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Need help with Bipap readings...
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iwant2sleep Offline

Members

Posts: 7
Joined: Dec 2012

Machine: Resmed 100
Mask Type: Nasal pillows
Mask Make & Model: resmed
Humidifier: unsure
CPAP Pressure: 9/4
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location:

Post: #1
Need help with Bipap readings...
Hi all,

I've been having problems with my machine readings. Since becoming a 'hose head' in November, I've not had the data on my machine show any AHI's until two weeks ago. Now I am getting between 3 and 6 per hour, and it's kinda scary. I took my machine to the sleep clinic last week and they said it was nothing to worry about, but were very vague when I asked 'why now?'

I also asked about the pressure support bar chart. Some nights it is coloured all the way up to the top and sometimes only 1/4 the way up the graph. I wanted to know should I be getting a full bar chart all the time? If so, why on some nights is it so low? Conversely, does a low reading mean that was a 'good night' and my lungs didn't need so much support? Or were they not getting enough due to leaks? Again, vagaries only offered...I've had leaks most nights but only between 7 and 10 litre per min. This I am told, is well within acceptable perameters. Strangley last month I had a week without registering leaks at all but I cannot work out what I did differently (Same mask, same sleeping position) but the pressure support still fluctuated!

If you can shed any light on my questions and confusion I'd be very grateful!!

PS I have a Resmed Stellar 100 bipap machine which I use because of co2 retention due to a severe chest wall deformity.
03-30-2013 04:17 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,057
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: #2
RE: Need help with Bipap readings...
I don't know about the bar charts but to have NO AHI's until now? That's rare. I'd be more concerned your machine was not recording correctly.

Just before it started to show numbers, did you unplug it or did the power go off?

Also, an AHI of 3 and 6 is not much to be scared about. Anything less than 5 is optimum.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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03-30-2013 07:22 PM
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iwant2sleep Offline

Members

Posts: 7
Joined: Dec 2012

Machine: Resmed 100
Mask Type: Nasal pillows
Mask Make & Model: resmed
Humidifier: unsure
CPAP Pressure: 9/4
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location:

Post: #3
RE: Need help with Bipap readings...
Thanks for your relpy. It is really the pressure support fluctuations I'm concerned about. Can anyone help me solve the mystery please?
03-31-2013 06:00 PM
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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: #4
RE: Need help with Bipap readings...
(03-30-2013 04:17 PM)iwant2sleep Wrote:  I also asked about the pressure support bar chart. Some nights it is coloured all the way up to the top and sometimes only 1/4 the way up the graph. I wanted to know should I be getting a full bar chart all the time? If so, why on some nights is it so low? Conversely, does a low reading mean that was a 'good night' and my lungs didn't need so much support? Or were they not getting enough due to leaks?

Hi iwant2sleep

I presume you haven't had any recent change in medications.

Your doctor apparently is not concerned about your sudden development of fairly low AHI numbers after having been virtually AHI free for months. OK, but I suggest you let him know right away if the AHI numbers continue to get worse.

I think your machine is kind of like mine, except instead of the Pressure Support (PS) changing breath-to-breath like on mine, on your machine the PS adapts much more slowly, perhaps changing a little bit each minute.

As as as I know, though, your machine is only able to vary the PS, and not also the Exhalation Positive Airway Pressure (EPAP).

I think a low amount of PS is (in a sense) good, since it means your machine decided you were breathing enough without needing a higher PS value.

How low and how high do you see the PS varying between?

What is the lowest possible value (0?) and highest possible value (37?) of the PS bar on your machine's display?

Also, do you know how low and how high is the PS allowed to go, if it is limited to a smaller range than 0-37?


(03-30-2013 04:17 PM)iwant2sleep Wrote:  I've had leaks most nights but only between 7 and 10 litre per min. This I am told, is well within acceptable perameters. Strangley last month I had a week without registering leaks at all but I cannot work out what I did differently (Same mask, same sleeping position) but the pressure support still fluctuated!

If your doctor is only looking at statistical reports rather than the ResScan time plots, then I would suggest that it may be good for you to look at the ResScan time plots (Detailed Data) to try to see what is happening so you can bring it to your doctor's attention.

I suggest you use ResScan 4.2 to look at your detailed data, especially the Detailed Data plots of Leak, and also the time plots of when your AHI events are occuring, and how long each event is lasting (how many seconds).

Maybe the low leak numbers are average numbers, and there are periods in which the leak is much worse, and maybe the AHI events are occuring during those "high leak" times?

Or, looking at the ResScan time plots, do the AHI events happen when the PS is max'ed out and unable to adjust itself higher, in which case maybe your doctor should increase the maximum amount of PS the machine is alowed to use.

Or, since your machine is not able to self-adjust the Exhalation Positive Airway Pressure (EPAP), perhaps your EPAP is a little too low, perhaps recently you have been needing a higher EPAP?

By the way, your profile says your pressure is 9/4. Is 9 the EPAP and 4 the minimum PS?

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: 04-01-2013 03:17 AM by vsheline.)
04-01-2013 02:50 AM
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