Question about Inhalation Issues

[itchy365]

Hello everyone.  I have been using a ResMed 10 Bipap ST machine for nearly a year.  While I still have some issues, my overall situation has definitely improved.  Lately however, I have had a handful of nights where I believe I may be having issues with the machine.

Basically, there have been times when I was unable to complete an inhalation.  Then upon exhalation, I received a puff of air as if I wasn't breathing.

Has anyone ever experienced this before?

I took my machine to my AdaptHealth office and they increased a time setting.  Since then, I hadn't had the problem until last night.  I didn't think that was the solution since I have used the machine reasonably successfully for almost a year.

Thanks for any comments or suggestions!

[SarcasticDave94]

It sounds like it may still be a timing issue. Unless you're dealing with allergies or a cold.

PS, why the ST machine? Weren't you dealing with untreated Central Apnea? Did your doctor put you on this instead of ASV? That's what was discussed in times past.

Your lung disease is what? Meaning again why ST?

[itchy365]

Thanks for replying!  I was given the ST machine after I apparently didn't do well during my ASV study.  I hardly slept at all and remember being repeatedly woken by air puffs just as I was falling asleep.  I always thought perhaps the test wasn't set up correctly but they handed me an ST as if that was the best option.

I have an appointment with my doctor tomorrow and will see if I could get another ASV study.

I don't have a lung disease.  Having said that, using the ST has been an improvement compared to not using PAP therapy.

I'd be interested to learn more about what can be done to address timing issues.  It happened twice in the last 30 days, so somewhat infrequently, but the machine is unusable when you cannot inhale sufficiently.

[jcp519]

An ST machine is really designed for someone with lung disorders (COPD, Neuromuscular diseases, etc). Its pretty much a non-invasive ventilator and isn't really designed for central sleep apnea. An ASV would probably work better for you if you only have CSA/OSA.

All of the issues you had with your ASV are easily solvable with changes to the settings. I had similar issues with my ASV and lower PS max kept me from being woken up.

[SarcasticDave94]

The ASV has been known to blow rather hard as a person falls asleep. The possible answer is blow back into the mask. Another possible was your breathing was faster than your normal and the ASV was attempting to pace that faster rate.

I don't know enough about edits to timing. I do think your doctor pushed you onto the wrong device, ST is really only for lung disease cases. Shame on them for not knowing how to handle this. Or they don't know ASV well enough to know how to handle this.

[Deborah K.]

Please post an Oscar chart. It will help the folks here help you better.

[itchy365]

My doctor told me that my blood CO2 level is high.  Therefore, he recommends the BiPAP ST to address my central apneas.  The ST has the different inhale/exhale pressures.  I was told that the ASV doesn't (at least that's what I believe I heard).  I need lower exhale pressure to expel CO2 easier.  Something like that.

I am getting another blood test to compare with the previous one.

I will have a follow up in a month.  Meanwhile, they made some adjustments to my ST settings.

[SarcasticDave94]

The ASV in ASV Auto mode has an EPAP, PS, and IPAP range, as in variable between min and Max settings for each of the 3, the ST does not. The ST gives static EPAP and IPAP. The IPAP setting in ASV is not manually set, but is the sum of EPAP and PS.

The ASV was designed to treat Central Apnea. The only thing ST has over ASV is manually adjustable timing. Even so, if you're dealing with CA then ASV is the correct device.

Call me skeptical, I'm not convinced your doctor knows how to really treat CA.

Lower blood CO2 would be a cause for Central Apnea, not it being high.