[CPAP] Help with bipap settings

[airwaystent]

Hi.


What is this variable breathing? Is it something to be concerned about?
https://imgur.com/a/2Cb0U0g

https://imgur.com/a/FJOpm8f

I slowly increase the pressure, because the higher I go the more I tend to hyperventillate and my also dries my nose. I don't have humidifer yet.

Should I still increase the pressure, or this graph looks good?

[Sleeprider]

See the Variable Breathing Wiki https://www.apneaboard.com/wiki/index.ph..._Breathing

It's of no concern whatsoever, and is part of the Philips auto pressure algorithm, affecting the response of the device when variable breathing volumes are detected.

[airwaystent]

Can someone check my graph?

https://imgur.com/a/qp35Pli

What should I change?

I cannot really go over 11 total pressure, because I get aerophagia and cant get to sleep with it either.

Also what about my tidal volume? DOes it look normaL?

[airwaystent]

my breathing looks all over the place, I don't know what to make of this graph, but it has forms like this all night long
https://imgur.com/a/Kl17Y3x

[airwaystent]

I was thinking about increasing the EPAP a bit and decreasing PS?

Like EPAP 5 and PS 4.5? What do you think?

[Sleeprider]

First observation is your Philips System One BiPAP Auto DS760 is quite old and worse, it's a Philips which is recalled for a health hazard from foam. Your AHI is okay, but there are frequent pressure pulses resulting from what appears to be pauses in respiration that fall short of flagging an apnea. Your charts have that monthly calendar that needs to be minimized to allow your tidal volume and settings to show up. Your minute vent is 6.5 L/min with a respiration rate of 16.2 which implies a tidal volume of 401 mL, which is not alarming or unusual.

You indicate that your tolerance for pressure is 8.0 or less. It may be easier to titrate your pressure in BiPAP S mode (fixed pressures) rather than BiPAP Auto. this will stop the IPAP from following the Philips auto algorithm that causes it to increase 1.5 cm. Your current pressure in BiPAP S is approximately EPAP 5.5 and EPAP 9.0 (PS 4.5), so your proposed settings are actually what BiPAP Auto is delivering. With most events being central, I think we can lower pressure support a bit, so I think EPAP 5.5 seems to be adequate for control of CA events, and if you drop IPAP to 9.0 you would get a fixed delivery of 9.0/5.0 (PS 4). Let's start with that and see where your numbers end up without the confusion of the auto algorithm.

[airwaystent]

First observation is your Philips System One BiPAP Auto DS760 is quite old and worse, it's a Philips which is recalled for a health hazard from foam.  Your AHI is okay, but there are frequent pressure pulses resulting from what appears to be pauses in respiration that fall short of flagging an apnea.  Your charts have that monthly calendar that needs to be minimized to allow your tidal volume and settings to show up. Your minute vent is 6.5 L/min with a respiration rate of 16.2 which implies a tidal volume of 401 mL, which is not alarming or unusual.

You indicate that your tolerance for pressure is 8.0 or less.  It may be easier to titrate your pressure in BiPAP S mode (fixed pressures) rather than BiPAP Auto. this will stop the IPAP from following the Philips auto algorithm that causes it to increase 1.5 cm.  Your current pressure in BiPAP S is approximately EPAP 5.5 and EPAP 9.0 (PS 4.5), so your proposed settings are actually what BiPAP Auto is delivering.  With most events being central, I think we can lower pressure support a bit, so I think EPAP 5.5 seems to be adequate for control of CA events, and if you drop IPAP to 9.0 you would get a fixed delivery of 9.0/5.0 (PS 4).  Let's start with that and see where your numbers end up without the confusion of the auto algorithm.

I will take care of the foam, just didn't had the chance to get the appropriate screwdriver for it. I checked on some videos and I can just encase the foam in some type of plastic container like a bread sac and it will be no health hazard.

Thanks  I will check the setting tonight and upload the results. I also ordered cervical soft collar, because my neck posture is terrible anyways I am sure that's why I get the aerophagia and some events.

[airwaystent]

https://imgur.com/a/NKThpAT

Looks good and I feel good!

[airwaystent]

Ok I got my soft cervical collar. No more aerophagia at all!

However, this is my new graph: https://imgur.com/a/0gxNNgz

I got some obstructives, which were very rare before.

Should I just increase both my ipap and epap a bit and keep the PS yeah?


I am planning to buy an airsense 1O and just flash the firmware to use it as a bipap. I am pretty good with these stuff so I think it will be no issue

[Sleeprider]

Well your night with 0.0 AHI was spectacular, and anytime you can get a low AHI less than 1 it's great and nothing to be concerned about. Your therapy time is 7 to 8 hours and it looks really smooth and quiet with very good statistics. I think you really "hit it out of the park" to use baseball slang. I don't know how I could improve on this. Well done! Some people do better with a fixed BiPAP pressure and others are good with auto-pressure. You clearly benefited from fixed pressure and achieved much better results.