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BiPap causing hi AHI
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brianwood619 Offline

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Post: #1
BiPap causing hi AHI
Ok so I'm almost two weeks into BiPap and I am noticing my AHI has gone from .3 on CPAP to anywhere between 20 and 30 on BiPap. The machine has constantly been pushing 22-24 on pressure each night and I am waking up at least twice to my mask burping from pressure. my son has consistently been at 18-22 on his pressure but his ahi has been less than 1.0 since starting therapy with no complications......any ideas why my ahi has climbed so much
05-07-2015 07:51 AM
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Sleeprider Online
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Machine: Resmed Aircurve 10 Vauto
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CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Location: Where they make Respironics

Post: #2
RE: BiPap causing hi AHI
What are all the settings? Min EPAP, Max EPAP, Pressure support, IPAP etc.?
What events make up your AHI now, CA, H or OA?

I suspect your AHI is CA and H, and you are too well ventilated, but please post more information.

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05-07-2015 10:25 AM
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brianwood619 Offline

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Posts: 171
Joined: Jan 2014

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 16-22cm/h2o
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Peaceful Acres

Post: #3
RE: BiPap causing hi AHI
Mode: VAuto
Max Ipap: 25.0
Min Epap: 8.0
PS: 9.0
Ti Max: 2.4
Ti Min: 0.3
Trigger: Med
Cycle: Medium

This is what it was set at from the sleep lab prior to going home.
All apneas have been central
(This post was last modified: 05-07-2015 10:56 AM by brianwood619.)
05-07-2015 10:55 AM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
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Post: #4
RE: BiPap causing hi AHI
(05-07-2015 10:55 AM)brianwood619 Wrote:  Mode: VAuto
Max Ipap: 25.0
Min Epap: 8.0
PS: 9.0
Ti Max: 2.4
Ti Min: 0.3
Trigger: Med
Cycle: Medium

This is what it was set at from the sleep lab prior to going home.
All apneas have been central

So, IPAP will range from 17 to 25. While the relationship of:
IPAP-EPAP=PS=9 will be held.

So, EPAP will range from 8 to 16.

Keeping in mind that I have no formal medical education, I would guess that with that wide split in PS, you are blowing off too much CO2 resulting in suppression of the central ventilator drive in the brain -- end result, central apneas.

What is the duration of flagged centrals?

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05-07-2015 11:26 AM
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brianwood619 Offline

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Posts: 171
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Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 16-22cm/h2o
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Peaceful Acres

Post: #5
RE: BiPap causing hi AHI
So the pressure support could be causing this?
05-07-2015 12:08 PM
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #6
RE: BiPap causing hi AHI
That was my original hunch. I think you should first give your doctor an opportunity to advise on this. Your pressure support is too high and you're being over ventilated. For most people in normal respiration, a PS of 5.0 is plenty to provide respiratory support without over-ventilating. By the time PS equals or exceeds 9.0 the machine breaths for you. If you are not treating chronic central apnea or complex apnea (this is not a ASV), you will over ventilate and experience centrals for the reason explained by justMongo.

And for the record, like JM, this is JMHO not medical advice.

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05-07-2015 12:42 PM
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brianwood619 Offline

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Posts: 171
Joined: Jan 2014

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 16-22cm/h2o
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Peaceful Acres

Post: #7
RE: BiPap causing hi AHI
Thanks for the input, I'm a veteran on cpap and a newbie on biPap...lol
05-07-2015 02:37 PM
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vsheline Online

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CPAP Pressure: 15 EPAP, PS 5-10
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Post: #8
RE: BiPap causing hi AHI
(05-07-2015 02:37 PM)brianwood619 Wrote:  Thanks for the input, I'm a veteran on cpap and a newbie on biPap...lol

Hi Brian,

I suggest lowering PS to 6 and consulting with your doctor.

Unless you have a lung disease/condition, having your Pressure Support at 9 seems very high to me. In addition to causing too many Central Apneas, it might also be raising your SpO2 too high. SpO2 is the percentage of O2 Saturation as measured using a Pulse Oximeter. I think an ideal range to stay in while sleeping would be 94% to 96%, but some think anything above around 90% is usually okay. I think 88% is considered to be too low.

When using Pressure Support higher than around 5, I suggest occasionally wearing a recording Pulse Oximeter. I think Supplier 19 sells them. (A link to the Supplier List is at top of each forum page.) The kind that are worn like a watch with separate finger sensor cup are more comfortable to wear all night and I think provide more consistent measurements.

Here are some articles on the dangers of having too much O2 in our system, which I think can be caused by using too much Pressure Support.

http://www.emsworld.com/article/10915304...uch-oxygen

http://www.ems1.com/columnists/mike-mcev...ygen-hurt/

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 05-09-2015 02:12 AM by vsheline.)
05-09-2015 01:55 AM
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MobileBasset Offline

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Post: #9
RE: BiPap causing hi AHI
I had horrible sleep with high CA events when my PS was originally set to 6. I reset the PS to 4 and it all cleared up. When it was too high I could feel the pulsing of the pressure changes.
05-19-2015 01:28 PM
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