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[Pressure] BiPAP adjustments
#1
Ohmy 
Hello Gents and Ladies, and thanks for all you do. I'm officially a first-time "CSA" participant.

After two years of diminishing returns with a CPAP, I now use a BiPAP AutoSV (with an EncorePro card, but no reader, and no software, so no way to check AHI). The machine had only 800 hours on it when I bought it and started using it two months ago.

I now hate going to bed because I always end up in a breathing battle with the machine. The first few minutes are fine, but soon I'm trying to exhale while it's trying to force an inhale.

My strategy, after three studies, is to use it as a basic CPAP with IPAP = EPAP = 4.0 until breathing stops, at which time we want IPAP to jump to 16. But it jumps while I'm still awake! So it's trying to inflate me while I'm trying to exhale. It does this with BPM set as low as 7, and in Auto, too. Why would it see the need to exceed 4.0 even before I stop breathing?

I've timed my resting BPM (but not sleeping BPM -- I live alone) at about 8, which is slower than I expected, but it's accurate. Also, I have a natural pause between the end of an exhale and the start of an inhale, but the very microsecond I finish an exhale, and often just before I finish it, the machine is blasting air into me. It apparently thinks I should breathe faster and faster.

Could this contest be due to a faulty pressure sensor? Or, more likely, operator error?

I will surely welcome your sage advice and am willing to serve as an experimental lab rat for as long as it takes, as I am very much Out Of Sync! Thx!
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#2
More than one ASV user has reported the machine is a cast iron female dog until you get it dialed in and you get used to it, and then it's a thing of beauty.

IPAP=EPAP=4 doesn't sound right to me, even for starting out, but I'm not really that familiar with ASV.

I've heard suggestions to pace your breathing, regular and either slower or faster until you find what keeps the machine happy. Then you have to learn to "go with the flow" and do what the machine wants.

You might want to try a lower pressure than 16 until you get the hang of it.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#3
Hi OutOfSync,
WELCOME! to the forum.!
Very interesting post.
Hang in there for more suggestions and I hope you get BackInSync soon, best of luck.
trish6hundred
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#4
Thank you, Trish and Archangel, for your rapid encouragement.

I thought that I had already done a good job of methodically working through the available settings, but today I met with an RT who made some good suggestions. Implementing them -- one variable at a time -- is going to take me several weeks.

These experiments require so much patience, but I guess that, somewhere, over that rainbow, I'll be Back In Sync!
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#5
Hi OutOfSync,
It is good that you met with an RT and that you were given suggestions to help you get through your CPAP therapy.
Yes it does take time, just keep going, (as you said, "somewhere, over that rainbow," and with much patience, you'll get Back In Sync.
trish6hundred
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#6
Good luck. Lucky for me I had no such problems in my move to ASV. I hope the RT's suggestions help. I never even feel the pressure and sometimes check to make sure the machine is on. So, OutOfSync hang in there and do as you are doing. Sleep apnea therapy for many of us involves a lot of small changes along with some big machine changes. Off the top of my head, since you got the machine (great machine) used it might need a maintenance check from a DME.
Mary
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