In anticipation of my BIPAP Re: New Thread

[Osiris357]

I wish there was also Plmnb. This for example I would’ve just “liked” instead of cluttering the thread with a couple words of agreement.

Although this post wouldn’t exist if there was lol

[Plmnb]

Hello advisors.  I’m really sorry to ask this but I’m having a little difficulty tonight getting on my BIPAP and I have searched my thread for what to do but I’m having trouble finding it.

I had decided to leave all my settings as they were last night to see if I would get the same type of results.

But for some reason I once again am having great difficulty exhaling, the brick wall feeling again.  If I don’t take as deep a breath and try not to exhale as feels natural, but a less powerful exhale it isn’t as tough.  But if I try to exhale at what does feel natural, a more forceful exhale, it is just awful.

I can’t decide if I should raise the PS again?
Or if I need to raise the EPAP?
Or if I need to adjust both?

Also, I have started and stopped the machine about 10 times in just a short period of time and the Events Per Hour reads 8.8 but I haven’t really worn the mask at all for very long.  Will this AHI reading mess up the real count for once I get this breathing thing figured out and lay down to sleep for real?

Thanks.

[Sleeprider]

We are currently at EPAP min 10 to IPAP max 21 PS 6.0 with Ti Min 0.7 Ti Max 2.0, Trigger High, Cycle Low. Starting pressure is 16/10. If you need ramp to get there, then set to to 10 minutes starting at you last comfortable pressure. As I recall you were using a minimum pressure of 6 before?

[ApneaQuestions]

I can't tell if the brick wall feeling is during the first few minutes or maybe 10 or 15 minutes later.

The problem may be that the pressures do tend to rise rapidly to the ceiling.
With a ceiling of 21 and a PS of 6 this means exhaling against 15.

Back on the Autoset machine plmnb said that exhaling against 17 was like a brick wall.

Maybe she's now at the ceiling and 15 feels like a brick wall too.

Can you narrow down what's actually happening plmnb?

[Plmnb]

Oh, phew, thanks for answering Sleeprider.

Regarding The Ramp: I have the ramp set to 5 minutes because I fall asleep in under 5 minutes. Won’t setting the ramp to 10 make me have this trouble for 10 minutes instead of only 5 minutes?or is my thinking totally wrong?

As to min pressure before, I do believe it was 6, at least at one point.

This is so weird, this was not a problem last night.

[Plmnb]

Hi ApneaQuestions.

So strange.  Last night all went well with breathing in the mask at the newest settings and the ramp is on 5 just like last night.

I have just put the mask back on and things are better all of a sudden.

The ramp was just showing 2 then 1 and now nothing is listed for ramp.  I realize now that the ramp must have run out.

Maybe like in my CPAP I should just turn the ramp off altogether from now on.

Thanks all...sorry to bother ya’ll.

PS.  What about that AHI reading?  Will it mess up my report for tomorrow?

[ApneaQuestions]

I wouldn't worry about the AHI reading.
We are looking more at the pressures and the flow limitations and the breath triggering and cycling....we can glance at the event area to see how many events you are having.
You probably only picked up a single rogue event anyway... one rogue event in 7 minutes shows up as an AHI of 9 (approx) now.... but it won't have a big impact tomorrow.

[Osiris357]

I’m wondering if you’re congested and the nasal part of the Dreamwear is pushing your open nostril closed or something like that. Last night I had to sleep without my collar because I was congested and when I would lay on my side the nasal cushion of the F30 was partially closing my open nostril so I was getting the “brick wall” on exhale. I took the collar off so my mouth could easily open. 

That’s the first time that happened to me. It was a struggle all around last night trying to get my mask right. I know you don’t have this problem but mine was caused by being lazy and not shaving so the mask wanted to float on my hair and not my skin. That’s in combination with the nose issue. I haven’t used my Dreamwear in a while so this may or may not be the problem but make sure your nostrils aren’t blocked by the side of the nasal cushion. In other words make sure your nostrils are centered in the hole so the silicone doesn’t partially block a nostril.

Just a thought because with that pressure support the wall should be nonexistent.

[Plmnb]

That’s the first time that happened to me. It was a struggle all around last night trying to get my mask right.

Hi Osiris and all you other patient helpers.  Thought you'd get a break from my posts did ya?  Nope, not only have I been exhausted today and overly emotional due to LACK OF SLEEP, I have been having computer issues.  Hopefully now fixed.

Osiris357, last night was the worst struggle with my mask I have ever had.  Not only the breathing against the wall issue, but leaks and the silicone irritating me.  The irritation was so annoying I made a liner of sorts out of a cloth headband.  It almost worked.  I tried it and did work pretty well.  But because of the adjusting due to the leaks it moved and I couldn't get it to fit as well, I eventually removed it.  I'm going to try again at some point.

This morning I awoke with a headache again.  I really sort of think it might have something to do with how tight the upper straps are.  I know we have discussed that the mask should not fit tight, but as Sleeprider said, it should "float".  I fiddled and adjusted the straps every which way in tiny increments, but nothing worked.  It was either way too tight or just too loose.  I finally settled on an adjustment I thought would be ok.

The whole breathing against the wall issue just vanished.  After one of my let me just take the darn thing off moments and then putting it back on moments, no more wall. Weird.

Anyway, here are the charts from last night.  Obviously not a good night.  I had the mask on so little that it was hard to find ANY decent looking Flow Rate waves.  I did find some at approximately 23:14:50 to approximately 23:15:52.  Not perfect good, but close?

I can't recall changing any settings last night as I previously mentioned.  I'm going to try again tonight with the same settings.

Awaiting your input,
Plmnb

[attachment=18799][attachment=18800][attachment=18801]

[Osiris357]

Your nose was probably smushed or the nasal cushion was off to the side and partially blocking your nostrils