Cpap Bipap or ASV

[jamadu]

I was originally diagnosed with severe OA and kept complaining to the Doctor that I didn't feel well. After 10 years of complaining, I was switched from Cpap to Bipap SV. I recently discovered sleepyhead and have been checking my results nightly with my ASV machine. I still have my Cpap machine and decided to do an experiment last night. Here are part of my results from last night. I just don't understand why my Doctors don't take me seriously when I complain about feeling terrible.

[Julie]

Hi, could you possibly post the bottom half of that graph?

[LSAT]

Specific reason for the fixed pressure of 15 vs Auto?

[jamadu]

Hi, could you possibly post the bottom half of that graph?

Yes. Hope this works

[Sleeprider]

As best I can tell you have a very sophisticated machine, BiPAP SV setup as a fixed pressure CPAP. In this mode, it will not help you resolve the central apnea that are showing up in a couple clusters at night. It would have been helpful to show the pressure graph so we can better see what's going on. Normally include Events, Flow, Pressure, Leaks, Snores.

It makes no sense to have been prescribed this machine, and then to set it up as a CPAP. You should discuss this with your doctor to find out what his intention was, and get a copy of the prescription.

If you want to set this up to resolve CA, and don't have any assistance from your doctor, I'm going to suggest some settings based on a best guess of your needs. It would be better if you got the settings recommended by your doctor, but these are probably a good start. The machine settings need to be changed from CPAP to AutoSV mode, with EPAPmin at 11, IPAP max at 25, PSmin 2.0 PS max 15. You currently don't have significant OA or snores, so a pressure of 15 obviously resolves that issue. You may want to use BiFLEX at 2.

You are currently getting pressure relief (Cflex) of 2, so your effective settings are 15/13 (IPAP/EPAP). It appears you can reduce pressure a bit, and let the auto algorithm work to increase pressure in case the 11 cm EPAP pressure is too low. The minimum pressure support of 2 is similar to what you are getting now, and the max PS is to allow the machine to induce breaths when you have CA events. The max IPAP is to leave the top pressure open for now until we can narrow things down a bit. These settings should be comfortable, and will cause the machine to behave much differently during OA and H events.