UARS - trouble switching from APAP to BPAP

Hi folks, I'm new to this forum (I started with apnea board). I'm posting today because I'm having some issues with the transition to bi-level. I welcome any advice you may have! Here's my situation:

I've been diagnosed with UARS (PSG results .2 AHI, RDI 27). Since May, I've been renting an Airsense 11 and my best settings have been on For Her mode at 9.6-10.6 with EPR at 3. With that machine and those settings, my AHI is nearly always less than .4 (predominately centrals) and I'm mostly able to sleep through the night without any insomnia. Many of my symptoms disappeared or improved EXCEPT that I don't wake feeling rested. I felt like I was 95% of the way there and just needed a little boost to feel rested and energetic during the day. When analyzing my OSCAR data, I noticed that a higher IPAP improves my flow limitations, but I can't go past 10.6 without severe aerophagia and gas pains. So, I did some research and found that bi-level might help me, given that I don't need a high EPAP, but IPAP may need to be higher.

I just started renting an Aircurve 10 VAuto and first used it 8/4/23 at EPAP min 5, IPAP max 11.6, and PS at 4. I went to bed at 10:30p, woke around 3am to pee as usual, then woke again at 5 for seemingly no reason, tossed and turned a while, then woke at 6:30 very groggy and kinda stiff/sore as though I didn't sleep well. My AHI was still low, but much higher than it usually is (.7), and was all centrals. Last night (8/5), I kept everything essentially the same, but changed my TiMax to 4 and moved by Cycle and Trigger to High. Those changes made for more comfortable breathing, lower AHI (.12), and I slept well from 11-5-ish--but I couldn't fall back asleep after that. I feel tired and beat up with sore joints and muscles--definitely worse than when I was on APAP.

I'm wondering how I should go about analyzing my data and trying to optimize BPAP treatment? Any thoughts? I had a handle on APAP, but this bi-level stuff is a whole new world for me. I want to make sure I give it a fair shot before I go back to APAP.

I have OSCAR screenshots I can share, but I saw that y'all have issues with attachment storage so I'm waiting to see if anyone responds first.

Thanks!

For posting OSCAR screenshots here, upload them to imgur.com and post the link in this thread.

Thanks, ChicagoGranny!

Here is a link to my last 3 nights of OSCAR data (8/3, 8/4, 8/5): https://imgur.com/a/WcMtOD8

Can I ask how the doctor determined you had UARS and not another kind of sleep disorder?

Would love to sift through my sleep data and see if I can make this determination myself.

Hi WillieRioli,

I was diagnosed but it's not confirmed, if that makes sense. My sleep study AHI was only .2, but I had about 27 arousals per hour of sleep (based on EEG readings). Barring any other indications of cause (no restless legs, no signs of any other issue) and being highly symptomatic, they diagnosed me with UARS. It seems like more of an assumption than a clear diagnosis, but it tracks, so I'm good with it.

Also, if anyone stumbles across this thread--
The night after this post, I adjusted my VAuto settings to make them more closely mimic my previous Airsense 11 settings, but with just a small bump in pressure support. So while I was previously at Min EPAP: 4 or 5, Max IPAP: 12, Pressure Support: 4-4.5, I changed it to Min Epap: 6, Max IPAP: 11.2, Pressure Support: 3.6, and was able to sleep through the night just fine! I'm guessing the change was too abrupt. Going forward, I'll make slower, more gradual changes. I'm still not feeling fully rested, but everything looks really good in OSCAR.

manders513 wrote: ↑

Wed Aug 09, 2023 4:29 pm

Hi WillieRioli,

I was diagnosed but it's not confirmed, if that makes sense. My sleep study AHI was only .2, but I had about 27 arousals per hour of sleep (based on EEG readings). Barring any other indications of cause (no restless legs, no signs of any other issue) and being highly symptomatic, they diagnosed me with UARS. It seems like more of an assumption than a clear diagnosis, but it tracks, so I'm good with it.

Thanks for sharing. I understand how difficult this topic is to diagnose considering all the variables right. That's interesting because I was diagnosed with moderate obstructive sleep apnea (AHI of 21.7) and given CPAP but both my specialists have never mentioned UARS. My Arousals per hour of sleep are 25.1. Interesting to see how you go on BIPAP, hope you find success