Sherry & Star, your PALS should be able to tell you, even via nods/shakes, whether the IPAP is too high ("getting too much air"), EPAP too high ("hard to breathe against the air"), IPAP too low ("not getting enough air").
PS min (minimum difference between IPAP and EPAP) should be at least 6 for most PALS in late stages, EPAP flat set or max 4 for the most part, unless there is a pre-existing obstruction. I have found many PALS have PS min set too low, EPAP too high or both. IPAP max is often too high. Lungs that have lost capacity can't handle huge blasts of air, and that just makes breathlessness worse. Some of you have target volumes that are set too high as well, resulting in IPAPs you can't handle. Most PALS do _not_ need a backup rate, which can also be exhausting if set too high. Backup rates are often set in lieu of correct settings, in a CYA spirit, I think.There are also settings to make breaths longer, shorter, faster and slower.
As a reminder, to access Trilogy settings if you are locked out, when the machine is off, press and hold the alarm silence button along with the down arrow key for a few seconds. (1) Then, to enable access to settings later while the machine is on, go to Options/Menu Access/Full/OK. (2) Then go to Settings and Alarms to adjust IPAP, etc. I am happy to help anyone make appropriate adjustments to a Trilogy or other machine.