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Bought New BiPAP - Settings ideas
#1
Bought New BiPAP - Settings ideas
As I've stated in replies to some posts I've wanted to buy a back up machine and because of my RERA count I decided on a BiPAP. This morning I pulled the trigger on a 'gently used' Respironics DS760 BiPAP from Supplier #2 for a very good price. According to them my machine should deliver within 10 days though my experience with Aussie customs suggest a lot longer.

I'll be able to attach it to the humidifier that came with the new DS560 I already own and the 760 works with a heated hose.

When it arrives I'll have to set it up and I have some queries regarding doing this process. In trying to lower my RERAs I have raised the minimum pressure over a period of time from 10.0 to 13.0. What I've noticed is that raising the minimum seems to raise the maximum and I felt far more comfortable at a lower minimum. When I was on 10 there were nights where I'd barely reach 12 though I did go past 14. I thought that when I eventually got to 13 that the range would be narrow but this has not proved to be the case. I've had nights where I've gone over 16 and even had an 18. The RERAs have come down but not to a point where they drop below 1.0. I'd like to eliminate them entirely as I feel that they do affect my sleep.

When the BiPAP arrives what settings should I use to start with regarding IPAP, EPAP and pressure support?
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#2
RE: Bought New BiPAP - Settings ideas
Have you read the clinical titration manual? it may help some. although a different brand the resmed clinical titration manual is ok too.
http://incenter.medical.philips.com/docl...%3d9792335
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#3
RE: Bought New BiPAP - Settings ideas
I agree your settings will come from the principles of BiPAP titration. Your EPAP pressure will be just high enough to prevent obstructive apnea, and pressure support is used for hypopnea, flow limitation and RERA. In your case with the Philips there is an automatic and variable pressure support capability, so I suspect you will start with a range, and observe results. In any event, I would not expect EPAP to be more than 8.0 with a likely pressure support of 4 to 6. That will give a starting pressure of 12/8 and it could increase from there based on what IPAP limits you choose to implement. What CPAP pressure resolved OA?
Sleeprider
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#4
RE: Bought New BiPAP - Settings ideas
(04-20-2017, 08:02 AM)Sleeprider Wrote: I agree your settings will come from the principles of BiPAP titration. Your EPAP pressure will be just high enough to prevent obstructive apnea, and pressure support is used for hypopnea, flow limitation and RERA. In your case with the Philips there is an automatic and variable pressure support capability, so I suspect you will start with a range, and observe results.  In any event, I would not expect EPAP to be more than 8.0 with a likely pressure support of 4 to 6.  That will give a starting pressure of 12/8 and it could increase from there based on what IPAP limits you choose to implement.   What CPAP pressure resolved OA?

My CPAP titration study suggested that 13 was the CPAP pressure that would resolve OA. However, using APAP this has been lower. When I get the machine I'll start with 12 IPAP and 8 EPAP and see what an automatic PS will do. Have I understood your suggestions correctly?

It's a start in the right direction and I appreciate your valuable input. Your comments about BiPAP possibly resolving my RERA issues prompted me to buy a BiPAP as a back up machine. Regardless of the result I now have a back up that will still do APAP but I'm sure that the BiPAP will significantly improve my therapy.
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#5
RE: Bought New BiPAP - Settings ideas
What has your observation been in regards to pressure and OA events. CPAP titration attempts to resolve all events with one pressure, and so it is set at the pressure where hypopnea and other issues seem to be well treated. EPAP pressure on a bilevel can be lower, but should be near the pressure where OA is treated. It isn't going to take long to figure it out once you use 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.
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