02-13-2024, 01:09 PM
(This post was last modified: 02-13-2024, 01:10 PM by Sleepyroshi.)
help! bipap making things worse
Hello everyone. I recently switched to a bipap machine and things have gotten worse.
Here is the short run-down. I was diagnosed with mild sleep apnea a couple years ago because of night sweating. I started cpap and begun experiencing what seems like sleep onset apneas soon after. I try to sleep and as I'm trying to falling asleep I find myself gasping for air or literally stopping breathing for 2 or 3 seconds. It feels like I might not start breathing again during some of the sensations. When I do end up falling asleep, I wake up unrested and do not sleep that long.
I recently was switched to bipap and these symptoms have only gotten worse. Even my AHI has gone up a bit. I'm trying to get an ASV machine because at this point I have zero clue what to do and have heard maybe that machine might fix my problems. I'm starting to wonder if this isn't even sleep apnea. However, I have had many heart tests done and all have been normal.
I am adding last nights oscar data. I experienced some really bad symptoms when trying to fall asleep the first hour or so. Once I feel asleep I did stay asleep however I did not feel rested this morning.
Does anyone have any insight they could share and possible suggestions on where to go froIm here? This is ruining my life and any help would be greatly appreciated.
RE: help! bipap making things worse
I don't think you need to switch to ASV. Your profile lists the Autoset 10, which is an APAP machine, not a bilevel. Do you have the Resmed aircurve? If so, there is a trigger setting that you can try changing to high or very high, this will encourage the machine to change from expiratory pressure to inspiratory pressure more quickly and that frequently cleans up CA events like the ones you have very nicely.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
RE: help! bipap making things worse
Sleepyroshi, it would help a lot if you keep your therapy threads and questions together. That would give us the history we need to better advise you. I see no evidence you need an ASV. Let's work with the great machine you already have.
You have the Aircurve 10 Vauto and it's set to fixed pressure S-mode with EPAP 5.0 and IPAP 10.0. I'd like to move you to Vauto mode with EPAP min 5.0, Maximum pressure 11.0 and PS 4.0. In addition set the trigger sensitivity to high. I think 5.0 cm of pressure support has you a bit over-ventilated resulting in the CA events. The high pressure support setting has increased your tidal volume from 440 mL on 10/18, to 520 mL in the current chart for 2/12. This extra ventilation has reduced CO2 and results in the significantly greater CA events. The settings I outlined above will give you the same exhale (EPAP) pressure and reduce PS by 1-cm. In Vauto mode the pressure can change up to 2-cm if needed. Finally the use of a high trigger sensitivity will cause the bilevel to trigger IPAP a little sooner with less spontaneous flow, so you will get more stimulus to breathe where you otherwise may have experienced a CA event. If necessary, we still have room to set trigger to very-high sensitivity.
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Looking back at your past threads, you seem to have fairly good results, short therapy time, and experience quite a bit of anxiety concerning your therapy. We need to get you to a more relaxed place concerning your PAP. I think you will find the settings above to be more comfortable, but if you are still having problems, be sure to check back in after giving them a try, and letting us know if there are any issues.
02-13-2024, 05:07 PM
(This post was last modified: 02-13-2024, 05:08 PM by Sleepyroshi.)
RE: help! bipap making things worse
Thank you for your detailed response. I will give this a try tonight!
(02-13-2024, 02:02 PM)BoxcarPete Wrote: I don't think you need to switch to ASV. Your profile lists the Autoset 10, which is an APAP machine, not a bilevel. Do you have the Resmed aircurve? If so, there is a trigger setting that you can try changing to high or very high, this will encourage the machine to change from expiratory pressure to inspiratory pressure more quickly and that frequently cleans up CA events like the ones you have very nicely.
I need to change my profile. I am now using an aircurve bipap.
RE: help! bipap making things worse
It's been awhile but I wanted to update my sleep progress. I'm still only sleeping about 3 hours a night. Falling to sleep is still a real problem. Feeling like I stop breathing or can't breathe. Once I do fall asleep It's never longer than a few hours.
Starting to wonder if something else besides sleep apnea might be the culprit.
RE: help! bipap making things worse
Provide screenshots zoomed to 2-3 minutes that show your respiration up to and including your arousal time. We can tell you breath by breath if there is a respiratory event, or if you're more likely dealing with anxiety.
RE: help! bipap making things worse
Sorry for the late response. I took some screen shots of the last few minutes before waking up from sleep. Thank you for taking the time to check it out.
RE: help! bipap making things worse
Another night
RE: help! bipap making things worse
The attachments on both of the last posts are from March 18, and I don't have a full night to compare. Did your sleep study by any chance document some PLM (periodic leg movement)? There are respiratory spikes at approximately 30 second intervals in the closeup provided, 5:19:30, 5:20:00, 05:20:30, 05:20:45: 05:21:15.
![[Image: attachment.php?aid=61561]](https://www.apneaboard.com/forums/attachment.php?aid=61561)
RE: help! bipap making things worse
My bad, I didn't realize they were the same night. Should I post a pic of that full night or a separate night? I do believe I had some leg movements mentioned in my last sleep study. Could that be something worth looking into? Also, does the change in respiratory rate have any meaning?
Thank you for the response.
