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[Pressure] BiPAP adjustments
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OutOfSync Offline

New Members

Posts: 2
Joined: Nov 2012

Machine: Respironics BiPAP AutoSV
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: Respironics REMstar
CPAP Pressure: 16-4-4
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
Ohmy BiPAP adjustments
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!
11-27-2012 12:01 AM
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archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #2
RE: BiPAP adjustments
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.
11-27-2012 02:41 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: BiPAP adjustments
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
11-27-2012 12:39 PM
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OutOfSync Offline

New Members

Posts: 2
Joined: Nov 2012

Machine: Respironics BiPAP AutoSV
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: Respironics REMstar
CPAP Pressure: 16-4-4
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #4
RE: BiPAP adjustments
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!
11-30-2012 09:26 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: BiPAP adjustments
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
11-30-2012 11:10 PM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #6
RE: BiPAP adjustments
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
12-01-2012 07:45 AM
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