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[Treatment] Waking up often - new to BiPAP
#1
Question 
Waking up often - new to BiPAP
Hi All,

Ive recently been diagnosed and went through a CPAP and then a BiPAP titration. I received my Dreamstation BiPAP Auto 2 days ago and have some questions.

You will see from the chart attached that I wake up every 1.5 to 2.5 hours.  I'm not quite sure what woke me, but it felt like i couldn't breathe.  I'm also attaching 3 zoomed in portions of the flow rate chart for the times I woke up.  Every time there seems to be a significant spike.

Can anyone make sense of this?


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#2
RE: Waking up often - new to BiPAP
Hello neelsk,
I can’t honestly say why you are waking up so often, except that you say that you feel like you can’t breathe. Possibly raise your EPAP setting to 5cm. Also, the Pressure Support range 2-6 could be narrowed, maybe limit the range to 2-4.

I’m no expert on BiLevel settings, so if anyone else can help, please do.

Also, the clusters of Obstructives suggest a positional problem. You may be tucking your chin to your chest. Many folk here have solved that problem by wearing a soft cervical collar.

http://www.apneaboard.com/wiki/index.php...cal_Collar

Maybe try the collar first before making pressure changes.
OpalRose
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Dreaming


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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: Waking up often - new to BiPAP
Your wake times and intervals are also some time after you are likely to have gone through REM sleep (dreaming). It isn’t so uncommon to awaken after having dreamt. Maybe with the novelty of PAP therapy you are more aroused generally and under stress. You are more vigilant.
Serial Tapist
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#4
RE: Waking up often - new to BiPAP
(10-20-2019, 01:13 AM)neelsk Wrote: Hi All,

Ive recently been diagnosed and went through a CPAP and then a BiPAP titration. I received my Dreamstation BiPAP Auto 2 days ago and have some questions.

You will see from the chart attached that I wake up every 1.5 to 2.5 hours.  I'm not quite sure what woke me, but it felt like i couldn't breathe.  I'm also attaching 3 zoomed in portions of the flow rate chart for the times I woke up.  Every time there seems to be a significant spike.

Can anyone make sense of this?

The spike I believe are recovery breaths, likely after you are awake, not the cause.  Each of these awakenings have some flow limitations preceding them, but nothing that should be waking you.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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#5
RE: Waking up often - new to BiPAP
I expected one of the previous posters would have pointed out you have what appears to be positional obstructive apnea. These are serious clusters of obstructive events that cannot be opened regardless of pressure. I really think you need a higher EPAP min setting, but the main problem is you are tucking your chin and obstructing your airway. Please read the links in my signature on "Soft Cervical Collar" and Optimizing Therapy" with focus on the positional apnea section. You will see a number of charts that, like yours, show clusters of persistent obstructive apnea, and how those can be resolved by fixing the chin-tucking.

Your settings are far too generalized. Please set EPAP min to 8.0, PS min to 3.0, PS max 4.0 and IPAP max can remain at 25.
Sleeprider
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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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#6
RE: Waking up often - new to BiPAP
(10-20-2019, 08:16 PM)Sleeprider Wrote: I expected one of the previous posters would have pointed out you have what appears to be positional obstructive apnea. These are serious clusters of obstructive events that cannot be opened regardless of pressure.  I really think you need a higher EPAP min setting, but the main problem is you are tucking your chin and obstructing your airway.  Please read the links in my signature on "Soft Cervical Collar" and Optimizing Therapy" with focus on the positional apnea section. You will see a number of charts that, like yours, show clusters of persistent obstructive apnea, and how those can be resolved by fixing the chin-tucking.

Your settings are far too generalized.  Please set EPAP min to 8.0, PS min to 3.0, PS max 4.0 and IPAP max can remain at 25.


Post #2.  I pointed out the positional Obstructives and suggested a collar.  Smile
OpalRose
Apnea Board Administrator
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Dreaming


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php...ganization
Using Attachments to Post ScreenShots.
Mask Primer
Machine Choices



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: Waking up often - new to BiPAP
Thanks
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

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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#8
RE: Waking up often - new to BiPAP
Thank you all for the replies. I will look into the collar and update you in a week or two regarding the results.

Regards,
Neels
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#9
RE: Waking up often - new to BiPAP
The fragmented sleep you're experiencing will likely subside as you adapt to the CPAP therapy.

The other suggestions made in this thread are good ones to be followed, but it may also take some patience for the fragmented sleep to subside.
Sleepster
Apnea Board Moderator
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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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