Self Titrating on BIPAP, need urgent help, got 3 days!

[peterlee]

Hello everyone!

I have been a long time reader of CPAPTalk but only recently have decided to register an account. The reason is that I have been presented with a peculiar situation. I will receive a loaner Respironics BIPAP from the Respironics distributor in my country (Thailand) to try out for three days in the hopes that it will improve my (somewhat self-diagnosed) UARS.

A little about myself:
I was diagnosed with sleep apnea with an AHI of 30 and arousal index of 45 per hour. I'm a 21 year-old male, 5'10 tall, and weigh 65kg (143 lbs).
I have been using CPAP since early this year. My unit is a Respironics System One 560 Auto Cpap. I have both the F&P Simplus FFM and Wisp Nasal Mask.

Why do I believe I have UARS?
Simply put, I still wake up feeling like crap everyday even though my AHI is consistently below 3. Sleepyhead report shows me that I pretty much gasp for air every 10-20 minutes in my sleep even though I do not stop breathing (seems very much like some kind of hypersensitivity due to flow limitation). The tidal volume and flow rate as shown in Sleepyhead seems very high in these instances. My current settings are 10-20cm of pressure with Aflex of 3 and humidifier of 3. However I have tried putting the machine in a straight CPAP mode for several of nights with no improvement.

This is where the BiPap (hopefully) comes in.
The reason I decided to loan the Bipap is because I read Barry Krakow's post on UARS and his treatment by using Bipap with high pressure and large gradient. I hope that I will be able to replicate what he has done for his patients and also be a lab rat for cpaptak users who might be wondering if BiPap really works for UARS :p . I do realize the 3 days might be too short to determine if treatment really does work, but it will probably give me a clearer picture of what is going on. I hope that the knowledgable users here will be able to help me set the pressures and gradient that is right for me.

I will post my current sleepyhead reports on the APAP in a few hours when I get home, and will follow up with the BiPap data when I have them.

Thanks in advance everyone! Lets beat UARS together

[ChicagoGranny]

I will post my current sleepyhead reports

You may already know how to format, but just in case - Pugsy's formatting instructions - viewtopic.php?f=1&t=111910

[peterlee]

Here they are, as promised.

1: This is a report of my typical night. Low AHI, many arousals. The pressure is set at 10-19 in this one.


2: This is a report when my pressure is 7.5-10.5, still pretty low AHI, but as you can see VERY bad flow rates with many spikes in tidal volume


3: A closer look at the cluster of flow rate spikes


4: A close-up of what I claim to be an arousal. This occurred at pressure of 13cm H2o


5: Another close-up of an 'arousal'.


My main problem is that these 'arousals' seem to come out of nowhere regardless of high pressures. I'm crossing my fingers that BIPAP can help solve the issue. I want my sleep back!
And since I'm in the +7 time zone, I will be heading to bed soon. I would be very grateful if anyone knows where I should start with my BiPAP settings for tomorrow (I'm still using the APAP for tonight). My hunch tells me that an EPAP of 8 seems logical since I pretty much get rid of all my large apneas at that pressure. The IPAP, however, is probably the key to beating my UARS. Does 13 or 14 cmH2o seem any good? Or should I go higher?

Thanks everyone

[peterlee]

Bump. I would really appreciate any help!

[palerider]

Bump. I would really appreciate any help!

it would help if you'd follow these instructions for arranging and posting:
https://sleep.tnet.com/resources/sleepyhead/shorganize

[peterlee]

Bump. I would really appreciate any help!

it would help if you'd follow these instructions for arranging and posting:
https://sleep.tnet.com/resources/sleepyhead/shorganize

palerider, your link doesnt seem to be working for me. How should I organize my reports?

[palerider]

Bump. I would really appreciate any help!

it would help if you'd follow these instructions for arranging and posting:
https://sleep.tnet.com/resources/sleepyhead/shorganize

palerider, your link doesnt seem to be working for me. How should I organize my reports?

try again, it's out there, it's a great page.

[blitzmr2]

Bump. I would really appreciate any help!

Ever figure this out?