Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

BIPAP making my CSA worse
#31
RE: BIPAP making my CSA worse
One step at a time, but I'll let SleepRider address those.
Post Reply Post Reply
#32
RE: BIPAP making my CSA worse
I also find this very interesting, (with previous settings ps4, 6/13)
towards the end of some sessions the pressure is ramping up while its clearly leaking,

I guess It's going out my mouth? It's a nasal pillow, or has it come loose.
But looking at the flow rate, it's very consistent during this, hardly any variations, no apneas
I had nearly a 15 minute duration like this

[Image: IChUMRn.jpg]
Post Reply Post Reply
#33
RE: BIPAP making my CSA worse
Regarding the question on TiMax setting, you're chart earlier shows a median inspiration time of 1.26 seconds and maximum inspiratory time of 1.86 seconds, so in that session, you never hit the TiMax. TiMax simply acts as a timer for cycling back to EPAP in the event you don't spontaneously cycle to exhale. Setting it longer than needed does not usually have an adverse effect on therapy as the machine will continue to cycle based on your spontaneous breathing pattern. We can usually spot an individual that needs a longer TiMax because the inspiration time frequently equals the set TiMax. Provided that person is not affected by COPD we often increase the TiMax setting. With COPD, we try to preserve expiration time and keep the shorter TiMax. Sorry for all the details. Increasing your TiMax should have no affect on your therapy and if you want to try 2.4 seconds, have at it.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#34
RE: BIPAP making my CSA worse
(02-04-2023, 09:15 AM)Sleeprider Wrote: Regarding the question on TiMax setting, you're chart earlier shows a median inspiration time of 1.26 seconds and maximum inspiratory time of 1.86 seconds, so in that session, you never hit the TiMax. TiMax simply acts as a timer for cycling back to EPAP in the event you don't spontaneously cycle to exhale. Setting it longer than needed does not usually have an adverse effect on therapy as the machine will continue to cycle based on your spontaneous breathing pattern. We can usually spot an individual that needs a longer TiMax because the inspiration time frequently equals the set TiMax. Provided that person is not affected by COPD we often increase the TiMax setting. With COPD, we try to preserve expiration time and keep the shorter TiMax. Sorry for all the details. Increasing your TiMax should have no affect on your therapy and if you want to try 2.4 seconds, have at it.

I really appreciate all the input, I figure, if I have this, I might as well become an expert in it all

Any idea about the leak chart above?

(02-03-2023, 09:43 PM)Gideon Wrote: One step at a time, but I'll let SleepRider address those.
Here's last night's attempt at PS 1, Plenty of hypopneas for the first time
[Image: GeXk4jr.jpg]


zoomed in
[Image: 6VknUZB.jpg]
Post Reply Post Reply
#35
RE: BIPAP making my CSA worse
The leak chart shows as steady increase in the leak rate from near zero to almost 20 L/min over 13 minutes. The VPAP compensates with an increased flow rate to maintain steady pressure of 10/6, and respiration was unaffected by this leak. Most likely a leak of air through the mouth that gradually increased and would have eventually disrupted your sleep, but that is not apparent from the flow rate.

Your trial at PS 1 does not seem to significantly increase AHI, but more hypopnea than central. It's hard to know if this is flow limited, obstructive hypopnea or based on a more central apneic threshold. The latter seems more likely with the variable breathing volume. Aside from having more H events than usual, we need your qualitative input on whether this was better or worse than the previous attempts. You are at 2:41 which is an improvement, but still short of the required 4-hours.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#36
RE: BIPAP making my CSA worse
(02-04-2023, 11:12 AM)Sleeprider Wrote: The leak chart shows as steady increase in the leak rate from near zero to almost 20 L/min over 13 minutes. The VPAP compensates with an increased flow rate to maintain steady pressure of 10/6, and respiration was unaffected by this leak. Most likely a leak of air through the mouth that gradually increased and would have eventually disrupted your sleep, but that is not apparent from the flow rate.

Your trial at PS 1 does not seem to significantly increase AHI, but more hypopnea than central. It's hard to know if this is flow limited, obstructive hypopnea or based on a more central apneic threshold. The latter seems more likely with the variable breathing volume. Aside from having more H events than usual, we need your qualitative input on whether this was better or worse than the previous attempts. You are at 2:41 which is an improvement, but still short of the required 4-hours.

I remember I kept waking up with an extremely dry mouth, at some point I tried tape on my mouth too, but couldn't stay asleep. It was not restful at all, but was also a stressful night to start sleep, with some unknown constant noise disturbance. It seemed to me every time I started to doze off my mouth would open and I'd wake up with air blowing out, I think the tape kept coming off on the edges of my mouth as well, allowing the air out and waking me up. I had a lot of air in my stomach from this attempt as well.

I also don't think I fell asleep until around 3:40am .. extreme headache today, but I did probably get 6 hours sleep.

I won't have access to using a mask for about another week, if that might help
Post Reply Post Reply
#37
RE: BIPAP making my CSA worse
What we see with the PS=1 is that yes, your "BiLevel" was "causing" your Centrals with the PS of 4. BTW I did expect some increase in hypopnea and flow limitation. This did have a very significant reduction in the CA events.

Please when you post a second image, please keep the left sidebar so we can see that it was or was not from a current data. Thanks.

You need another 1hr 20 minutes to get to a compliance level so try to get that by hook or crook.

Two changes
decrease Min EPAP to 5 as you had no OA events or if you want go all the way to 4
and Increase PS to 2

Now tell us which settings feel better and why.
Post Reply Post Reply
#38
RE: BIPAP making my CSA worse
Would recommend a full face mask that is more tolerable for you to help with leaks. Also a second sleep study if possible.
Post Reply Post Reply
#39
RE: BIPAP making my CSA worse
accidental dup
Post Reply Post Reply
#40
RE: BIPAP making my CSA worse
ps of 2 and ipap of 5
Extreme brain fog today, I definitely sleep better without the bipap
tossing and turning all night, and a belly full of air, but less than before.

[Image: iQFVeLT.jpg]
Interesting to note, I wore my muse band to monitor my eeg:
~ 3:40am-4:00am, 5:20am-5:45am, 6:30-7:30am was deep sleep
I only had a half hour of rem from 6:00-6:10am and 7:30-7:50am, it seem my REM times coincide with leaks/apneas
heart rate with under 60bpm most of the time, as low as 49 around 6:30am, not sure how accurate that is for any spikes
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Apnea has gotten worse recently, I have no sleep study, can I just buy a cpcp? replayablecontent 12 249 03-27-2024, 12:38 PM
Last Post: replayablecontent
  [Equipment] Much worse sleep with ResMed? Jookia 8 184 03-25-2024, 11:16 PM
Last Post: staceyburke
Sad help! bipap making things worse Sleepyroshi 11 595 03-23-2024, 01:40 PM
Last Post: Sleeprider
  CPAP making me feel very tense while I'm asleep jlpool 15 836 03-16-2024, 05:34 PM
Last Post: jlpool
  Feel worse on lower EPR even though AHI seems the same? LarkinM 10 330 03-14-2024, 10:53 PM
Last Post: SarcasticDave94
  Which biPAP? HalfAsleep 9 259 03-14-2024, 09:04 AM
Last Post: HalfAsleep
Gross Need help interpreting data and making adjustments tiredandexpired 13 589 03-01-2024, 10:07 PM
Last Post: TechieHippie


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.