[Treatment] Waking up on BiPap [adjustment assistance needed]

[rowanbustaman]

Hi,

The zoomed in flow rates have been attached. I tried to snap a two-minute interval hourly from 3am to 7am. Is this the right format which you require?

At the moment, BiFlex setting is turned on and set to level 2.

There is also another setting called Rise Time which you mentioned. However, BiFlex requires to be turned off in order to use it. 

Both BiFlex and Rise Time can be set from 1 - 3. But both of them cannot be switched on at the same time. Is Rise Time or BlFlex more appropriate for my use case?

Thank You,
Rowan

[Sleeprider]

Your zoomed image shows that your inspiration and expiration times are normal.  By "normal", we expect that inspiration time is generally equal or shorter than the time for expiration.  This means that IPAP may be triggered too soon, during the expiration, and that is why we sometimes see a positive flow bump before expiration ends.  Your normal exhale has a period of very low or zero flow before inhale begins, and the Philips machines handle this poorly. BiFlex and Rise Time cannot be used at the same time.  BiFlex is a feature that anticipates the beginning of expiration and drops pressure, and also restores EPAP pressure just before inspiration.  I think you might do better with it at a setting of 1 or off.  Higher setting numbers increase the amount of pressure relief and amplify the timing error.



Rise Time is the time in milliseconds that the machine takes to trigger from EPAP to IPAP pressure. The default is 300 milliseconds (ms) at setting 2.  Rise time is 150 ms at setting 0, 200 ms at setting 1, 300 ms at setting 2 and 400 ms at setting 3.  If you turn off BiFlex, then I would start with Rise Time at 3 and experiment with other settings to see where the best "feel" occurs.

With regard to settings you are using 5 to 15 pressure with EPR at 3 to 4 cm. I would try PS 2 to 3 instead and see if this helps cut down on CA. You don't have a lot of obstructive events and flow limitation is not visible in the close-up graphs.

[rowanbustaman]

Hi,

Thanks for the information about BiFlex and its consequences. I'll test out lowering BiFlex setting or using Rise Time to reduce the timing error.

I can't find the EPR setting of 3 to 4. However, my PS min is 3 and PS max is 4? Are they the same thing?

Should PS min be set to 2 and PS max to 3?

Thank you,
Rowan