BMC Bpap RESmart GII settings

[Oskar.Kim]

Hello dear apneaboard fellows! 

Hope you and your families are doing fine during not so bright times. 

I have a couple of questions to the community, would be great if you could share some expertise with apnea treatment. I myself use an Resmed airsense autoset 10 with auto mode settings form 5cm to 11cm. Usually my AHI is 4-6 I feel much much better when I sleep with the cpap, without it I'm a walking zombie. Nevertheless I rarely feel super fresh in the morning, like I used to be when I did not have the apnea or when for half a year everyday I was doing throat exercises to fight apnea and lowered the pressure to 4-6, and AHI to 2-3 (they are really good I just don't have enough will anymore) If you want to I can share the link. I've tried many setting for quite some time with the Resmed machine. EPR off, humidity level 5, 5-11cm, are the best settings for me. But with the pressure 11cm I feel like it is difficult for me to exhale also my stomach is like a balloon in the morning. 
One my relatives was prescribed a bpap machine to help fight the covid infection, he has recovered since then and gave me the bpap machine since he no longer needs it. It is BMC bpap RESmart GII. BMC is a chinese company, the machine is well made, with good quality plastics, I'm pretty impressed since it costs 2.5 times less than the cheapest new bpap from Resmed. It is a bit nosier though than the airsens 10. So here comes the question I want to try the bpap therapy and see If I would get better results than with the cpap. My initial settings for the bpap are:
Mode: S/T  Should I use just S or just T? I decided to start with both modes.
IPAP: 9.0cm
EPAP: 5.5cm
Ti Max: 3s Am I right that that is the max time machine spends in inhalation mode?
Ti Min: 1s
Rise Time: 1s
I Sens: 6 I guess that is sensitivity of the inspiration, not sure how it works. Would be great to have an insight on that.
E Sens: 6
Ti: 2.5 Why do I need Ti Max and Ti Min if I can set Ti?
Res Rate: 10BPM
Vt: OFF Should I try and experiment with it later on?

Thanks everyone in advance for your support and knowledge!

       

[Sleeprider]

Please post an image from OSCAR to show us your current therapy. I would prefer to optimize your Resmed from the settings you are using than deal wit the BMC machine. Once we have the Resmed working to keep your AHI consistently less than 2.0 I will offer suggestions on the BMC.

[Oskar.Kim]

 sir will do If you say so! Though I have to get a card reader since the last time I was adjusting my settings I've switched to a laptop without any. Thank you very much, can't wait to see your advices! 

[JJJ]

What you say about your machine curiositizes me. I am especially interested in what features it has and the price. And assuming it turns out to be a good deal, where can you get one?

It has long been high time that the major players got a comeuppance in the prices they charge. If it takes the Chinese to do it, so be it.

[Sleeprider]

We are a bit handicapped with the BMC machines because we have not incorporated them into OSCAR yet.  The reason it will help to see your Resmed data is we can infer appropriate EPAP and IPAP pressure and view respiratory data to identify if there are issues such as flow limitation that may respond favorably to pressure support.  I will confess to a strong prejudice against BMC machines because like many products out of China they are built to a low price-point using largely ripped-off technology from Resmed and Philips (search for patent infringement lawsuits), and are a lower quality machine.  While that cost savings is beneficial for direct buyers, it is also used by some equipment suppliers that recover the same insurance dollars for a BMC as they do for the far superior Resmed.   Just so you know where I'm coming from. 

I would like to circle back and discuss your previous quesitons:

It is a bit nosier though than the airsens 10. So here comes the question I want to try the bpap therapy and see If I would get better results than with the cpap. My initial settings for the bpap are:
Mode: S/T  Should I use just S or just T? I decided to start with both modes.
IPAP: 9.0cm
EPAP: 5.5cm
Ti Max: 3s Am I right that that is the max time machine spends in inhalation mode?
Ti Min: 1s
Rise Time: 1s
I Sens: 6 I guess that is sensitivity of the inspiration, not sure how it works. Would be great to have an insight on that.
E Sens: 6
Ti: 2.5 Why do I need Ti Max and Ti Min if I can set Ti?
Res Rate: 10BPM
Vt: OFF Should I try and experiment with it later on?

S mode is spontaneous and is the most appropriate for any individual with normal respiration. In S mode the machine follows your breathing changes to trigger IPAP during inhale and cycle to EPAP during exhale. T mode is a timed respiration rate and can be set as breaths per minute. The S/T mode is a blend of spontaneous trigger with a timed backup to maintain the respiration rate in the event the patient fails to take a breath in an expected amount of time. Unless you have central apnea or a neuromuscular condition that affects respiration. My recommendation is S mode.

Your pressure range seems appropriate and is is only a pressure support of 3.5 cm. Note your Resmed CPAP can produce up to 3 cm of pressure support and the closest equivalent settings would be a CPAP pressure of 9.0 with EPR full time at 3 to produce 9.0/6.0 bilevel pressure. Typical settings for Ti max would be 2.0 to 2.5 seconds, and for Ti min 0.3 seconds unless you are relying on the machine to support a weak spontaneous respiration problem. We rarely exceed 0.8 seconds for Ti Min.

I assume there is a range for trigger and cycle sensitivity. I would keep those at default "medium" values until you know what you are trying to accomplish. Res Rate is the backup breath rate in BPM. If you use a backup rate, it should be at least 3 BMP less than your normal median respiratory rate. I recommend you do not use the timed function. Vt is apparently a tidal volume function. Leave that off since you don't know.

[Dormeo]

Oskar, you might be interested to see this thread:

http://www.apneaboard.com/forums/Thread-...mc+resmart

[Oskar.Kim]

What you say about your machine curiositizes me. I am especially interested in what features it has and the price. And assuming it turns out to be a good deal, where can you get one?

It has long been high time that the major players got a comeuppance in the prices they charge. If it takes the Chinese to do it, so be it.

I honestly have no idea where to get it, especially in Western countries. 

We are a bit handicapped with the BMC machines because we have not incorporated them into OSCAR yet.  The reason it will help to see your Resmed data is we can infer appropriate EPAP and IPAP pressure and view respiratory data to identify if there are issues such as flow limitation that may respond favorably to pressure support.  I will confess to a strong prejudice against BMC machines because like many products out of China they are built to a low price-point using largely ripped-off technology from Resmed and Philips (search for patent infringement lawsuits), and are a lower quality machine.  While that cost savings is beneficial for direct buyers, it is also used by some equipment suppliers that recover the same insurance dollars for a BMC as they do for the far superior Resmed.   Just so you know where I'm coming from. 

I would like to circle back and discuss your previous quesitons:

It is a bit nosier though than the airsens 10. So here comes the question I want to try the bpap therapy and see If I would get better results than with the cpap. My initial settings for the bpap are:
Mode: S/T  Should I use just S or just T? I decided to start with both modes.
IPAP: 9.0cm
EPAP: 5.5cm
Ti Max: 3s Am I right that that is the max time machine spends in inhalation mode?
Ti Min: 1s
Rise Time: 1s
I Sens: 6 I guess that is sensitivity of the inspiration, not sure how it works. Would be great to have an insight on that.
E Sens: 6
Ti: 2.5 Why do I need Ti Max and Ti Min if I can set Ti?
Res Rate: 10BPM
Vt: OFF Should I try and experiment with it later on?

S mode is spontaneous and is the most appropriate for any individual with normal respiration. In S mode the machine follows your breathing changes to trigger IPAP during inhale and cycle to EPAP during exhale.  T mode is a timed respiration rate and can be set as breaths per minute.  The S/T mode is a blend of spontaneous trigger with a timed backup to maintain the respiration rate in the event the patient fails to take a breath in an expected amount of time.  Unless you have central apnea or a neuromuscular condition that affects respiration. My recommendation is S mode.

Your pressure range seems appropriate and is is only a pressure support of 3.5 cm. Note your Resmed CPAP can produce up to 3 cm of pressure support and the closest equivalent settings would be a CPAP pressure of 9.0 with EPR full time at 3 to produce 9.0/6.0 bilevel pressure.  Typical settings for Ti max would be 2.0 to 2.5 seconds, and for Ti min 0.3 seconds unless you are relying on the machine to support a weak spontaneous respiration problem.  We rarely exceed 0.8 seconds for Ti Min.  

I assume there is a range for trigger and cycle sensitivity. I would keep those at default "medium" values until you know what you are trying to accomplish.  Res Rate is the backup breath rate in BPM. If you use a backup rate, it should be at least 3 BMP less than your normal median respiratory rate.  I recommend you do not use the timed function.  Vt is apparently a tidal volume function. Leave that off since you don't know.

Thank you very much for so much detailed information! Really appreciate it! Let's see what we can get out of Resmed and then start with the Bpap if needed. Yes. I know about EPR function, thank you. I did not feel comfortable with the function on, so I just switched it off.  

I fully understand and agree with you about Chinesse knock-offs.  The machine itself looks like a Philips rip off, but it seems to be of a decent quality. At the same time there are so many people who are very cost sensitive. In my country for example average salary is 100$ per month. That is why I'm personally glad that BMC exists even if they rip something off, I'm pretty sure that Resmed and Philips are doing well financially. Don't get me wrong, I don't think that is the right way of doing business, but at the same time, when this equipment can save lives. The situation is radically different in developing countries comparing to developed.  

Oskar, you might be interested to see this thread:

http://www.apneaboard.com/forums/Thread-...mc+resmart

Thank you, I'll have a look.

[Oskar.Kim]

What you say about your machine curiositizes me. I am especially interested in what features it has and the price. And assuming it turns out to be a good deal, where can you get one?

It has long been high time that the major players got a comeuppance in the prices they charge. If it takes the Chinese to do it, so be it.

Please have a look at the screenshots. I've actually tried to turn on EPR. Hope I've posted the right data. The data is only for one day, I have not found a card reader, so I just inserted a microsd card, and downloaded the data with my phone. I'll get the reader and will uplaod more graphs if you need it. Thank you one more time.

P.S. Today I have a slightly high body temperature of 37.2 and a light burning sensation in my chest. I might have caught a virus, or worse the virus   Just saying if that would affect the data interpretation.

[Sleeprider]

With pressure on your Aiesense 10 Autoset using a minimum pressure of 6.0, maximum 11.0 and EPR 2 you have significant central apnea and periodic breathing flagged as CSR.

I would like you to try a night with fixed pressure and see if we can reduce central events. Set minimum and maximum pressure to 6.0 and turn off EPR. Give it a try and post back tomorrow.

[Oskar.Kim]

With pressure on your Aiesense 10 Autoset using a minimum pressure of 6.0, maximum 11.0 and EPR 2 you have significant central apnea and periodic breathing flagged as CSR.

I would like you to try a night with fixed pressure and see if we can reduce central events. Set minimum and maximum pressure to 6.0 and turn off EPR. Give it a try and post back tomorrow.

Sorry Ilve quoted a wrong post in my previous message. Epr off. Pressure 6.0-6.0 - done. Thank you, I'll post an update tomorrow.