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BiPAP on the way - help with first night?
#1
BiPAP on the way - help with first night?
Hi All!  - Coming from Reddit. Looking forward to joining the ranks although I wish we were meeting under better circumstances Smile  

I have an AirCurve 10 BiPAP on the way, along with a P30i Nasal Pillow mask kit. I’d like to be prepared to get up and running once it shows up. Could someone recommend or give any tips as to what I should do vs just starting with the basic pressure settings? I’ve attached my WatchPat test results. 

Thank you!! Really hope a good night’s sleep is on the way.


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#2
RE: BiPAP on the way - help with first night?
A generic setting for the first night

Setting VAUTO
Min 6
Max 20
Ps 4

Other
Ramp off
Humidity 4

Then post tomorrow and get suggestions o. Your nights sleep.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: BiPAP on the way - help with first night?
Thanks @staceyburke. Will start with the settings you mentioned and post as soon as I have an update for you!
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#4
RE: BiPAP on the way - help with first night?
Well I'm finally back. Last night was there first night using the AirCurve that wasn't a complete mess. I still could only keep it on for ~4 hours but that is much improved relative to the past week. Can't say I felt super rested and waking up was still quite difficult but I don't feel terrible.

Beyond increasing compliance I would really like to increase my Tidal Vol and Minute Vent. Would love to hear some tips on how can I improve Smile Charts attached.


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#5
RE: BiPAP on the way - help with first night?
First question. How do you feel?
Before we go and jump off the cliff, we really need to know how you feel.

Why do you want to increase tidal volume and minute vent? Those are typical questions from someone who has a breathing insufficiency.

Could you post a 3 minute segment of your central apneas, that will tell us what is going on there.
My initial impulse is to cut the PS back to 3, and maybe further BUT that is contraindicated if you need to increase your tidal volume and minute vent so again why do you want to raise those? Do you have other breathing issues?
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#6
RE: BiPAP on the way - help with first night?
@Gideon: I feel OK. Waking up was still very difficult but today has been as much of a slog as they often are. 

I specifically commented on tidal vol and minute vent as I was under the impression that higher #s would equal a better night's sleep. Seems like I was misunderstanding what they meant and will do more research. We can ignore that comment of mine for now.

I've attached three zoomed in snapshots of central apnea events from last night. Thanks for your help!


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#7
RE: BiPAP on the way - help with first night?
Welcome to the show.

Minute vent and tidal volume look OK. Myself, I'd look at AHI and the individual Apnea types like Central. Then how many hours can you get therapy per night. And the answer to how do you feel question. Then if needed, things that disrupt sleep like leaks or lots of start stop sessions.
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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#8
RE: BiPAP on the way - help with first night?
Hi Goethe and welcome.

You probably already know this but it might help others.

The Wiki Charts organization link will help you arrange the charts for optimal viewing and display.

(If you use a small screen or laptop and you want to include the whole of the left side bar you can go:

File > Preferences > Appearance > Application, Font, Size and choose one that suits your display.

ResizeLeftBar

Once you have selected which charts to display, they should all fit on the screen: if you see the scroll bar on the right you can tweak them by dragging the charts to fit and then pinning in place, like this:

ArrangeCharts

This will help get all the data into one screen for all to see and reduce the amount of screenshots you need to upload.)

The Wiki will help you choose which charts to display and then you are set to go!

The Pro's here will help you with the machine settings and comments about your leak rate.
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#9
RE: BiPAP on the way - help with first night?
SevereApnea, You can go to File/Preferences/Appearance and adjust the Graph Height setting. This setting will be different for different screen resolutions, so I can't tell you what will work, but mine is set at 230 px which works to clearly show the labels, scaling and has a good graph height. It is a trial and error process to determine where that setting needs to be, but once you do it, the setting will give very consistent appearance to all the graphs.

My screen resolution is 2560 x 1600 and if I want to fit 6 graphs on my display, I need to divide the vertical pixles by 7 (one for headers and title space) and the result is 1600/7=228 px, so that is why 230 pixels works on my screen. If I wanted to fit 4 graphs, I would divide my vertical screen resolution by 5 and use that number. If the tutorial can find an easy way to explain how to look-up vertical screen resolutions and divide that by the number of graphs desired plus 1, then that might be a good addition. I was struggling with trying to explain that in the Organize Your Oscar Charts wiki which I edited the other day to add more information and an image on the View / Reset Graphs and the Zoom functionality in Daily Events.
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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#10
RE: BiPAP on the way - help with first night?
OK,
Titration 101
1. EPAP controls OA events. You are good here. We may be able to lower this if you like.
2. PS (Pressure Support) is increased to manage Flow Limits, hypopneas, RERAs, and UARS, none of which appears to be a problem.
3. Increased PS, in some lucky people, will increase CA events.

In the presence of CA events lowering of PS on a BiLevel is something we want to do looking for a good balance point between CA (you have some) and obstructive events (you have none)
Tonight set PS = 3 and we may try lower.

It is important your you to critically evaluate how you feel. OK is either not critical enough or we have reached an endpoint of getting restful sleep.
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