Hi I am new! Need help understanding some stuff

[dnar82]

Hi everyone! I am new to both this forums and CPAP/BiPAP machine. Abit of background story.

My doctor diagnose me with serious obstructive sleep apnea and refer me to a vendor to get the CPAP machine. There is no prescription.

The vendor look through my sleep report and proceed to give me a trial CPAP unit with humidifier (for 1month). The setting he set for me is 4min 15max. I have to buy a mask for hygiene purpose for the trial unit. I brought Comfort Gel Full Face CPAP Mask. 

I decided that CPAP is really really hard to make me fall asleep and I brought a Respironics DreamStation BIPAP Auto with Heated Humidifier - DSX700H11 & Nuance Pro Nasal Pillow System thinking that BiPAP review seem like it can work miracle.

Now the reason for the nasal mask is I really wanted to train to breathe with my nose, due to sinus issue I frequently have blocked nose and have being breathing through mouth for 80% of my life. Using the CPAP/BiPAP machine somehow miraculously enable me to breathe through my nose in daytime and so far I experience zero flu symptom or blocked nose that urge me to try use my nose to breathe even more.

Now the problem, regardless which machine I use, I found that breathing through nose with the mask give me a feeling like I am not breathing enough air. I kept breathing harder and harder. Using FFM, I will use my mouth to breathe until I fall asleep and unsure whether I use my mouth or nose to breathe.

I will be returning the CPAP machine soon so I will just try to tweak the respironics to best suit my need. Should I just continue to use FFM and breathe through mouth every night? Or I really should train my nose? If I increase the minimum pressure will I breathe easier? Anyone experience this? Any contribution is welcome.... I really need to get this solve to have a good nite sleep.

[srlevine1]

I wish you the very best of luck in sorting out your issues. 

Might I suggest that you obtain some monitoring software like #Sleepyhead and then post the results so that forum members can see how the machine is responding to your breathing?

Might I also suggest that training yourself to breathe in a certain fashion is less important than finding a mask and machine settings that will sustain your airway to reduce or eliminate apneas, hypopneas, and other events?

Was there a specific reason why you are using a biPap rather than an adjustable CPAP? There must have been something: a prescription, an equipment order, or a sleep study that told your vendor how to set up the machine. You should request copies of the order and the sleep study.

As for feeling that you are not getting enough air and/or you are breathing harder and harder, it may be that your machine settings are wrong for your condition or some of the comfort settings are improperly set.

You may wish to get a clinician's manual (see the top row of the forum for CPAP setup manuals) and write down some of your settings to submit along with your machine data.

Let us know if you need further help -- that's what our forum members do -- mutually help each other understand our conditions and our machines. Along with supplying a measure of comfort knowing you are not alone in this journey to a good night's sleep.

[DeepBreathing]

G'day Dnar82. Welcome to Apnea Board.

If you've always breathed through your mouth, I can understand the desire to breathe through your nose now? However I agree with srlevine that you should concentrate on getting your apnea under control rather than changing your life-long beathing habit. If you're comfortable with the FFM, why not just stick with that?

Your minimum pressure of 4 is very low and a lot of people feel starved for air at that pressure. We usually recommend a minimum pressure of 6 or more to overcome that feeling (but this will vary from one person to another).

To provide more help, we really need to understand a bit more about your circumstances. Are you able to share a copy of your initial sleep report? Was the Bipap recommended, or did you just get it because of the good reviews? Because a Bipap might not be necessary for your condition, but we don't really know without seeing the sleep report. Can you tell us what mode your Bipap is set to, and what pressure settings you are using?

I know it's a lot of questions, but that information will help us provide better advice for you.

[dnar82]

Understood. I will search for the sleep report after work... slacking in office now
Will gather 1 more day of sleep data as the first 2 night of report won't be accurate as I am adjusting to the machine.
Previous data before this respironic will not be obtainable as I do not know how to extract apex cpap machine data...

Just add a few more points to some question. FFM is comfortable when going to sleep but I will wake up multiple times due to the leaking sound cause by flipping around in bed and the mask got out of place.... not sure why I flip... being a habit since young.

[Walla Walla]

Many people with use nasal pillows instead of full face masks because they can breath better. It seems to help keep the nasal passages open. If you do want to use a full face mask you probably need to increase the pressure up 1cm or 2cm.

You really should download the SleepyHead program. It will give you much more data to help you monitor your treatment.

The links just below will help you download it and show you how to post results on line here.

Good luck and Welcome to Apnea Board! 

[dnar82]

//imgur.com/4QQL3V8
//imgur.com/9vsgKMf
//imgur.com/ZE1aJZc

[Sleeprider]

dnar82, it would help if you would clearly identify your current settings:
Mode
EPAP min
EPAP max
Pressure Support min
PS max
IPAP max

I suspect your machine is not set up well, but we can help with a little information. The suggestion to download #Sleepyhead is the fastest way to ensure we have both your settings and a look at your therapy needs.

[dnar82]

Still looking for the report.... not sure where I misplace them
Anyway the above post is the link to my first day of respironics use.

---

Machine Settings
 
PAP ModePAP Device Mode Auto Bi-Level (Variable PS) <--- This mode was set to default when it arrive so I leaving it as it is..... 
Min EPAPLower Expiratory Pressure 5.00 cmH2O  <--- for tonight I am trying 8 not sure whether is it wise to do so....
Max IPAPHigher Inspiratory Pressure 15.00 cmH2O <--- If I am not wrong I should up it a little right?
PS MinPressure Support Minimum 2.00 cmH2O <--- No ideas what is this so I leave it at this number since it come as default
PS MaxPressure Support Maximum 8.00 cmH2O<--- No ideas what is this so I leave it at this number since it come as default

[dnar82]

dnar82, it would help if you would clearly identify your current settings:
Mode
EPAP min
EPAP max
Pressure Support min
PS max
IPAP max

I suspect your machine is not set up well, but we can help with a little information.  The suggestion to download [url=http://OSCAR Official Download Page ----> CLICK HERE ./]SleepyHead[/url] is the fastest way to ensure we have both your settings and a look at your therapy needs.

Machine Settings
 
PAP ModePAP Device Mode Auto Bi-Level (Variable PS) <--- This mode was set to default when it arrive so I leaving it as it is..... 
Min EPAPLower Expiratory Pressure 5.00 cmH2O  <--- for tonight I am trying 8 not sure whether is it wise to do so....
Max IPAPHigher Inspiratory Pressure 15.00 cmH2O <--- If I am not wrong I should up it a little right?
PS MinPressure Support Minimum 2.00 cmH2O <--- No ideas what is this so I leave it at this number since it come as default
PS MaxPressure Support Maximum 8.00 cmH2O<--- No ideas what is this so I leave it at this number since it come as default

Sorry I can't post picture yet from Sleepyhead. but I have posted the link above. just need to add http.

[Sleeprider]

Found your links and posted below.  Your settings are Auto BiPAP 15/5.0 at PS 2-8.  Due to a lot of obstructive apnea, your median pressure ends up at the IPAP max of 15.0 and pretty close to the maximum EPAP of 13.0 with PS 2.  Your pressure is completely at the maximum you have set, so you do need some changes.  

I think for starters, you should leave the mode unchanged,  and try these settings:
EPAP min 10.0
IPAP max 20.0
PS 3-4

This is going to start you off at a higher pressure to work on that obstructive apnea, but for comfort and to address hypopnea,we're going to add a little more pressure support.  You have a fair amount of snoring and flow limitation indicating the need for both more pressure and pressure support.  You can disregard VS2 or event turn off that event in your preferences.  Overall, this is not too bad, and you chose the right machine for your severe obstructive apnea.  We just need to help it out by increasing the minimum and maximum pressures.