BIPAP user trying to reduce snoring, AHI

[bipapnewbie]

I am only 5 months into therapy. Started with CPAP and due to high flow limitations, I moved to BIPAP 2 months ago. Tried soo many masks, and various mouth tapes, etc. Still have some leak issues, but that seems to be better than it was using KT tape doubled up.

I have played around with bipap settings and am generally sleeping well except for dry mouth from too much air in mouth. But mostly I am trying to dial in my settings to get AHI's lower and eliminate snoring.

See attached OSCAR data and if you have any guidance I would appreciate.

Screenshot 2025-09-17 at 11.04.48 AM.png (487.35 KiB) Viewed 6940 times

Screenshot 2025-09-17 at 11.04.17 AM.png (486.86 KiB) Viewed 6940 times

Screenshot 2025-09-17 at 11.03.45 AM.png (483.46 KiB) Viewed 6940 times

[Miss Emerita]

Welcome! Thanks for posting your charts. Next time could you include the flow-rate graph?

It looks as though the pressure support is helping with flow limitations, which is good. The snoring is clustered, which makes me wonder whether you are rolling onto your back off and on during the night. Could you describe your sleep positions and your pillow set-up?

Generally to reduce OAs you'd want to raise your EPAP, but I'm wondering whether at least some of the OAs are also related to sleep position. Many of them occur during snoring, and some of them occur in mini-clusters, which can indicate a position issue.

[bipapnewbie]

thanks so much for responding. I was trying to show snoring graph and could not fit it all in on Oscar. Here is SLeep HQ link too if that helps. https://sleephq.com/public/teams/share_ ... /dashboard

I mostly sleep on my back say 80% of night. I cannot stay on side long due to shoulder pain. I had back surgery in february so sleep with a whole pillow arrangement around my body so I definitely and not shifting posiitons without moving pillows, so i am pretty confident of when I am on back and when on side.

As to my head pillow i use.a pretty flat latex pillow.

As I increase pressures my leak rate increases and when leak rate is higher then AHI seems lower. It is like whack a mole.

[Miss Emerita]

Because you have to sleep on your back, I suspect that tweaking your settings won't help a lot with OAs or snores. Would you be willing to try using a soft cervical collar to try to keep your neck and head well-aligned?

That would be my top recommendation for an experiment to try.

If that's out of the question, or doesn't help, then you might try one of two additional experiments: (1) bumping up your min EPAP, maybe to 6.8. Be sure to increase your max IPAP so that you get your full PS of 4.6. Or (2) keeping your IPAP min at 6.6 and bumping up your PS to maybe 5. (1) might help with the OAs, and (2) might help with the snores.

I strongly recommend doing only one experiment at a time and trying a new setting for at least a few nights before evaluating it (unless it's a disaster).

Your leaks are fine as far as your therapy goes; your machine can easily compensate for leak levels up to around 24. The question would be whether they tend to wake you up. What do you think?

About Oscar graphs: you can grab the gray bars between the graphs and push them up a little. That way you can fit in events, flow rate, pressure, leaks, FLs, and snores.

[bipapnewbie]

Miss Emerita, thanks for your response. I have a cervical collar and have used it from time to time but it didn't seem to change my numbers so I stopped bothering with it. But could try again. I see your posts about Bleep and i have the system and love it but stopped using it due to increase in mouth leaks. I used it for a couple of months and Stuart helped me by reducing my pressures to 11 IPAP and 6 EPAP, my AHI were better as was snoring, but leak rate was always around 10 or higher at 95%.

I would love to go back to bleep and i guess learn to live iwth higher leak rates.

[Miss Emerita]

Do you think the leaks interfere with sound sleep? If you don't think they do, then I'd say don't worry about them unless they go up into large-leak territory.