new tritation working so far!

I just had my first anniversary sleep study last Sunday night. First titration was July 2006. I had been on bi-pap auto, and talked the doctor into starting me during the titration at 11 IPAP and 7 EPAP, a fairly common 90% pressure for me. He agreed but felt like it should be 12 and 8. Well, guess what? Most of the night I spent at 12-8. When the tech tried 13 it woke me up, so he backed it down to 12. The doctor told me to try my machine at bi-level, NOT auto, and use 12-9 to catch that one apnea I had. He thought the auto might be causing me to wake up a bit, even if I didn't notice it.

I just checked my data for the 2 nights at those pressures, and WOW, zero AHI both nights!

I have had zero AHI from time to time for several months, but never 2 nights in a row.

Maybe this doc knows what he is doing!

(This is the doc who let me set my own RX on the machine and said he loves self-sufficient people and especially those who are involved in their treatment.)

Now if I can just beat the insomnia problem.....

Catnapper

Congratulations!!! Ain't it great when you get it right.

Catnapper wrote:The doctor told me to try my machine at bi-level, NOT auto, and use 12-9 to catch that one apnea I had. He thought the auto might be causing me to wake up a bit, even if I didn't notice it.

I just checked my data for the 2 nights at those pressures, and WOW, zero AHI both nights!

I have had zero AHI from time to time for several months, but never 2 nights in a row.

I'd bet that the real key to the zero AHI you're getting is that you've set the EPAP higher now. That, moreso than that you've switched from auto bi-level mode to bi-level, imho. I've always felt that the EPAP is the pressure that's the most important to get set right and "up there enough to prevent apneas in the first place" with bipaps. I think the same way about the "minimum" pressure setting in autopaps.

If you want to experiment a bit to see what's realllly giving you those low AHI's now, set the machine to auto bilevel again, but this time set your IPAP at 20 and your EPAP at 9. Set the Max PS at 8. Set Bi-flex at 3 (my personal preference) or 2. The machine will start out the night using IPAP 11 / EPAP 9 and bi-flex will give a nice softening to the beginning of the exhale yet let your EPAP pressure of 9 back in before exhale is finished.

Another experiment, almost same settings: auto bi-level mode, IPAP 20, PS 8, Bi-Flex 3 (or 2), but set EPAP at 10. Machine will start out the night using IPAP 12 / EPAP 10.

Bet either of those (especially the second one) will yield equally low AHI's as what you're getting in bi-level mode at IPAP 12 / EPAP 9 , yet you'll still have more of either I/E available if ever needed on occasions.

If after trying those experiments for about a week each, you find that you feel better using bi-level 12 / 9 then that's the way to go. It's nice you have a machine you can tweak several different ways.

Hi rested gal

Thanks for the tips. You know I like to experiment with the treatment to get it right. I will try your suggestions in the weeks ahead. The changes are subtle, but I can see why they might do the trick.

Thanks again. You always rescue me, and I think of you as rescue gal!

Catnapper - Joanie