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First-time Bi-Level user to be - Need Help!
#1
Smile 
Dear Forum Members,
I have an old prescription but no current insurance so I am going on my own. I don't have a machine yet and I am deciding on one. I briefly tried an old basic borrowed CPAP just to get an idea what PAP therapy feels like, It was set at 8 and did nothing for my UARS but it gave me some questions to explore.
After reading many expert MD reviews and some quality comments on this forum, I realized that I need a Bi-level machine, preferably Auto, so I am going to buy a used one. I like ResMed S9 VPAP Auto for its programming but Respironics System One BiPAP Auto is said to have an adjustable (vs. fixed) Pressure Support which is said to be helpful for UARS... I briefly tried a new DreamWear nasal mask (with on old cpap) and tolerated it, so this is the mask I want to go with the Bi-level. Now comes the real dilemma where I need your advice on. When trying the mask, it leaked as I turned from back to sides all night long (used to be a stomach sleeper so I am re-training myself), so:
1. Will using the auto Bi-level machine (vs. non-auto) be nearly useless and even taxing to the machine's motor trying to adjust to the loss of pressure during the night? (assume the leaks can vary from small to significant over night).
2. I developed air bubbles in my mouth when I tried the old cpap. My mouth was shut so I was letting these bubbles out consciously (not fun). Some say that I need to train my tong inside the mouth to prevent the nasal-to-mouth inner leakage, is that right? Will the use of the more advanced Bi-level machine (vs. old cpap) with a great EPR support help me with not having air bubbles or I still need to train my tong (have no idea how and dread it)?
3. Is there a way to read the data from SD card on my own?

I would greatly appreciate your advice on any question.
Cheers!
p.s. I don't know what my Bi-level machine initial pressure settings will be yet, but I will start in 5-15 range to see how it goes both on a "feel" basis and hopefully quantitative basis if I can read SD card and/or the machine's basis use data display.
p.p.s. please don't advise me to go to a sleep clinic as I have no money for it and the last one did nothing but gave me a preset cpap which did nothing. The experts are right - most of them are nearly clueless how to treat UARS right.
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#2
My first advise is to get an auto bilevel (Vauto / BiPAP auto) because they have both the fixed and auto bilevel capability. So you can experiment with what works best for you. I'm going to guess auto bilevel will be better.

You can choose from Resmed VPAP Auto or Aircurve 10 Vauto; or Philips Respironics System One 60 series BiPAP auto, or Dreamstation BiPAP auto. I have used bilevel machines from both manufacturers. Resmed machines let you set the EPAP min, EPAP max and pressure support. With Resmed, the pressure support is a constant, while Respironics allows a range of pressure support. Both machines brands are comfortable and effective in auto bilevel mode. Resmed seems to change pressure much more readily than the Respironics. I think you will find both the Respironics and Resmed machines tend to stay very close to minimal settings through the night in treating UARS. The biggest advantage to you for Respironics is that they will record RERA, while Resmed bilevels do not.

For starting settings, I don't disagree with your ideas. Use auto mode with EPAP min at 5-6, IPAP max 15 and PS 4.0. On the Respironics machine, you could try a range of 3-6 for PS. As you move on, for the sense of more air or obstructive events, increase EPAP. For more UARS relief or hypopnea, increase PS.
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#3
Hi TeddyBear777,

I will try to give you some insight on "training your tongue".

This isn't hard and many have mastered it. It takes some time and commitment, and a lot better than having to wear a chin strap.

Place your tongue to the roof of your mouth, with tip of tongue behind your front teeth. Then suck tongue upwards. This places your tongue in a natural position and creates a seal at the back of your throat so that no air will escape from your mouth. Once perfected, you should even be able to open your mouth and test that no air escapes. Some folk can even talk. Smile

Also, to get an idea of what that feels like....just think about where your tongue is right now as you are reading this (hopefully your not eating), Eat-popcorn and you will find its resting at the roof of your mouth.

There are also tongue exercises you can do that strengthen the muscles in throat and tongue if practiced regularly. One that I used even before I got my machine was to place the tip of tongue
to roof of mouth behind front teeth and slowly slide the tip of tongue as far as you can toward the back of your throat withoug lifting tongue. Hold to count of 10, then slide tongue slowly forward back to the front.
The whole time, do not lift tongue from roof of mouth. Repeat 6 to 10 times. Do a few sets of this exercise daily.

Good luck with your search for a new machine.
If you are looking for gently used, check the supplier list above (Supplier #2). They also have new open box machines.
OpalRose
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#4
Hi TeddyBear777,
WELCOME! to the forum.!
I wish you much success with your CPAP therapy and setting up an auto bi-level machine on your own.
Let us know how things go as you restart your CPAP journey.
trish6hundred
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#5
Thank you kindly for your reply!
I got a used System One Auto Bi-pap to go with DreamWear mask and got it going. My single BIGGEST problem now, is that when I am asleep, and likely having UARS episodes, the machine likely kicks in to a higher pressure, and there is a terrible, plumbing-type noise in my mask which wakes me up and defeats the whole purpose of the system. It does not sound like a noise of a rushing air - that I can live with. It is some strange, almost mechanical-type noise which you may hear in apartment homes with bad plumbing as if the pipes themselves sing their awful tunes.
What is going on? Is it my snoring noise amplified by the rushing air? But even as I wake up, I still hear it for a brief while. Is it my throat creating some echo effect with the mask? Is there any way to deal with it?
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#6
Thank you for a great tip on training a tong! I am already practicing it which isn't too hard after years of marriage.Smile The question is - what is the ultimate goal - how do I want my tong positioned during sleep?
Oh, and any insight as to why my nasal DreamWear mask is waking me up with a horrible piping sound (not air rushing sound but some weird loud almost mechanical noise)?
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#7
(09-26-2016, 08:00 PM)TeddyBear777 Wrote: Thank you for a great tip on training a tong! I am already practicing it which isn't too hard after years of marriage.Smile The question is - what is the ultimate goal - how do I want my tong positioned during sleep?
Oh, and any insight as to why my nasal DreamWear mask is waking me up with a horrible piping sound (not air rushing sound but some weird loud almost mechanical noise)?


I don't use the dreamware, so will let someone else answer that, but the goal of training your tongue is to have it rest at the roof of your mouth during sleep.
This allows a seal at the back of throat so that air does not escape if you start to mouth breath. If this dosen't work for you, you may want to try a chin strap.

I started out using both the tongue technique and using a chin strap. After I mastered keeping my tongue at the roof of my mouth, I was able to stop using the chin strap.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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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#8
Got it - thanks! I still wonder, even if get my tongue touching the roof of the mouth during sleep, does it really form a seal? It feels that there are still gaps on the sides of the mouth. Anyway, I am already trying the suggested technique. Also, how do chin straps work in this regard? They keep the mouth shot which is not my issue. My issue is the air leakage inside the mouth.
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#9
Once you download SleepyHead software, you will be able to see if your leak rate is a problem.
http://sleepyhead.jedimark.net/
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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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