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 pressures at maximum
#1
BiPAP pressures at maximum
   
Dragging the mouse along the AHI graph - which you cannot do with this online version of course - I see that I am almost always at maximum EPAP and IPAP. 

The seemingly obvious conclusion is that I need to increase pressures - is that correct?
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: BiPAP pressures at maximum
I've honestly lost track, whatever the reason for the Respironics System One 60 Series, I have forgotten why this machine. Even so, it's not enough pressure as is. You still have too many events, especially Hypopnea, which means partially treated. Respironics machines are slow responders and need you pretty much parked on your correct pressure. Yes both pressures need to go up. If you're not comfortable with this pressure increase, they need to get you something else.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#3
RE: BiPAP pressures at maximum
I believe you show positional apnea. Positional apnea is when your chin drops down to your Sternum cutting off your airway. NO PRESSURE can help and your machine is raising pressure trying to help IT CANNOT.

Please look in my signature for a link on collars. They have helped many on this site.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
Post Reply Post Reply
#4
RE: BiPAP pressures at maximum
This is in ST mode which is a manual mode, "S" for Spontaneous and most of your night is no Triggered breathing meaning that you did not use the trigger much.
This is why your pressure is constant.

FYI your PS =6 which should be very good for your hypopneas, but isn't.
Your hypopneas are clustered. These 2 facts point to you tucking your chin. The fix is a soft cervical collar, see the link in my signature for an indepth discussion. It is surprisingly common.
When looking at OSA your machine is set up wrong, you likely need to reduce both pressure and PS. Your settings, and the ST machine are setup for someone with significant pulmonary disease such as COPD or Asthma. So before we go and suggest changes, any change except for the collar I mentioned and assuming you have a competent doctor, what significant disease do you have and are treating besides apnea?
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: BiPAP pressures at maximum
Yes it could be at that Stacey. And unless that's mask disconnects to end therapy, you've gotten some bad leak rates as well.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#6
RE: BiPAP pressures at maximum
(08-17-2021, 03:25 PM)Gideon Wrote: This is in ST mode which is a manual mode, "S" for Spontaneous and most of your night is no Triggered breathing meaning that you did not use the trigger much.  
This is why your pressure is constant.

FYI your PS =6 which should be very good for your hypopneas, but isn't.  
Your hypopneas are clustered.  These 2 facts point to you tucking your chin.  The fix is a soft cervical collar, see the link in my signature for an indepth discussion.  It is surprisingly common.
When looking at OSA your machine is set up wrong, you likely need to reduce both pressure and PS.  Your settings, and the ST machine are setup for someone with significant pulmonary disease such as COPD or Asthma.  So before we go and suggest changes, any change except for the collar I mentioned and assuming you have a competent doctor, what significant disease do you have and are treating besides apnea?

Actually, all ST machines are fixed pressure in either S or ST modes.  We can see patient spontaneous breaths are 91% so the other 9% are triggered.  Pressure does not change in ST mode and there is no Easybreathe algorithm available.  I think positional apnea is possible in this case, and good pickup on the clustering. The real answer to the question posed by Chalkie, is your pressure is always at the maximum because there is no auto-pressure algorithm with this machine. It is fixed EPAP and IPAP and has a spontaneous or spontaneous/timed mode.  It is currently the dumbest advanced bilevel on the market, and I can't wait for it to be displaced by the ST-A with iVAPS.
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
#7
RE: BiPAP pressures at maximum
Ah yes, square waves, high then low pressure because that's all it can do. Doc needs a dope slap for this one.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: BiPAP pressures at maximum
Thanks for all the replies. I actually went to the clinic today and after reading the thread am now confused as to whether pressure needed to go up or down.

They put the pressure up to 14-20. The clinician checked the data said there is significant mouth breathing. She is tallking about a full face mask if the pressure rise does not work.

I recently changed masks and leaks are way down: now <10% rather than >40% as they often were. Speikes are probably down to trips to the bathroom with the machine running.

I do use an SCC. If chin tucking is the issue it is not doing the job. I am going to re-read the Wiki to see if there is anything I can do here. I do have a long neck so wonder if the SSC is wide enough.

I was put on the ST to treat complex apnoea. I do not have COPD or any lung disease.

I want an ASV - as I have been told this BiPAP is causing centrals - but have been told no new machines are available right now because of the Respironics safety notice. However some nights central are only around one per hour and it is all hypopneas so I don't see how centrals are such an issue.

@Dave do you mean the machine can and should be used in a different mode, i.e. not manual?

Could there be another explanation for the glut of hypopneas? Do pressures really need to rise?
Post Reply Post Reply
#9
RE: BiPAP pressures at maximum
Hypopnea can be obstructive or central. Obstructive hypopnea generally appears flow-limited with flat inspiratory peaks and a relatively long inspiration time, while central hypopnea appears as normal respiration but diminished volume. The only way I know of to interpret that is a close examination of the flow rate. As far as no machines being available due to the recall, I believe your PRS1 60 Series BiPAP ST is also affected. https://www.respshop.com/recall/Affected...rlist.xlsx It is not just the Dreamstation but also the System One machines.
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
#10
RE: BiPAP pressures at maximum
From me, I don't believe I mentioned a mode change. However a machine change to ASV would be good as you've mentioned the Central Apnea. As Sleeprider mentioned earlier, it's probable that they're trying to treat Central events with the dumb ST instead of ASV. ST use for Centrals is an outdated treatment, with ASV out there.

Disregard my suggestion early on about increasing pressure. It's the wrong direction. There's been revealed info I didn't know at the beginning of the thread.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  BiPAP ST to ASV - Optimizing fikus56 110 2,256 10-06-2021, 09:21 PM
Last Post: SarcasticDave94
  Need help with asking for BiPAP from doctor. blancobonzo 11 303 09-08-2021, 07:40 AM
Last Post: Sleeprider
  Runaway Pressures, CAs, Horrible Sleep wantingsoundsleep 10 300 08-31-2021, 07:32 AM
Last Post: wantingsoundsleep
  Self Titration of a Bipap help? Zoltyzolt 1 143 08-30-2021, 07:52 AM
Last Post: Sleeprider
  [Pressure] Danger Involved - Changing your own CPAP pressures SuperSleeper 112 40,183 08-29-2021, 11:34 PM
Last Post: cathyf
  Mask Suggestion for High Pressures upsman 3 188 08-16-2021, 09:38 PM
Last Post: SarcasticDave94
  My doctor finally agrees...High therapy pressures can increase apnea events S. Manz 3 354 08-05-2021, 10:49 AM
Last Post: clownbell


New Posts   Today's Posts






About Apnea Board

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