Self-titrating using an Auto machine

[drdigital1]

Browsing through the postings I saw several references to auto-titrating or self-titrating using an Auto machine.
Presumably you set up wide parameters and then adjust the settings based on what the machine figured out as optimal. Is there any guidance on how to do this? My machine is Auto Bi-PAP.

[bbridge_GA]

I was told to do just that. I have read something about using the 95% pressure, but I have been told not to by the sleep doc.

[SleepyCPAP]

Hi DrDigital1,

I've been told the newest 560 models have a choice in the clinician set-up menu for the machine to figure out the best starting pressure ("Opti-Start" though the menu might list it as "Auto-Trial"). Does your 760 have that as a choice (I'm assuming you have BiPAP, BiPAP Auto and CPAP choices, but maybe they added Opti-Start too)?

--SleepyCPAP

[Pugsy]

The 95% (90 for PR S1 and 95 for the S9) pressure by definition is simply the pressure where you were at OR BELOW for 90/95% of the night. People often forget the "or below" part of the definition.
It is a number that is easily skewed sometimes. Sometimes it is what you would want to use if you were doing straight CPAP and sometimes it isn't. I have seen it often myself....need to evaluate it long term (a month or more) to get the best idea for cpap pressure.
The minimum pressure is actually the most critical pressure if using APAP mode. Set it optimally and the pressure shouldn't roam around wildly giving the 90% pressures a chance to be skewed high.
See this thread. It's old but the basics are unchanged no matter which model or brand machine.
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

[drdigital1]

My machine doesn’t have "Opti-Start" or "Auto-Trial" options but, even if it had, after reading the link mentioned by Pugsy, I decided that I’ll continue my manual tweaking process especially increasing the EPAP min pressure

[Pugsy]

My machine doesn’t have "Opti-Start" or "Auto-Trial" options but, even if it had, after reading the link mentioned by Pugsy, I decided that I’ll continue my manual tweaking process especially increasing the EPAP min pressure

You have a BiPap machine like I do and they don't have the OptiStart Auto Trial stuff. To be honest..those features aren't that big of a deal and it really doesn't take but a few nights on any auto adjusting machine to come up with a decent range of pressures when using any auto adjusting pressure machine.

Since you have a BiPap and are using dual pressures..the general rule is
EPAP for Obstructive Apneas
IPAP for hyponeas (if large in number and not many OAs)

EPAP is going to be the most critical just like the minimum is with the APAP mode machine.

Pressure support is the difference between EPAP and IPAP. Normally most people will be using 4 or 5 PS. This is for the bipaps that you and I use. Now the BiPap ASV machines are a totally different beast and PS has more specific functions on those machines.
For us with the plain bipaps...mainly comfort as it lets us have a more like normal breathing rhythm.
I don't normally suggest going over 5 PS with the plain bipaps as I have seen some instances where too much of a difference seems to create a bit of breathing instability but if a person's doctor has a specific reason then of course that takes precedent.

[Julie]

The one thing I'd keep in mind is that the usual default settings for most machines are 4 and 20, and most people cannot breathe properly at 4 (and I've never heard of anyone getting a script for that setting!), so I might start off with the low one at least at 6 or 7 for a 'regular' Cpap or Apap. I couldn't advise re bipaps though.