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Can’t get to sleep with the BiPAP machine.
I’ve been recently diagnosed with treatment emergent central sleep apnea. My original sleep study showed server obstructive sleep apnea. The CPAP machine 12-8 then drove the central apnea. The second sleep study determined a 18 in – 12 out with a back up of 12. My problem is I can’t fall asleep with the Bi PAP machine. I’ll go to bed exhausted but the machine with the changing pressures keeps me up. Any suggestions?
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It is important to know exactly which BiPAP machine you have. Only the Philips Respironics Auto/SV is designed to solve complex sleep apnea. The BiPAP S and BiPAP Auto will not. It is my guess that you have been dispensed one of those machines until you fail to have adequate treatment, and insurance will pay for the Auto SV or Resmed Aircurve 10 ASV. I would recommend the latter.

Please reply with what exact machine model you are using, and what the settings are. It will be important that you communicate this difficulty to your doctor if you have not been dispensed the Auto SV. Otherwise, we can help you with settings.

Edit: I see you have a backup rate, so you are likely on the Auto SV or ST. Still need to know the settings, especially mode.
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ResMed AirCurve 10 ST
Mode ST
Pesp. Rate 12
TiMax 2.0s
TiMin .3s

Thanks so much for your help.
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okay so what does using the machine feel like is going on? For me I was feeling like my inhale was being cut short. Try and describe what it feels like while you are trying to go to sleep.
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You need the Auto SV or preferably the Resmed Aircurve 10 ASV. Tell your doctor he got it wrong.

The ST is for COPD or Obesity related hypoventilation. ASV or SV is for complex apnea with centrals. The guy needs to read more.
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(09-13-2016, 06:35 PM)Sleeprider Wrote: You need the Auto SV or preferably the Resmed Aircurve 10 ASV. Tell your doctor he got it wrong.

The ST is for COPD or Obesity related hypoventilation. ASV or SV is for complex apnea with centrals. The guy needs to read more.

Thanks so much for your feedback. I'm new to this whole thing. I had read that ASV was the preferred treatment. I don't know why they changed me from a CPAP to a Bi-PAP. I would have thought the Cleveland Clinic would be on top of the latest technology/treatment. Maybe there is something else going on that I don't know about.
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It's always possible that someone in the supply chain thinks a SV is the same as the ST. It's not. You were issued the wrong machine for your problem. As you can see, I'm not as tactful about it, as you may need to be in approaching your doctor. Please do it as soon as possible, and start with the question, "did you mean for me to be issued a ST machine?"

The ST is a great machine for people with obstructed breathing from pulmonary disease or obesity. When those people fall below a certain number of breaths per minute, or respiratory volume, the machine goes to IPAP mode, increasing pressure longer and ensuring a full breath is taken. Your settings of 18/12 mean that if you fail to take 12 breaths per minute, the machine starts delivering 18 cm pressure. It will never work for complex, central apnea.

An ASV automatically monitors your breathing on a breath by breath basis. If you fail to initiate a breath (central apnea), it delivers up to 25 cm of pressure to induce that breath. It automatically calibrates the pressure and time required to have you breath a normal inspiration, and then releases the pressure to EPAP. It resolves reduced volume breathing, centrals and obstructive apnea. The Resmed machine seems especially well suited to follow your breathing pattern and seems to disappear, even though it is providing pretty aggressive adaptive therapy. The Respironics machine is more adjustable, and will work, but the automatic adaptive functions of the Resmed seems to work better for a lot of people.

I don't know how you deal with this kind of error tactfully, but it's your health and life. You must get this error fixed. My dad used to work in Cleveland Clinic Pediatrics. It is a highly respected organization, but it has also grown into a huge corporate entity. There will be egos involved, but hopefully your doctor(s) want to get this right.
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Thank you for your frankness. I will pursue.
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Now that you're over 4 posts, you can post attachments and links. It would be interesting to see how that ST is responding to your needs, or failing to do so. Sleepyhead software is free and a link is at the top of the forum. Here is a link to teach you how to organize the data https://sleep.tnet.com/resources/sleepyhead/shorganize and how to post it. https://sleep.tnet.com/reference/tips/imgur

Hopefully you will stick around and we will learn how this turns out, and be able to help each other. One other thing. You should get paper copies of your sleep studies and prescription. It's the best clue to see if what you received was your doctor's intention, and it comes in handy if you ever need supplies in the future.
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Hi StrugglinginOhio,
WELCOME! to the forum.!
It's great to hear that you are going to pursue the right machine for your needs.
I wish you good luck.
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