Lumis 150 VPAP ST BiLevel Settings for Persistent Flow Limitation/UARS

[gthanop]

Hey everyone,

I have been using CPAP for 4 months now with AHI < 1 for most nights, trying different pressure ranges (above 11-12 I get aerophagia) and EPR settings (0-3) but still tired af and brain fog during the day. I was suspecting UARS and after much effort I convinced my doctor to try BiPap for 10 days. So, last night, which was the first night of treatment I ran my ResMed Lumis 150 VPAP ST in manual S-mode (so IPAP/EPAP stay flat by design) with these settings:

IPAP 11 cmH₂O / EPAP 6 cmH₂O (PS = 5)

Rise time: 150 ms

Ti min/max: 0.3 s / 2.0 s

Trigger/Cycle: Med/Med

What I saw:

Flow still looks flattened and jagged breath-by-breath—no smooth sinusoidal shape.

I’m pretty sure I’ve got UARS/residual flow limitation as I previously mentioned —CPAP compliance is fine, but clearly the upper airway isn’t staying open effortlessly.

My questions for those of you with BiLevel/ST experience:

Would you drop PS from 5 cm to around 3–4 cm first, or tweak trigger/cycle before lowering support?

Does Rise time = 150 ms sound about right, or would you go faster/slower?

Any opinions on switching from manual S-mode to VAuto (auto-EPAP + PS) to let the machine react to flow limitation?

What trigger/cycle settings have you found best for catching subtle inspiratory effort (without false-triggers)?

Thanks in advance—any tips or your own nightly screenshots are hugely appreciated! Below are a sleephq link to last night and a glasgow index screenshot.
https://sleephq.com/public/teams/share_ ... 08834c7291

[zonker]

I don't have the answer, i'm just bumping this post up so others may take notice.