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[Equipment] Phillips Respironics BIPAP Dream Station
#1
Phillips Respironics BIPAP Dream Station
I just got this machine on February 3. The problem is, it is forcing me to inhale and exhale faster then I need to. I get up bloated and feeling lightheaded. I don't know what setting is causing this. I called my doctor and I'm waiting for him to call me back. But in the meantime, I get a bad nights sleep. If anyone is familiar with using this machine and can tell me what setting I need to adjust.
Thank you, Howard
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#2
RE: Phillips Respironics BIPAP Dream Station
The first thing we need is what your machine is set to, but at a quick guess check that if flex is on turn it off
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#3
RE: Phillips Respironics BIPAP Dream Station
Howard can you tell us precisely which machine you have? The BiPAP range includes Auto Bipap, Bipap Pro, Bipap AutoASV, Bipap AVAPS, Bipap S/T and possibly others. All are referenced by a part number which (in the American version) looks like DSX500S11 or DSX1030T11 or some variation on that theme. There is a label on the bottom - make sure you remove the humidifier tank before turning the machine over!

Then, as jaswilliams said, let us know the settings.
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#4
RE: Phillips Respironics BIPAP Dream Station
Dream Station BIPAP S/T. It is set to S mode, and Flex is off. EPAP 26, IPAP 17. BPM 12, Ti 0.5. My other machine was a System One and  didn't have a Flex Mode, so I don't know about it. The company that brought over the Dream Station told me my problem could be the Flex Mode, but it isn't enabled as I just checked.
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#5
RE: Phillips Respironics BIPAP Dream Station
Thanks for the info. I'm by no means an expert on Philips machines but I understood there is no backup rate applied in S mode. So the key parameter which is driving your breathing rate would be the Rise and/or Ti settings. Rise time is the amount of time it takes the device to change from the expiratory pressure setting to the inspiratory pressure setting. Ti controls the length of time the machine gives you for inhalation. You should be able to slow the machine's rate by increasing Ti - at a guess I would say you should double it. You can also adjust the rise time. A setting of 1 is the fastest rise time while a setting of 3 is the slowest.

Hopefully somebody more familiar with these machines will be along shortly, but this should give you some basis to experiment in the meantime.
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#6
RE: Phillips Respironics BIPAP Dream Station
I assume your correct settings are S-mode IPAP 26, EPAP 17, which is a presure support of 9.0 cm. That is enough presure support to fully replace spontaneous effort and perform all breathing work for you. S mode does not use he timed breath in ST, but with that much pressure support I would not be surprised if you are using ST mode. Those are high and intrusive pressures. What are you treating? Do you have a diagnostic or titration sleep study? If you could post more details, we could put this kind of therapy in context or perhaps suggest better alternatives. The Philips ST is about as uncomfortable of a dinosaur as there is on the market, and the kinds of pressure you are dealing with suggest some kind of chronic hypoventilation or COPD.
Sleeprider
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#7
RE: Phillips Respironics BIPAP Dream Station
I’m sorry but in S/T Mode IPAP 26, EPAP 17. No COPD. I had a sleep study done in 2015 @ the hospital. Then the numbers were IPAP 22, EPAP 17. But the AHI number was in double digits. So in IPAP had to keep being increased by one digit until my AHI dropped to low AHI. Also have daytime sleepiness because I was undiagnosed for about twelve years. So my sleep and wake receptors have been reversed. So I was put on Provigil to stay awake during the day. If I didn’t take it, it had the same affect as Narcolepsy, where you just fall asleep suddenly. Seems like every time I need a refill, OptimRx asks for authorization for the medication, then be home to sign for it. Even though I have the key to my mailbox.
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#8
RE: Phillips Respironics BIPAP Dream Station
I would recommend a new titration study. Back in 2015 they may have seen central apnea and kept addng pressure. Your machine then and now does not identify the type of apnea. There is a good chance you have complex or central apnea, and if so, a very different machine is appropriate. You are using your ST like a ventilator, and you are totally dependent on it with these pressures.

You have not achieved efficacy with these machines and a new machine is not the answer without a good look at what is being treated. Let's ask your doctor to get it right. Ask for a titration study. Let's find out if you are having central apnea that is being hidden by this ST, but should be treated at low pressure by ASV. If you have copies of the old sleep studies and can redact personally identifying information, it would help if you post those results. I just strongly suspect you are on the wrong machine.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#9
RE: Phillips Respironics BIPAP Dream Station
Thank you all for your advice. I had recently taken the Phillips System One BIPAP S/T apart for a complete cleaning. There was a lot of white powder inside and on the blower motor. Every two hours the machine would shut down and the alarm would go off. So I believe since this machine was 4 years old, that’s why the IPAP pressure had to continually go up by one digit. That machine works fine now, but will use it as a backup. My insurance was sending out a Dream Station BIPAP S/T. I have now changed some settings. I put it in S mode, IPAP 26, EPAP 17. I changed the Rise Time to 3 from 1. I changed the Biflex to on, and set it to 3. Now as I tried it, it’s comfortable and it’s not forcing me to breathe in and out faster. I also  set BPM to 9 from 12. So with the Biflex set to on and flex to 3, so now incoming pressure isn’t that strong, but very comfortable @ the most 17. I will see how my sleep  number AHI will be. Because last night my AHI was 38.0. Which is horrible.
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#10
RE: Phillips Respironics BIPAP Dream Station
We haven't seen any daily charts, Please download OSCAR and post your daily charts.
I'm going to ask for 2 sets of charts because of your pressures and pressure support.
Basic Chart
Events
Flow Rate
Pressure
Leak Rate
Snores

Advanced Chart
Events
Flow Rate
Mask Pressure
Tidal Volume
Minute Vent.

We will likely ask for a couple of zoomed views once we see this, but this will give us a good idea of what is going on.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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