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Transition from CPAP to BiPap - Printable Version

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Transition from CPAP to BiPap - paxis - 05-23-2024

Hello guys.
I've been using CPAP for about 6 months now ( resmed airsense 10). My numbers are very good and I'm overall happy with my therapy BUT: I wake up around 5 am. almost every night, which is not good because I don't feel rested after 6 hours of sleep. Then I go back to sleep for another 2 hours and wake up at 7am. It's not caused by urge to go to the bathroom or anything like that. My sleep doctor said that looking at my Oscar charts there is nothing he can see that causes my early wake ups. He also said that I might be a little sensitive to therapy and the bigger pressure relief might be a way to go (already using PS at 3).
The only way I can try that is using a Bipap. So I borrowed Resmed Vauto from my healthcare provider and hopes It's gonna come soon. And here is my question. How do I set up this machine? Generally I get what it is and how it works but I need some guidance to set up it proper way.
Since I use auto mode already, I would like to use it in Vauto mode with PS at 4. So I guess I have to start with min. epap 4 max. Ipap 11 and PS 4? What about other weird stuff like Ti min, max, etc.?
Below I'm posting few Oscar charts. Sorry for my broken english, I hope you will understand what I'm trying to say Smile thank you for your help guys.

Here are my current Airsense 10 settings:
Mode: Auto
Pressure: 7.4-11
PS: 3
Mask: Philips Full Face



[attachment=64466] [attachment=64467] [attachment=64468]


RE: Transition from CPAP to BiPap - PeaceLoveAndPizza - 05-23-2024

You do have quite a few arousals, which may account for the general tiredness. I assume your GP has done a blood workup already and nothing showed up, but if not it would be worthwhile just to be sure you are right as rain.

Use the following when you get the bilevel. It should hopefully be comfortable and help.

EPAP min 6
IPAP max 15
PS 4

I have it on the low side of things, but it is easy enough to change. If things are uncomfortable or the OSCAR charts look off, let us know and we can help tweak from there.


RE: Transition from CPAP to BiPap - Phaleronic - 05-23-2024

PL&P suggested a good range, I would bump EPAP min to 7 though personally as 6 is borderline too low for most people (myself included when I was using Bipap). He's also right about getting a blood workup done asap!


RE: Transition from CPAP to BiPap - paxis - 05-23-2024

Thank you very much, I will try suggested settings as soon as I get my machine!
Just to be clear, is there a chance that higher range of pressure will treat arousals? I understand they can mess my sleep, but I have no idea where they come from. Also, I did blood tests right before starting cpap therapy and as far as I remember there was nothing wrong with it, at the time. Of course, I can do it again anytime, but our doctors here where I live are not very easy to cooperate with, so what should I look for when testing my blood?


RE: Transition from CPAP to BiPap - PeaceLoveAndPizza - 05-23-2024

Pressure in moderation will help with arousals. Once we have managed events, arousals are the next problem we treat. 

In many cases it requires only a bit more pressure, others quite a bit. As long as we are not creating more problems than solving we will slowly increase pressure by 0.2 or 0.4 every few nights to see how things go.


RE: Transition from CPAP to BiPap - paxis - 05-23-2024

Perfect, can't wait to see the results. Thank you again.


RE: Transition from CPAP to BiPap - paxis - 05-29-2024

So, couple of nights passed and I can give you some feedback. As you can see numbers are generally okay (except second night when CA's spiked), but I can't say I sleep better. I had to manage some leaks due to a higher pressure but it's okay now. All of the nights I woke up 1-3 times, feeling tired in the morning. Also, I've changed Ti max to 2.7 because it felt like the machine is dropping pressure too fast when I was taking deeper breaths. Should I make some changes already or should I wait some more time? What do you guys think?

[attachment=64776] [attachment=64777] [attachment=64778]


RE: Transition from CPAP to BiPap - paxis - 05-30-2024

Here is next night with same settings except that I set the trigger to very high.
[attachment=64854]


RE: Transition from CPAP to BiPap - PeaceLoveAndPizza - 05-30-2024

Things look good. How do you feel?


RE: Transition from CPAP to BiPap - paxis - 05-30-2024

After setting trigger to very high a little bit better but still not rested completely. But I woke up twice last night so I would not expect to feel perfect. Overall it's not much better than with CPAP so far, unfortunately.