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BiPAP Pressure in the morning
#1
I have tried both Respironics and ResMed bipap machines and the machine pressure is still very high in the morning after I woke up. I would assume the machines can sense that I have waken up and lower the presssure to around 4. Any have same experience?
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#2
Hi apdtap,
WELCOME! to the forum.!
Hang in there for answers to your question and best of luck to you.
trish6hundred
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#3
(12-04-2013, 10:40 AM)apdtap Wrote: I would assume the machines can sense that I have waken up and lower the presssure to around 4. Any have same experience?
These machines have NO way of telling when you are awake or when you are asleep since they have no EEG. So they're not going to magically lower the pressure just because you wake up.

On the PR machines if you have the ramp feature set up, you can just hit the ramp button and it will reduce the pressure to the starting ramp pressure. On either the PR System One BiPAP Auto or the Resmed S9 VPAP Auto, if you turn the machine off and back on, it will lower the pressure back to the minimum settings for the Auto range.

The only brand of PAP machine that I know of that has an algorithm that attempts to determine when the user is likely awake and lowers the pressure because it thinks the user is likely awake is the Fisher and Paykel ICON Auto with SenseAwake. How well SenseAwake works in practice seems to vary tremendously from user to user because SenseAwake is based on nothing more than a change in breathing patterns. And sometimes the change in breathing patterns when a person goes into REM is very close to the change in breathing patterns when a person wakes up. So the ICON Auto doesn't always get it right: There are times when you're awake and the ICON still thinks you're asleep and there are times when you're going into REM and the ICON thinks you're waking up; and lowering the pressure just as you're going into a REM cycle can be counterproductive.

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#4
(12-04-2013, 10:40 AM)apdtap Wrote: I would assume the machines can sense that I have waken up and lower the presssure to around 4. Any have same experience?
Hi apdtap
I use APAP, not bipap
Most morning, LCD display minimum set pressure but checking pressure graph, pressure does not vary a great deal through the night


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#5
Thank you for all the reply. But I believe the machines can detect "apnea" or "blocked air way", hence if I am awake and breathing nomally, the "top line" machines shoud be smart enough to reduce the presure as my aire way is not blocked. If the machines cannot even detect this, I wonder how good those "auto" or "bi-level" machines are over the "basic auto" CPAP. I will be seeing my doctor again in Jan but I hope to get more of your feedback too. Thany you again.
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#6
(12-04-2013, 07:19 PM)apdtap Wrote: Thank you for all the reply. But I believe the machines can detect "apnea" or "blocked air way", hence if I am awake and breathing nomally, the "top line" machines shoud be smart enough to reduce the presure as my aire way is not blocked. If the machines cannot even detect this, I wonder how good those "auto" or "bi-level" machines are over the "basic auto" CPAP. I will be seeing my doctor again in Jan but I hope to get more of your feedback too. Thany you again.

your profile data shows that you are at a pressure of 14 and that means your pressure is always 14 whether you are having an event or not.

Specifically what CPAP machine are you using?

Hope this makes sense to you.
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#7
The machine does not know if you are asleep or awake, yes. And your airway is not necessarily all the way open just because you are awake. When you first wake up, unless you are one of those obnoxious morning people, you are laying there still groggy from sleep. You do not yet have full control over your voluntary muscles. This includes your throat. They are still relaxed in sleep like the rest of you.

You are swallowing (closed airway). Maybe yawning. Maybe drifting in and out of sleep. If you are on your back, gravity is not your friend.

So until you sit up and are full awake and turn off the machine, that beast is going to assume you are asleep.
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#8
Thanks for the reply. My main point is whether those high end machines can find the best EPAP IPAP quickly. I will try and inform after a few more days. My experience in the morning so far is that they cannot?
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#9
(12-05-2013, 12:02 AM)apdtap Wrote: Thanks for the reply. My main point is whether those high end machines can find the best EPAP IPAP quickly. I will try and inform after a few more days. My experience in the morning so far is that they cannot?

We might be able to help you more if you can provide a little more information about what machine you are using and what your settings are. My your profile, it looks like you are using a machine in CPAP mode (set pressure) when you are sleeping.
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#10
(12-04-2013, 07:19 PM)apdtap Wrote: Thank you for all the reply. But I believe the machines can detect "apnea" or "blocked air way", hence if I am awake and breathing nomally, the "top line" machines shoud be smart enough to reduce the presure as my aire way is not blocked. If the machines cannot even detect this, I wonder how good those "auto" or "bi-level" machines are over the "basic auto" CPAP. I will be seeing my doctor again in Jan but I hope to get more of your feedback too. Thany you again.

The resmed auto algorithm is pretty simple as I understand it. Basically, when it detects you are having breathing problems, it jacks up the pressure, and then lets it lower very, very slowly. It does not consider whether you are breathing well or not -- it just lets the pressure down very slowly as long as it does not detect breathing problems. So if you are waking up shortly after having an apnea, it makes sense that the pressure might still be high. You should be able to figure out what is going on by looking at a chart of your pressure. Is the high pressure bothering you? Because if not, it really shouldn't matter. As mentioned, the machines have no way of detecting whether you are awake.

adptap Wrote:Thanks for the reply. My main point is whether those high end machines can find the best EPAP IPAP quickly. I will try and inform after a few more days. My experience in the morning so far is that they cannot?

Unfortunately no, it's not absolutely optimal, though most people find auto to be more tolerable as it allows you to spend more time at a lower pressure than just fixed pressure.

edit: I assumed you were using an auto bipap. If you're not, you're just at a fixed pressure, the machine will never change it.
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