Trying To Get AHI to Reasonable Level on BiPap Auto

Hi

About a week ago, my Dr. switched me over from a Respironics Auto CPAP to a Respironics Auto BiLevel to see if that might reduce my Aerophagia Issues (nothing else seems to have worked)

I'm ok with interpreting the graphs from my APAP machine but not yet used to the EncorePro graphs from my Auto BiLevel.

Can anybody shed some light on what might be going on here ?

This is typical of the results from the last 4 or 5 nights - I don't understand why the AHI value is so high - is there a reason why the pressures are not going to a higher value to deal with some of these events ? My leak level seems to be fine, so I don't think it's a leak issue.

FYI I am using Swift LT & although my Aerophagia issues are not so bad, they are still present.

Would appreciate any input!

Thanks
Mike

23 September:




22 September:

Two possibilities that come to MY mind are insufficient minimum pressures or positional sleeping (do you sleep on your back?)......or a combination of both.


Den

Hi mike, I agree with Den, if you have no underling medical problems. I would set my Epap to 8, leave Ipap along, set SP to 6 and Biflex to 3 and see if that doesn't help eliminate some of the OA's. Everything else looks good.

Dan

sleepngo wrote:Hi mike, I agree with Den, if you have no underling medical problems. I would set my Epap to 8, leave Ipap along, set SP to 6 and Biflex to 3 and see if that doesn't help eliminate some of the OA's. Everything else looks good.

Dan

Hi Dan, Den

Thanks for the feedback.

So currently, looks like my original machine settings are:

Auto BiLevel
Max IPAP = 17.0
Min EPAP = 7.0
Max Pressure Support = 5.0
BiFlex Setting = 1

So you are suggesting that I increase "Min EPAP = 8.0" ?

I need to do some research on here, but curious why there are NO "MIN IPAP' or "MAX EPAP" settings on the machine ?

Thanks
Mike

Mike, your Ipap looks good, it's taking care of the HI's, you need to bring up the Epap to take care of the OA's. If Epap of 8 helps to bring them down, but not low enough, than try moving it up higher. The only problem you have to worry about is if you have pressure related centrals, than all bets are off. What is you original titrated pressure? You should try to set Epap about 2cm lower than your titrated pressure, your Ipap can be set as high as you want. Hope this helps.

Dan

mymontreal wrote:I need to do some research on here, but curious why there are NO "MIN IPAP' or "MAX EPAP" settings on the machine ?

Because this are both decide by the PS - pressure support - which in Respironics has a minimum of 2.

So, the minimal IPAP will be, by definition EPAP +2
And the maxumal EPAP will be, by definition, IPAP - 2.

Pressure support can vary between 2 and 8, you doc. has limited the maximum variation to 5.

O.