First BiPaP Auto Home Titration. Help Interpreting

[Dolpp]

Just figured out how to post these. I'm not sure how to read this. Can anybody recommend where to go from here? It doesn't seem to correlate with my daily totals each of these nights.

[cflame1]

what're your pressures sitting at now... and what's your PS?

[torontoCPAPguy]

You realize, of course, that these numbers on their own are almost meaningless. I do not believe that there is anything called an auto home titration per se. You can titrate yourself in order to minimize things like apnea events and hypopnea events, leak rates and so on, but in the end you still need a GOOD sleep study with EEG, EKG, BP, SO2 and so on to tell you if you are sleeping well (i.e. what stages of sleep and how your body is working under the APAP machine). All the numbers from the APAP are going to do is set you up in the best possible position for the sleep study for the best possible results - they are NOT going to guarantee that you are getting a good nor a healthy night of sleep. They are just 'pointers' to problems that can be used to reduce the problems. Pretty good pointers granted, but still I suggest that an EEG is needed to determine the quality of sleep being attained and the other readings are necessary to determine if there are other issues still in play. Low SO2 causes high BP and it is a killer. That is why doctors want you to have a sleep study and I suggest that it is a valid request; you should be demanding same at the beginning to have a start point and during your self titration to determine the effects of same.

I have just reached the point where my numbers are about as close to perfect as I think they are going to get according to my S9 Auto data; but I am going to get a sleep study done to determine if I am actually getting quality sleep or if there are other factors at play preventing me from stage 4 and REM sleep sufficient to satisfy my personal sleep requirements.

Does this make sense?

[Dolpp]

I do not believe that there is anything called an auto home titration per se. You can titrate yourself in order to minimize things like apnea events and hypopnea events, leak rates and so on

Well I titrated myself at home using the auto function of my BiPaP, I'm not sure what you would call it but I called it an "BiPaP Auto Home Titration" On the recommendation of another user of this forum I ran my machine in the auto setting from 6-12 and the results I got were what I posted.

You realize, of course, that these numbers on their own are almost meaningless.

I posted them to see what they mean. I was having trouble figuring them out. What is the point of the auto function if the numbers are pointless? I guess I just don't understand. I thought they would give me a recommendation of what setting to put my machine at. I did have a titration with my BiPaP and the doctor put me at a setting of 12/8, but that didn't seem to be working I tried it for a month and my centrals were very high and I was still very tired during the day, so I tried the auto function to see what it would say. From what I can discern it looks like it wants me to use 10/7 (where the 90% is) but those don't look like the best numbers, I have way better numbers at 6/5.

what're your pressures sitting at now... and what's your PS?

I've been using a setting of straight 8 and getting real good numbers but I'm still really tired. What is "PS"?

[cflame1]

it's available when you're using it in auto bipap mode.... but based on what you're saying you've got them set to the same values so it won't be available you (I believe).

PS is the pressure support #... it's the max that the IPAP and EPAP can be apart.

[unadog]

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[Boston Guy]

You realize, of course, that these numbers on their own are almost meaningless. I do not believe that there is anything called an auto home titration per se. You can titrate yourself in order to minimize things like apnea events and hypopnea events, leak rates and so on, but in the end you still need a GOOD sleep study with EEG, EKG, BP, SO2 and so on to tell you if you are sleeping well (i.e. what stages of sleep and how your body is working under the APAP machine). All the numbers from the APAP are going to do is set you up in the best possible position for the sleep study for the best possible results - they are NOT going to guarantee that you are getting a good nor a healthy night of sleep. They are just 'pointers' to problems that can be used to reduce the problems. Pretty good pointers granted, but still I suggest that an EEG is needed to determine the quality of sleep being attained and the other readings are necessary to determine if there are other issues still in play. Low SO2 causes high BP and it is a killer. That is why doctors want you to have a sleep study and I suggest that it is a valid request; you should be demanding same at the beginning to have a start point and during your self titration to determine the effects of same.

I have just reached the point where my numbers are about as close to perfect as I think they are going to get according to my S9 Auto data; but I am going to get a sleep study done to determine if I am actually getting quality sleep or if there are other factors at play preventing me from stage 4 and REM sleep sufficient to satisfy my personal sleep requirements.

Does this make sense?

Cheer up buddy, I know canada's a little boring but ... cheer up

[unadog]

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[timbalionguy]

The centrals you are seeing are of definite concern, as they are showing up at rather low pressures. You have to be at pressures that are not likely very comfortable for the centrals to be at anything close to an acceptable number.

I am no doctor, but here is what I would consider trying, based on my experience. For people with central or complex sleep apnea, or CompSAS, BiPAP modality can make things worse. Try using straight CPAP at 7, 8 and 9, for a few nights each. The ideal pressure is the lowest pressure you can comfortably tolerate, consistent with near zero OA and CA. If you can achieve these conditions, and are still tired, you need to look elsewhere for problems.

You may very well be a candidate for ASV (Adaptive Servo Ventilation). These machines treat you on a breath-by-breath basis, and are designed for people with central apnea, periodic breathing, and other complex respiratory problems. This is what I, and a fair number of other folks on this board use. Make sure you discuss this with your doctor, and be ready to try ASV on your titration.