Is every piece of gear I get broken? or is it my DME?

[tlauts]

Hello community, I am really hoping someone out there can assist me.  I have had 4 different machines within the past year, and 3 of them seem like they didn't work properly.

My first machine (ResMed AirSense 10 AutoSet) actually did work, but was not the right prescription for me.  After a full sleep study, it was determined that I needed a BiPAP, so my DME provided me with an AirCurve 10 ST BiPap.

After using this machine for a couple of months, it just seemed like it was not working as it should have.  i would wake up in the middle of the night seeming to gasp for air and ripping hte mask off to breathe.  After enough complaining to the DME, they swapped it out with a new one.

After a little while, I seemed to have the same issue.  This time, I knew I would have to prove it to get it swapped.  So I purchased a manometer (TMS-13700) and waited for the issue to happen again.

This time, I took a cell phone video and proved that there was an issue.  As I was trying to breathe in, the pressure was dropping below my EPAP pressure when it should have been jumping up to my IPAP pressure.

Here is the video (https://www.youtube.com/watch?v=_b_M8TSgRTg ).  At a pressure of 17/25 the machine starts at 17, drops down to 10 while I am breathing in, then kicks for a split second at the end when it returns to 17.

I then unplugged the machine for 5 minutes and started it back up again.  Here is a video of how it is supposed to work. (https://www.youtube.com/watch?v=mA8Vg967M40 )
Starts at 17, goes up to 25 as I breathe in, then kicks up slightly right before it returns to 17.

I put a camera on the manometer all night and realized this was happening every night after about an hour of use.

Finally, the DME agreed to get me another machine as Resmed has no answer to why this has happened on multiple Aircurve 10 ST's.

Now I have a Dreamstation BiPAP S/T.  I think this machine is also acting weird.

I have the pressure now at 16/26 with a BPM of 15, a Ti of 1.5 and a rise time of 1 (lowest setting).

This machine starts at 16, only goes up to 18-20, then kicks up as I am trying to exhale.  Here is the video for this behavior ( https://www.youtube.com/watch?v=yAujEcpE4UM ).  Note: I lift my finger as I breathe in, and put it back down as I exhale.

Now, I don't know if my DME provider just has absolutely no clue what they are doing with the options for these machines, or if I seriously have had issues with 3 seperate machines from two manufacturers.

It may be a mute point as I need to have another sleep study, and will most likely be moved to an ASV, but it is not scheduled for a few months.

Does anyone have any suggestions as I really don't see many options to change on this machine to effect the issue I am having.

Thanks in advance

[Sleeprider]

Glad to hear you are moving to ASV, it should be much more comfortable and effective. The ST machines are relatively uncommon, and I doubt most DMEs are very familiar with them. They should clearly increase pressure (IPAP) on inhale, and release pressure (EPAP) on exhale. The behavior you documented is not desirable, but there may be something in your respiration pattern that "fools" the machine into pressure switching at the wrong time.

If you download and install #Sleepyhead, you may get a better idea of the respiratory flow rate vs mask pressure provided by the machine. Many people seem to have a hesitation in their inhale/exhale that results in the machine switching incorrectly. Sleepyhead could help you identify if the problem is indeed mechanical, or a response to your breathing pattern. Just an observation, your BPM rate is relatively high, and the Ti setting short for most people. Again, we could better evaluate this by looking at the graphic details.

[trish6hundred]

Hi tlauts,
WELCOME! to the forum.!
I wish you good luck as you switch to ASV.

[tlauts]

Thanks!

I contacted the DME provider with the video, and they say they contacted Respironics.  Apparently this is abnormal behavior and the DME is just hoping that I will hold out until I swap machines.

Than means another month of  1 - 4 hours of sleep per night.

Think I am going to fight them on this one.

Interesting that these $7000+ machines (insurance price not retail) have so many issues ?!?

[KSMatthew]

3 machines, two different manufacturers, and all 3 show strange symptoms?

The DME might have something set up incorrectly, or may not have turned off the "strange symptoms" checkbox.