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Need to increase BiPAP air pressure?
#1
Need to increase BiPAP air pressure?
Hello.  I am new here and need your help please.  I am struggling at night even with my bipap and full face mask.  I think I need to increase my pressure and range since I am still having mild apnea with compliant use of my new machine.

The settings are


Mode-VPAP-S
EPAP-8.00 cmH2O
IPAP-18.60 cmH2O

Total AHI last night was 14.41
of that 3.63 was due to Clear Airway and Obstructive was 10.79.  Hypopneas were only.10

I am waking in a panic, feeling smothered, heart racing.  Last night it happened so many times, I lost count.  I am thinking of increasing to 20 or more on the IPAP and increasing the EPAP too.

Any suggestions would be greatly appreciated.  
Nita
Nitaslenz Smile
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#2
RE: Need to increase BiPAP air pressure??
Welcome to the forum.

Why are you using a PS of 10.6?

Please post your OSCAR daily charts so we can see what is going on.

Do you have any respiratory issues other than apnea?
Any Cardiac issues?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
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Dealing with a DME
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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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#3
RE: Need to increase BiPAP air pressure??
No. No other issues and not sure why the PS is set there.

Hmmm. Should I change the mode from s?
Nitaslenz Smile
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#4
RE: Need to increase BiPAP air pressure??
I am struggling with saving and posting my daily reports from OSCAR.  As soon as I figure it out I will post.  Thank you so much.
Nitaslenz Smile
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#5
RE: Need to increase BiPAP air pressure??
Are there any hypopneas? If not, I would reduce the the IPAP a bit while increasing the EPAP. EPAP will improve the obstructive apneas, and less PS (pressure support, difference between IPAP and EPAP) will reduce the clear airway. A PS greater than 5 is normally not used for OSA, absent some type of issue causing ventilation/respiratory problems, or if using an ASV.
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#6
RE: Need to increase BiPAP air pressure??
(01-12-2020, 04:32 PM)nitaslenz108 Wrote: I am struggling with saving and posting my daily reports from OSCAR.  As soon as I figure it out I will post.  Thank you so much.

what is causing you trouble?  There are many here that can help you with this.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#7
RE: Need to increase BiPAP air pressure??

.pdf   1-11-20 OSCAR.pdf (Size: 306.77 KB / Downloads: 24)  Here are my daily reports.  Finally!  Thanks

I think the problem I am having with posting my reports is on my end.  I reviewed and followed the OSCAR instructions but my screen shots did not capture what I needed.  I printed and scanned.

I am having very few hypopneas now.  Last night was only .10.  Thank you so much for your help.
Nitaslenz Smile
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#8
RE: Need to increase BiPAP air pressure??
Try an F12 to take the screenshot  (next time). 

1.  You are very likely tucking your chin.  This is the most common cause of the clustering of your obstructive events.  The fix is usually a soft cervical collar, see the link in my signature for details.  An anti-snoring or sleep collar will also work.

2.  I would like to get you back to "normal" values of PS,  Get you eventually back to PS of 4, then take it from there.  4 is the common default setting for PS.

3.  Because this PS is so far off.  I would like to see all of your settings, even ones that you don't think are important because we don't have a reason I'll assume that other settings may be "off"

New settings
EPAP is what treats Obstructive Apnea, we will, for now, keep that at its current setting of 8
IPAP is what determines your PS,  two options here, IPAP = 12 (PS=4, ultimate goal) if it doesn't "feel" right or you are having ANY difficulty try IPAP = 15 (PS=7, intermediate value)  Based on comfort

So new settings
EPAP = 8 (current setting)
IPAP = 12 (goal) or 15 (Intermediate value) depending on comfort  This will deliver a PS of 4 or 7 respectively.  

Note: the reduction of PS should result in lower values for your central apnea.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#9
RE: Need to increase BiPAP air pressure??
Thank you so much Fred! I will try these settings tonight.  
I did try the F12 multiple times on my Oscar page but the pic it took was totally white/blank when I checked the save file.

Your being here brings hope to a distressful, bleak situation (for me at least).  I have felt so alone while trying to get well.  This evening, I do not feel so alone thanks to you.
Nita Smile
Nitaslenz Smile
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#10
RE: Need to increase BiPAP air pressure??
Take a regular screen print. The data is so much better online and not in the report.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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