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+--- Thread: Changed BiPAP machines--need advice (/Thread-Changed-BiPAP-machines-need-advice)
RE: Changed BiPAP machines--need advice - Sleeprider - 03-22-2018
Your chart shows ramp starts from 11 and increases to 16 over 15 minutes. As suggested by Walla, turn it off. We don't need all those charts, the only one worth looking at was this:
RE: Changed BiPAP machines--need advice - gwc2795 - 03-22-2018
Ramp is on for 20 minutes. I have tried turning it off and I was not able to breathe. I have tried 5 and 10 min ramp without success. I increased the ramp start pressure on March 17 from 8 to 9. I checked the unit and it is still set at Start Epap 9 (default 8). This is why I was asking about Timax earlier, would that allow me to have more time to inhale, I have already increased Timax from 2.0 (default) to 2.2 and my 95% Insp time is 2.2.
any ideas appreciated.
RE: Changed BiPAP machines--need advice - Sleeprider - 03-22-2018
I'm trying to figure out why your statistics don't show a separate IPAP and EPAP channel and your pressure line on Sleepyhead looks like CPAP pressure rather than VPAP-S. Weird! So in reality, your pressure is starting at 11/7 ramp to 16/12 over 20 minutes. Maybe we need to increase your cycle sensitivity from medium to high, to cause your machine to drop pressure for exhale. That seems to be where your problem lies unless I'm missing something. Inspiration looks good, but you may be blocked on expiration? Talk to me.
RE: Changed BiPAP machines--need advice - gwc2795 - 03-22-2018
"I'm trying to figure out why your statistics don't show a separate IPAP and EPAP channel and your pressure line on Sleepyhead looks like CPAP pressure rather than VPAP-S."
Unless it is not set in SH i don't know about the charts, It is BiPAP 15.8/13.
It seems to me that the machine drops pressure before I have fully inhaled. I breathe through my nose and finally have to breath through my mouth to catch up. I am not aware of any heart, lung or other heath issue, other than being overweight. 246# and 5'11" and 71 yrs old.
I will be inhaling and the pressure drops. When I tried without ramp support I could not seen to properly exhale. Using an F20 FFM. The advice the forum has given me has helped greatly as the event chart shows.
Last night it took me over an hour to get to sleep (this is very unusual for me normally 5 - 10 min), the last time I looked at the clock was 9:48, went to bed around 8:45. After going to sleep the pressure seems OK.
On 3/17 I changed Start EPAP from 8 to 9. I think I went the wrong way. The pressure was set to 8 from the DME, maybe the feeling I can't get enough air is because I can't exhale it against the pressure??? In my reading the suggested default seems to be 4.
Hope this helps
RE: Changed BiPAP machines--need advice - Sleeprider - 03-22-2018
It's unusual for inspiration to be longer than 2.2, but the flat top on the inspiration graph at the beginning of the night tells that story. Until 21:50 there is a flat top on that graph that says you're being cut-off. Try more TiMax time. Let's think about why your inspiration is clipped or restricted so that it is taking so long to inhale, but I don't see any harm in increasing TiMax.
Whatever is affecting you time of inspiration is also clipping the flow rate, and I imagine that a closeup of the flow rate graph will look like flow limitation.
RE: Changed BiPAP machines--need advice - gwc2795 - 03-22-2018
I looked at my old system one BiPAP and it showed the following
Min Med 95% Max
Insp. TimeTime taken to breathe in (Seconds) W-Avg: 2.03 0.30 1.84 3.44 10.30
Exp. TimeTime taken to breathe out (Seconds) W-Avg: 1.80 0.20 1.84 2.44 5.30
Does this help?
RE: Changed BiPAP machines--need advice - Sleeprider - 03-22-2018
Your 95% inspiration time appears to be 3.44 seconds, and the max is over 10 which would practically be an apnea. I think TiMax only goes to 3.0, but set it there or 3.5 if available.
You don't seem to be getting a higher inspiratory volume, in spite of the longer time at the beginning of therapy. That suggests restriction or flow limitations. We can try to make your settings more comfortable and functional, but if you want to pursue the cause, that is between you and your doctor.
RE: Changed BiPAP machines--need advice - gwc2795 - 03-22-2018
Thanks Sleeprider. I have changed the tiMAX to 3.4 (the max is 4.0). I also changed the Start EPAP to 4. That is the recommended default setting. I am wondering if the high Start EPAP caused me to be unable to exhaust the air and made me fell like I couldn't breathe. I guess the DME set it to 8.
I will post tomorrow with results.
Thanks again
RE: Changed BiPAP machines--need advice - Sleeprider - 03-22-2018
You only had 1 OA on the night we posted. It would seem you have some room to move pressure downward. Good luck.
RE: Changed BiPAP machines--need advice - gwc2795 - 03-23-2018
This is the chart from 3/22/18
Inspiration time is still being chopped after raising the TiMAX to 3.4. Ramp pressure started at 7.14 last night vs the previous 11.9. CA dropped significantly OA's stayed the same. I am still concerned about the insp. time being chopped off.
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