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New Dreamstation Auto Bipap - lost on support settings
#21
RE: New Dreamstation Auto Bipap - lost on support settings
PS/Pressure Support is the difference between EPAP/exhale and IPAP/inhale.
Dave

OSCAR
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: New Dreamstation Auto Bipap - lost on support settings
Russ, many of us on the forum have a strong preference for the Resmed Aircurve 10 vs the Philips Dreamstation BiPAP. It just performs better and more comfortably. We can and will fix your wife's problem and get her to a safe place. In addition to a collar, consider buying a recording pulse oximeter. This will measure and record the oxygen saturation, which is usually inverse to the CO2.

When you reset the settings, feel free to take a picture of the settings, and we can verify you have them properly set. A BiPAP differs from CPAP because it has pressure support. With CPAP the inhale and exhale pressures are the same. A notable exception is the Resmed CPAP series which actually provides some limited bilevel capability. So on CPAP if I set the pressure to 10.0, that pressure stays constant for both inhale and exhale. Auto CPAP does the same thing, but can increase or decrease pressure according to the amount of obstruction it detects in the respiratory flow. With BiPAP, the inhale pressure is greater than the exhale pressure. This is more comfortable, as the machine does part of the work of respiration, increasing pressure to assist or support inspiration, and reducing pressure to make expiration easier. The difference between inhale and exhale pressure is called pressure support. With the settings we recommended for your wife, the starting pressure will be 11.0/7.0 (IPAP/EPAP). Note the difference is 4.0 cm, and that is the pressure support. With Auto BiPAP, the pressure can rise or fall within the set range, much like auto CPAP, but pressure support will be maintained through that range, so if obstruction is high, your wife's pressure will top out at 20/16.

In the Titration Protocol Chart I posted earlier, you will see that for obstructive apnea, the EPAP or exhale pressure must be increased. The AutoBiPAP will do that automatically. We treat obstructive apnea by increasing EPAP, and we treat flow limitation and hypopnea (flow restriction) with pressure support.

Your top priority remains to get a soft cervical collar. That could be on your wife tonight by going to your local drug store. They come in different heights, so measure the distance from the top of her sternum to her jaw while she is looking straight ahead, then buy that width. You may not stay with that collar, but it will solve this problem tonignt!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#23
RE: New Dreamstation Auto Bipap - lost on support settings
True on that. Local pharmacies like CVS, Rite Aid, Walgreens, etc. all might have one on the shelf. Look up the store's webpage or call and find out.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#24
RE: New Dreamstation Auto Bipap - lost on support settings
Thanks,

I'm struggling with is the min support and max support settings, and what changing them does. 

I get it, everybody hates the Dreamstation, but this was what we could afford since it's completely out of pocket. I guess I was stupid when I made that decision.

What chart can tell me if what we are doing is working for clearing the co2?

All I'm trying to do is accomplish what has saved her life twice in the last six months.  Co2 was high, they put her on bipap, things improved almost immediately.

We presented our argument to her sleep doctor.  He knew then her co2 levels are rising again. We asked about just paying for an auto bipap and could we at least get a rough starting point.  He visibly flinched when we said bipap and he almost snickered at the word "auto". He's not doing anything without a study. We'll be bound to his settings while getting treatment for the co2 issues.  My only hope is that he might get lucky and get something right.
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#25
RE: New Dreamstation Auto Bipap - lost on support settings
Have you really read the post Sleeprider posted? He explained PS and its interaction pretty well. No offense, but you're probably overthinking this a bit. He's given a good number set. You're willing to allow the doctor to fumble and bumble, so why not try this?

Yes, we can explain things more in-depth as needed. We are not intending to offend by stating ResMed is better. For most, it's a fact ResMed treats better. We aren't judging or looking down on you for a Respironics, we're just stating things observed.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#26
RE: New Dreamstation Auto Bipap - lost on support settings
The minimum and maximum pressure support can be set to different or equal numbers. The original setting was PS min 4.0 and PS max 8.0. When you reset the setting, you set PS min 0.0 and PS max 8.0. You MUST KEEP PS min above zero or your wife will be very uncomfortable! Set the PS min to 4.0 and the PS max to 5.0 and that should cover everything.

Remember, PS min is the minimum pressure support the machine will maintain at all times. Set it to 4.0
The maximum pressure support is the maximum pressure support the machine will allow. Set it to 5.0
The machine will still vary pressure with 7.0 minimum EPAP and 20.0 maximum IPAP, in the range from 11.0/7.0 to 20.0/15.0
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#27
RE: New Dreamstation Auto Bipap - lost on support settings
I did see it.  Sorry, I just don't want to do her any harm and it sounds like I did last night. I know I'm making this harder than it has to be. I'll try his settings and see what happens.  

Thanks
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#28
RE: New Dreamstation Auto Bipap - lost on support settings
I will use IPAP 11  EPAP 7  PS MIN 4 and PS MAX 5.

What did having MIN PS at 0 do?
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#29
RE: New Dreamstation Auto Bipap - lost on support settings
PS of 0 will add nothing to EPAP. And she's seeming to need PS added to increase IPAP. It does help on inhales if PS is above 0.

EPAP + PS = IPAP is math formula
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#30
RE: New Dreamstation Auto Bipap - lost on support settings
(01-20-2021, 05:01 PM)Russ702 Wrote: I will use IPAP 11  EPAP 7  PS MIN 4 and PS MAX 5.

What did having MIN PS at 0 do?

Russ, If you set the IPAP at 11.0 the pressure will be fixed.  Based on past results, I am good with setting IPAP anywhere from 14 to 20, but if you set that to 11.0 the pressure will be static all night.  I am still willing to look at an image of your final settings to check your work. Smile
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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