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Help - Trying to Adjust to Machine (Again)
#1
Help - Trying to Adjust to Machine (Again)
I bought a Resmed BiPap in February this year and have had a hard time adjusting to it. Most nights I don't use it. I am making a renewed effort to begin using it consistently. Here are my two most recent nights of data and some overall statistics on ahi and usage in the last 6 months. I would appreciate any advice on adjusting settings to reduce waking throughout the night and use the machine consistently. I typically wake several times a night and take the mask on and off. Hope I am following the proper rules with my post. Please let me know if I need to modify my screenshots. 

Thank you all!!!!!!!!!!!!


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#2
RE: Help - Trying to Adjust to Machine (Again)
Not sure why you are only using pressure support of 1, but you have Flow Limitations that will drive your pressure up to the max set.  You need Pressure Support to tackle Flow Limitations.

Raise your Pressure Support to 4, leave EPAP at 4, and set max IPAP at 12.  This may help with the pressure swings which could be the reason you are waking up so many times.

Also, it may be helpful to set the Trigger to High.  This seems to help tackle Clear Airways.

Try these setting and see if that helps with your comfort level.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: Help - Trying to Adjust to Machine (Again)
Thank you for the suggestions. I will give this a shot tonight!
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#4
RE: Help - Trying to Adjust to Machine (Again)
Maybe you understand what your settings do and maybe not.  If you do I'm sorry to take up your time with this but here goes.

Your min number is your exhale pressure
your min+ps is your inhale pressure
max is the highest the machine will go to stop events (it may never get that high)
 
your pap machine can only go to the absolute low of 4 which would be used for young children - not for an adult.  If mine inhale is less than 9 i feel as I am sucking air through a straw...  I can lie there and do it but I end up pulling my mask off to get enough air.  Right now I THINK that is happening to you.  I would suggest you move up the min and PS.

I would try Min - 6 PS - 3

That would give you an inhale pressure of 9 and an exhale pressure of 6

I think you will sleep longer and have a better night.
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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#5
RE: Help - Trying to Adjust to Machine (Again)
Ok, come back tomorrow with an updated screenshot and we'll see how it looks.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: Help - Trying to Adjust to Machine (Again)
Min pressure of 4 on a VAuto is fine, IF the PS is higher. Min + PS >= 6 as a min, I prefer 7 to start, yours is 5, Stacy has recommended 9, mine is 13. (we are all different.

How does your breathing feel? Labored, AirStarved, Thru a Straw? if so your min IPAP (inhale) needs to be higher.
Why is PS set at 1? typically on a VAuto PS is => 4, default is 4.
too low of an inhale pressure may be a cause of mask removal and waking,
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#7
RE: Help - Trying to Adjust to Machine (Again)
Thanks for taking the time to explain. I have very little knowledge regarding the terminology, so this was helpful. Thank you.
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#8
RE: Help - Trying to Adjust to Machine (Again)
I have a hard time tolerating higher pressures when I am trying to fall asleep but figure the pressure may be too low at times when I am waking up because I wake up feeling like I am out of air. Not sure if this answers your question. 

As an aside, I am 26 years old. I originally had a sleep study done 5 years ago when  21 years old weighing approximately 200lbs. I am attaching some screenshots from that report. I was prescribed a bipap at 14/9cm. My understanding is that I had a 74 AHI at 5cm? Due to issues with insurance I have used the bipap for three months with very little compliance and insurance took it away. Didn't have insurance or money for a while, didn't follow up, and began struggling with daily function and migraines. Sill struggling and it is rather unbearable. In December 2020 I went for a new sleep study, which showed that I had an AHI of 5.5. It was supposed to be a split night study but the technician stated I had very few events and did not qualify to have the machine placed during the study. I slept very little that night but given that I am now approx. 220 lbs and 5 years older, it was a surprise to find such a disparity between the two studies. My current insurance would not allow me to get a bipap and said I needed a cpap based on my sleep study. I was figuring this sleep study had to be skewed or an outlier given my previous study, so I gave up with them and purchased my own bipap in February this year. 

Any thoughts on this and whether this information leads you to think of additional recommendations to adjust any settings? You are all my lifeline at the moment as I am really struggling. I hope to become more educated on the topic so that I can help others in the future like you all are doing with me. Thank you so much.


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