better suggestions than I have.

[aspen]

Yes, with PS = 0, you aren't using an auto BiPAP. Hopefully someone more knowledgeable will give you the reason, but it was suggested by Pugsy for me to set the PS to 4. You also likely don't need the huge factory range that has been set there, but I will definitely leave that to other smart people .

[Pugsy]

PS is the key to the 2 distinct pressures.
When it is set at 0 your EPAP is going to equal IPAP...and that like an apap. It can move but PS remains at 0 so only one pressure is moving.

Right now your PS setting is
Min PS 0
Max PS 0

so your machine can't make use of the available 2 distinct pressures which what make bilevel so nice for most people.
It looks like it is working like at apap because it is working like an apap because its little hands have been tied.

My suggestion...since apparently you don't need really high pressures

Minimum EPAP 5 or 6
Max IPAP 25 if you wish but it won't ever go anywhere even close to it...if it hits 12 I will be surprised. But it hurts nothing to have it set higher. It doesn't affect anything as long as it never goes there.

PS...you need to give it some room to roam
Min PS...2 or 3...it's a comfort thing mainly
Max PS ...4

I don't advise using more than 5 PS max....unless under a doctors direct care and he is aware of using higher than 5 PS.
Higher PS can cause unstable breathing resulting in centrals in some people. Now some people use higher PS for other reasons but they usually have some sort of lung issue and the doctor is using higher PS for a specific reason...that's fine.
I just don't advise people doing this DIY bilevel thing using more than 5 PS.

[Seiru]

PS is the key to the 2 distinct pressures.
When it is set at 0 your EPAP is going to equal IPAP...and that like an apap. It can move but PS remains at 0 so only one pressure is moving.

Right now your PS setting is
Min PS 0
Max PS 0

so your machine can't make use of the available 2 distinct pressures which what make bilevel so nice for most people.
It looks like it is working like at apap because it is working like an apap because its little hands have been tied.

My suggestion...since apparently you don't need really high pressures

Minimum EPAP 5 or 6
Max IPAP 25 if you wish but it won't ever go anywhere even close to it...if it hits 12 I will be surprised. But it hurts nothing to have it set higher. It doesn't affect anything as long as it never goes there.

PS...you need to give it some room to roam
Min PS...2 or 3...it's a comfort thing mainly
Max PS ...4

I don't advise using more than 5 PS max....unless under a doctors direct care and he is aware of using higher than 5 PS.
Higher PS can cause unstable breathing resulting in centrals in some people. Now some people use higher PS for other reasons but they usually have some sort of lung issue and the doctor is using higher PS for a specific reason...that's fine.
I just don't advise people doing this DIY bilevel thing using more than 5 PS.

Ah, I thought something was up. Thanks again for the advice, I'll give these settings a try for a while.