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In anticipation of my BIPAP Re: New Thread
#31
RE: In anticipation of my BIPAP Re: New Thread
I read what you posted. I just don't find it convincing. I don't see how you can possibly proclaim it's "not a mistake."

And it certainly doesn't fit my own experience, where I was titrated at 6/12, and prescribed at min EPAP of 6, PS of 6.

With such a gap, why bother with the titration study?

Maybe you are right, but I think the OP should hear that directly from the doctor.
Caveats: I'm just a patient, with no medical training.
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#32
RE: In anticipation of my BIPAP Re: New Thread
(01-02-2020, 05:41 PM)ApneaQuestions Wrote: I believe this is how it works...

The sleep study said your optimal pressures were 18 over 14 aka 18/14 (ie Pressure Support of PS=4 which is 18 minus 14)
( See Impressions & Recommendations)

The machine setup allows flexibility going as high as 20/16 and as low as 10/6 (ie PS=4)

So try a night and see what you see in OSCAR.  

If the machine "agrees" with the sleep report then expect it to start low at 10/6 then maybe rise to 18/14

The Max IPAP setting of 20 will prevent it trying to go higher than 20/16 (PS=4)

Oy vey, duh.  Rolleyes

Guess I'll wait to call them and see what transpires with what you and bonjour have indicated.

Sorry, JUST SO ANXIOUS FOR A DECENT NIGHT SLEEP and well, one of the replies made me concerned.

Good Night and thanks!
Plmnb

PS.  Uh, oh....We shall see how it goes tonight, I'll post the chart, and we shall go from there.  I appreciate EVERYONE who has taken the time to reply.
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#33
RE: In anticipation of my BIPAP Re: New Thread
(01-02-2020, 05:49 PM)Plmnb Wrote: ... What are Ti Max and Ti Min?..
...What are Trigger and Cycle?...
Grab the Clinical manual and read it. :-)
It's fine-tuning.
They control how aggressively (ie how quickly)  the pressure builds up as you start to inhale and how fast it drops when you exhale.

Here are some quotes from the manual (there are pictures in there to make it more understandable)

Triggering and cycling
VAuto and S modes only
The device has adjustable trigger/cycle sensitivity to optimise the sensing level according to patient conditions.
Under normal conditions, the device triggers (initiates IPAP) and cycles (terminates IPAP and changes to EPAP) as it senses the change in patient flow. Patient breath detection is enhanced by ResMed's VSync automatic leak management.

TiControl - Inspiratory time control
VAuto and S modes only
Unique to ResMed bilevel devices, TiControl™ allows the clinician to set minimum and maximum limits on the time the device spends in IPAP. The minimum and maximum time limits are set at either side of the patient’s ideal spontaneous inspiratory time, providing a ’window of opportunity’ for the patient to spontaneously cycle to EPAP.
The minimum time limit is set via the Ti Min parameter and the maximum time limit is set via the Ti Max parameter.
TiControl’s Ti Max and Ti Min parameters play a significant role in maximising synchronisation by effectively intervening to limit or prolong the inspiratory time when required. This ensures synchronisation even in the presence of significant mouth and/or mask leak.

The pictures help a lot though
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#34
RE: In anticipation of my BIPAP Re: New Thread
(01-02-2020, 06:46 PM)slowriter Wrote: I read what you posted. I just don't find it convincing. I don't see how you can possibly proclaim it's "not a mistake."...
Yes... I should rephrase... What I mean is...it's not going to stop the machine from doing the right thing (eventually) as it steps up.
Yes a prescription could (and maybe WAS) written with a higher Min EPAP... in that case it would indeed be a configuration "mistake".
What I mean here is.... it's nothing much to worry about and in 24 hours we'll see the numbers ourselves to see if Min EPAP needs to be pushed up closer to the median levels.
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#35
RE: In anticipation of my BIPAP Re: New Thread
Rolleyes

Yeah, I sort of figured someone would suggest I read the manual.  Thought I'd give the admittedly lazy method a try first.  Sorry.  Big Grin 

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#36
RE: In anticipation of my BIPAP Re: New Thread
Plmnb,
You have a success. You have a BiLevel. IMHO ANY new machine, even if it was the same model, needs to be reoptimized. The starting point is usually what the Doctor suggested. Any needed changes will become very apparent once you post nightly charts. Relax. I know that is hard.
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#37
Exclaimation 
RE: In anticipation of my BIPAP Re: New Thread
Omg!  I’m suffocating!  

I just put the mask on and started the machine.  Right away it is awful!  I have waited a little to try to get used to it.

It is so different.  I absolutely can not breath with this.  The air keeps getting strong then not strong.  I can’t breath through the the mask air.

What is going on???

Help, please.
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#38
RE: In anticipation of my BIPAP Re: New Thread
Try turning the ramp on if it's off.
It will start gentle until you are asleep.

[Image: attachment.php?aid=18611]
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#39
RE: In anticipation of my BIPAP Re: New Thread
(01-02-2020, 07:56 PM)ApneaQuestions Wrote: Try turning the ramp on if it's off.
It will start gentle until you are asleep.

Actually, the VAuto does not have auto ramp. You have to specify the time.
Caveats: I'm just a patient, with no medical training.
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#40
RE: In anticipation of my BIPAP Re: New Thread
Sigh. I’ll try now. But remember, I had to turn the ramp off on the CPAP because on that machine I couldn’t breath right with the darn thing on. Let me see though, maybe it will be different on BIPAP. If I post again tonight it will be because the ramp on didn’t help.

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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