(08-19-2014, 05:32 PM)Galactus Wrote: Will it require two specific pressures an inhale and exhale and then a setting pressure difference between them or will it do all the setup, calibration, and setting by itself automatically? I was under the impression cpap was set with 1 pressure, and apap set the pressure automatically (maybe I am mistaken). This bipap really has me confused. I don't want to buy it and then be unhappily unable to set it up properly.
You should request the clinician setup manual for the DS760 to see what adjustments there would be. It may seem complicated at first, because in addition to the basic pressure settings which I will discuss below there is also a Rise Time setting for how abrupt or how gradual the transitions will be when changing from EPAP to IPAP, but initially this can be left at the default value (or if you want to adjust, then 0 is fastest and larger is more gradual), so it's really just the pressure settings which you would need to focus on at first.
I was first set up with a ResMed S8 AutoSet five years ago, after using a fixed-pressure machine for a year. The Respiratory Technician left the pressure range at their default values (wide open, 4 as Min and 20 as Max) under the theory that the machine would adjust itself. That was dumb, because I had gotten used to using a CPAP pressure of 13 and couldn't stand such a low minimum pressure. I got him to raise the "Min Pressure" setting to 6 and then 8 and then 9 which finally was not uncomfortable. The "Max Pressure" setting he continued to leave at its default of 20. In retrospect, I think he would have been wiser if he would have initially set my Min Pressure to about 5 less than my previously-titrated pressure of 13, and if he would have set my Max Pressure only zero or 1 or 2 cm H2O higher than my previous fixed CPAP pressure, and then checked the data regularly to see what adjustments would make sense.
You have been using fixed Pressure of 18 but without any efficacy data. So, if I were you, I would initially set the settings the same and would gather some efficacy data with your present settings. After looking at your data for a week or longer you will be ready to start tweaking the settings from there.
If you now like to use the Ramp feature then I would suggest continuing to use Ramp with the same Start Pressure you do now.
If you now like using C-Flex then I would suggest continuing to use the same amount of Flex as you do now, except in BiPAP modes it is called Bi-Flex.
If using a PRS1 BiPAP Auto, the machine has a therapy mode called "CPAP" mode which will work exactly like your present machine except it will be recording data about leaks and about every breath you take, and apneas, hypopneas, etc).
After watching the data for a week or longer in fixed pressure mode, you could switch to AutoB (Auto BiPAP) mode and set the Settings as follows (and watch the data for a week or longer and then decide where to go from there):
Min EPAP: 13 (about 5 less than now)
Max EPAP: 18 (about the same as now)
Min Pressure Support: 1
Max Pressure Support: 4
Max IPAP (or perhaps called Max Pressure): 22 (set to the sum of Max EPAP plus Max Pressure Support, unless you start to experience problems from high pressure.)
Ramp: same as now
Bi-Flex: same as C-Flex now
The above settings would make the EPAP pressure start at 13, so the pressure whenever exhaling would be 13 until the machine automatically raises the EPAP pressure when it senses obstructions or partial obstructions.
The above settings would make the Pressure Support start at 1. The IPAP would start at IPAP = EPAP + PS = 14, so the pressure whenever inhaling would be 14 until the machine automatically raises the EPAP pressure when it senses obstructions. If PS remaines unchanged and EPAP is raised in response to obstructive events, then EPAP and IPAP would be raised and lowered together the same amount.
But also, ocasionally, the machine will do a slow dance to see whether to raise or lower PS, based on how this affects Flow Limitation. In brief, PS is occasionally raised a little (causing IPAP to be raised because IPAP = EPAP + PS) and if this causes Flow Limitation to be reduced then PS will stay at its new higher value for the next several minutes, until the next test to see if PS should be raised or lowered. Also, PS is occasionally lowered a little (causing IPAP to be lowered because IPAP = EPAP + PS) and if this does not cause Flow Limitation to start then PS will stay at its lower value for the next several minutes, until the next test to see if PS should be raised or lowered. But PS will always stay within the limits set by the Min PS and Max PS settings.
In this way the machine will raise the pressure only as much as needed to avoid obstructive events and any signs of Flow Limitation.
After watching the data for a week or longer you would see if there is something you would like to change, and watch the data again for a week or longer before making other changes.