Post Reply 
First night on Bipap
Author Message
BustaTC Offline

Members

Posts: 7
Joined: Jan 2014

Machine: ResMed S9 VPAP S
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: Heated Humidifier
CPAP Pressure: 17/14
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
First night on Bipap
Ok, I got my new Resmed S9 VPAP S yesterday and it was set by secondwind for me. I know how to access the hidden settings. My first night was not what I expected. The pressure seemed very high, I feel like I was up all night, but I know I got some sleep as I don't feel all that tired today. I slept for a little over 9 hours and kept the mask on the whole time. In the morning and during the night I noticed my lungs burned a little. Kind of the same feeling where you go out in the cold and shovel snow. Now that I have been up a few hours I still feel it a little but it is a little better. My guess is that it is because I am not used to the pressure on my lungs, is this normal after starting cpap/bipap therapy? The worse part is that my AHI was 84.3! This is bad. During my sleep study before therapy my AHI was 106. After they initiated bipap it went down to 8. What is going on? I did notice something. On my sleep study the sleep doctor recommended settings of 17/14 with EPR of 3. I noticed that the inspiration pressure was set to 17, but the expiration pressure was only set to 4 on the machine. Shouldn't the expiration pressure be set to 14? I know how to change this. Oh, I also am using the Resmed software to look at the data.

I am thinking that Secondwind accidentally set the expiration pressure wrong. I would appreciate if someone more experienced than me on this forum could let me know and if they agree, I can change the setting and see what happens tonight. My only worry is that it will be even more difficult to sleep because of the increased pressure. Thanks ahead of time for taking the time to read my post.
01-18-2014 10:56 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,840
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: First night on Bipap
Sounds like the settings do not comply with the prescription.
My Rx is 14/9 and that's how my machine was set -- and S8 VPAP S.
(I bumped it up by 0.6 cm-H20)
I hesitate to tell you to change pressures -- I can only say as described by you, your settings appear wrong.

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.
01-18-2014 11:06 AM
Find all posts by this user Post Reply Quote this message in a reply
ChadIAm Offline

Members

Posts: 29
Joined: Jan 2014

Machine: Resmed VPAP Adapt (S9 w/ ASV Auto)
Mask Type: Nasal pillows
Mask Make & Model: Resmed Swift FX
Humidifier: H5i with Climateline Oxy Air Tubing
CPAP Pressure: EPAP 15
CPAP Software: ResScan SleepyHead

Other Comments: Supplemental Oxygen 3L/min

Sex: Male
Location: Ventura, California

Post: #3
RE: First night on Bipap
(01-18-2014 10:56 AM)BustaTC Wrote:  Ok, I got my new Resmed S9 VPAP S yesterday and it was set by secondwind for me. I know how to access the hidden settings. My first night was not what I expected. The pressure seemed very high, I feel like I was up all night, but I know I got some sleep as I don't feel all that tired today. I slept for a little over 9 hours and kept the mask on the whole time. In the morning and during the night I noticed my lungs burned a little. Kind of the same feeling where you go out in the cold and shovel snow. Now that I have been up a few hours I still feel it a little but it is a little better. My guess is that it is because I am not used to the pressure on my lungs, is this normal after starting cpap/bipap therapy? The worse part is that my AHI was 84.3! This is bad. During my sleep study before therapy my AHI was 106. After they initiated bipap it went down to 8. What is going on? I did notice something. On my sleep study the sleep doctor recommended settings of 17/14 with EPR of 3. I noticed that the inspiration pressure was set to 17, but the expiration pressure was only set to 4 on the machine. Shouldn't the expiration pressure be set to 14? I know how to change this. Oh, I also am using the Resmed software to look at the data.

I am thinking that Secondwind accidentally set the expiration pressure wrong. I would appreciate if someone more experienced than me on this forum could let me know and if they agree, I can change the setting and see what happens tonight. My only worry is that it will be even more difficult to sleep because of the increased pressure. Thanks ahead of time for taking the time to read my post.

I would call Secondwind and talk to one of the Respiratory Therapist and explain your AHI and the feelings you are having... Making unadvised changes could be bad... ask them to recheck the numbers and make sure it matches the prescription... people are Human and they may of made an error... Just ask... Big Grin
01-18-2014 11:38 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
BustaTC Offline

Members

Posts: 7
Joined: Jan 2014

Machine: ResMed S9 VPAP S
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: Heated Humidifier
CPAP Pressure: 17/14
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #4
RE: First night on Bipap
Thanks for posting. I understand your hesitation, that is mine as well. I know what the prescription says, but just kind of wanted someone else's opinion. Thanks again, I think I will adjust it and see where I am at.
01-18-2014 11:38 AM
Find all posts by this user Post Reply Quote this message in a reply
PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,064
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #5
RE: First night on Bipap
I don't think the exhale could be 4. That's a jump of 13cm of pressure.

If you are using ResScan software, can you post a screenshot where it tells you want the pressure is?

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
01-18-2014 07:16 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #6
RE: First night on Bipap
I am with justmongo here, based on what you've said, I would say a goof happened, and the EPAP pressure is set way to low. Please double check what the Doc wrote, and what the machine says, and adjust as needed (writing down which settings you changed, and from what to what).

EPAP- pressure for everything but inhale
IPAP - pressure for inhaling
PS - pressure support - IPAP-EPAP=PS

Personally, am kinda confused on why using "EPR" with a bi-level machine, but as mine is too old, I have zero personal knowledge of "EPR" and it's features.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
01-18-2014 07:37 PM
Find all posts by this user Post Reply Quote this message in a reply
BustaTC Offline

Members

Posts: 7
Joined: Jan 2014

Machine: ResMed S9 VPAP S
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: Heated Humidifier
CPAP Pressure: 17/14
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #7
RE: First night on Bipap
Last night I changed my bipap setting to 14/10 as I tried with the 17/14 settings and the pressure was too much. I set it down lower in hopes over time, I can work up to what I need. First of all it seemed it took me around an hour to fall asleep, but I actually feel like I slept most of the night! I just downloaded the data and was pleased with the results. My AHI dropped to 16.7! I know that isn't perfect, but it is much better than what I have seen in the past. Here is the thing. It appears my AHI for obstructive was 1.2 and for central was 14.7. During my sleep study I had some central apnea's but they were pretty much written off as a non-issue. By the sounds of it I am not sure if even working up to my prescribed setting of 17/14 will even be beneficial. Could it be because I am still getting used to the therapy? Any thoughts? Thanks again for the help.
01-19-2014 09:38 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,840
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #8
RE: First night on Bipap
(01-19-2014 09:38 AM)BustaTC Wrote:  ...Could it be because I am still getting used to the therapy?

For certain you need time to get used to the therapy. Both psychologically and physiologically.

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.
01-19-2014 11:08 AM
Find all posts by this user Post Reply Quote this message in a reply
me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #9
RE: First night on Bipap
can you use the ramp to help you so hopefully you are asleep before your pressure gets that high?
01-19-2014 11:23 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #10
RE: First night on Bipap
(01-19-2014 09:38 AM)BustaTC Wrote:  Here is the thing. It appears my AHI for obstructive was 1.2 and for central was 14.7. During my sleep study I had some central apnea's but they were pretty much written off as a non-issue. By the sounds of it I am not sure if even working up to my prescribed setting of 17/14 will even be beneficial.

Hi BustaTC,

I think whoever wrote the prescription meant Pressure Support (PS) instead of EPR. If EPAP=10 and IPAP=17, this represents a PS of 7.

I would suggest discussing with your doctor trying EPAP=10 and IPAP=13, and slowly increasing both pressures so that PS remains 3, the initially prescribed setting for PS.

Compared to EPAP=10 and IPAP=13, I think the only reason to slowly increase the pressures toward EPAP=14 and IPAP=17 would be to provide further protection against obstructive events, like obstructive apneas and obstructive hypopneas. (For example, in case you roll onto your back while asleep and need EPAP to be higher than 14.)

For some people, reducing PS (or EPR) can reduce the number of centrals.

For some people, increasing PS can improve sleep quality by eliminating something called RERAs (Respiration Effort Related Arousals), which are arousals caused by respiration effort but which are not accompanied by apneas or hypopneas. (Therefore, RERA events are not counted in the AHI.)

The number of centrals tends to reduce over the first weeks and months of treatment, as we get used to treatment. But if we had centrals in our original diagnostic study (when not being treated by CPAP) then there is less confidence that most or all the centrals will eventually go away, and a machine with a backup rate (such as the VPAP ST, VPAP ST-A or VPAP Adapt) may be needed to completely eliminate all centrals.

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: 01-20-2014 06:25 AM by vsheline.)
01-20-2014 06:09 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  New User Problem with BiPAP AVAPS - Part 1 jmayer180 35 1,260 11-27-2016 09:50 AM
Last Post: jmayer180
  First time Bipap User, years of suffering SleepyMersim 18 621 11-16-2016 11:46 PM
Last Post: Galactus
Question BiPAP vs EPR/Flex etc? SleepyBee 7 258 11-13-2016 08:52 PM
Last Post: Galactus
  [Equipment] Annoying on/off beep on Respironics BIPAP S/T C series rcattell 8 337 11-06-2016 12:07 PM
Last Post: rcattell
  Blood sugar issues after treating apnea with BIPAP Gugliano 7 411 10-21-2016 01:59 PM
Last Post: southerndoc
  Can’t get to sleep with the BiPAP machine. StrugglinginOhio 26 1,519 10-20-2016 03:52 PM
Last Post: Sleeprider
  BiPAP ST Rx: Back up rate=0 jgoole 3 232 10-10-2016 11:35 AM
Last Post: Sleeprider

Forum Jump:

Who's Online (Complete List)