New PR S1 BiPAP Auto 60 Series. Where to start

[Sleeprider]

AHI 0.80 with 0.00 RERA! I feel great today. I never got these results consistently with APAP. I think I'll just let this thread go away, I don't anticipate any other changes. Hopefully if anyone else tries out a BiPAP this will help them narrow settings down to an effective range. For me, EPAP 11.0, IPAP 18 max PS min 1 PS max 3.5. The machine makes changes through the night but since the pressure swings are in inhalation they are not disruptive, and it keeps me well ventilated and open.

[Macpage]

Conrats! Those are some nice results. I appreciate you sharing. It makes me really want to get an auto bilevel.

Like you. I think the pressure change on exhale may be what's keeping me from getting better rest. I have been very sensitive to perceived flow when awake from the moment I started, especially exhale. This is with really low pressures. I guess it can translate to sleep as well. My Resmed drags the epap (EPR 3) right up. I now know from looking at your experience that this doesn't always have to be the case.

If I were to be looking for a Respironics on the secondary market with this same algorithm, what would be the models?

Best,

Mike

[Sleeprider]

This is a BiPAP Auto with Auto Biflex DS760.

For me the advantage is being able to set a relatively low minimum pressure support that can automatically rise as needed, is less disruptive to sleep than having a constantly high IPAP pressure. It's there when I need it, but only when I need it. I found the partial night on fixed BiPAP to be the worst sleep I ever had. Great AHI results, terrible sleep with lots of RERA. Early in this thread the difference between Resmed and Respironics was discussed. We have seen many charts by Resmed VPAP users of parallel lines of variable pressure with fixed pressure support. Respironics increases the pressure of IPAP and EPAP independently, and tends to keep a lower EPAP than Resmed, at least in my experience.

Here is last night's data, and while there were few events, the rise of IPAP on FL, H and unflagged periodic breathing variations is visible. Most of the night, pressure stayed at very comfortable levels.

[Macpage]

This is a BiPAP Auto with Auto Biflex DS760.

For me the advantage is being able to set a relatively low minimum pressure support that can automatically rise as needed, is less disruptive to sleep than having a constantly high IPAP pressure. It's there when I need it, but only when I need it. I found the partial night on fixed BiPAP to be the worst sleep I ever had. Great AHI results, terrible sleep with lots of RERA. Early in this thread the difference between Resmed and Respironics was discussed. We have seen many charts by Resmed VPAP users of parallel lines of variable pressure with fixed pressure support. Respironics increases the pressure of IPAP and EPAP independently, and tends to keep a lower EPAP than Resmed, at least in my experience.

Here is last night's data, and while there were few events, the rise of IPAP on FL, H and unflagged periodic breathing variations is visible. Most of the night, pressure stayed at very comfortable levels.

I think your results speak to the success of this approach can have for some folks. I hope you enjoy the better nights!

Is the newer 60 series the only ones that work in this manner or do any of earlier ones as well? I'm not opposed to experimenting with an older, higher hour machine just to see how well it works for me before making a real committment. However, it would have to have the variable pressure support as the series you are using.

Best,

Mike

[Sleeprider]

I think the DS750 works pretty much the same, but doesn't have the ability to use a heated hose. The firmware will not be as current and I have no idea what, if anything, changed in the therapy algorithms. You could probably download the DS750 and DS760 manuals and compare features and menu options.

[cpapernewbie]

Just want to get feedback from you on the BIPAP settings for me (who for years use this settings on an APAP)

No Ramp
Auto mode, Minimum 6, max 11
A-Flex 1

result has been good: AHI on PR System One <1 and on Resmed 10 now AHI is < 0.2 - except for occasional dry mouth

[Sleeprider]

Just want to get feedback from you on the BIPAP settings for me (who for years use this settings on an APAP)

No Ramp
Auto mode, Minimum 6, max 11
A-Flex 1

result has been good: AHI on PR System One <1 and on Resmed 10 now AHI is < 0.2 - except for occasional dry mouth

If you're asking what Auto BiPAP settings you might start with, based on my experience, it would be
Auto BiPAP mode
EPAP min at 6.0,
IPAP max at 14
PS min =1.0 (or higher best comfort)
PS max = 5.0
biflex auto on 1.0.
No ramp, humidity for comfort

It takes some tinkering, but that's my thought for starters.

[cpapernewbie]

Hi Sleeprider

thank you for your pointers. i will try my Bipap 760 next week with that settings and see how it goes.

Another adventure in CPAP universe

[Macpage]

Hi Sleeprider

thank you for your pointers. i will try my Bipap 760 next week with that settings and see how it goes.

Another adventure in CPAP universe

Let us know how it goes. I would love to see more of this device in action, and I hope it works great for you.

Best,

Mike

[cpapernewbie]

OK,I was too excited to try and see the results!

Here it is for last night




http://s1301.photobucket.com/user/cpape ... sort=3&o=0

http://s1301.photobucket.com/user/cpape ... sort=3&o=1

[Sleeprider]

Oops, no image! My AHI stayed under 1 last night, so while not as good as the previous days, still successful considering the long-term. A couple event flags while awake skewed the results a bit.

Hope your results last night were good and your sleep was restful.

[cpapernewbie]

Pls accept my apologies. I have opened an account at Photobucket, upload the images and made it public. But I guess this does not work. Not for me!


OK, my sleep was restful. Continous for more than 7 hours which is not common (and a very nice bonus for trying BIPAP again after 1 year)

The stats:7 hrs 49 min sleep
AHI 0.89
Hypopnea 0.3
Clear airway 0.13 ( this is NOT common, soi I have to keep an eye on this)

Despite the Clear airway (which I hope is just a fluke), I would like to continue with BIPAP. Thanks to Sleeprider for showing the way!

[Sleeprider]

Don't sweat the CA events. Many of those happen when you shift position and can occur when you're awake. If not accompanied by periodic breathing, it's probably an anomaly. Also, considering your low AHI, it could be a single event. When looking at your Daily results, click on the events tag on the the left, and you can see the count and duration of events. Events less than 15 seconds probably won't cause you much of a problem in terms of oxygen desaturation, as long as they are not clustered together.

FWIW, I had a Cheyne-Stokes flag for nearly 3-minutes last night, so I do watch the CA events. Of the CA events I had last night, one was 50 seconds, and occurred near the end of the night (other two were 8 and 13 seconds). I can tell from the wave form that I was awake. Although this event was counted by the machine as an apnea, it wasn't. So, take a look at the event details if something worries you and make sure it's worth worrying about, and ask questions on the forum if you don't understand what you're seeing.

Images are pretty easy to post. I also had a Photobucket Pro account. I recently let it go and am using Imgur. Take a look at this tutorial on posting images, and try again. https://sleep.tnet.com/reference/tips/imgur

Remember, the easiest way to get an image on Sleepyhead is to use the F12 key which automatically takes the image and saves it in your My Documents/Sleepyhead/Screenshots directory. Imjur is a simple drag and drop operation and gives you the linked BB code you need here.

[cpapernewbie]

At last I can do the chart by using HTML codes... What I need to learn now is knowing what IPAP, EPAP, PS min max really and how it affect me
What's the best place to learn all this BIPAP terms?

[cpapernewbie]

Hi Sleeprider
thank you fior the advise. I will watch my charts and hope no more of CA tonight.... Will now check my SH charts and check the details...


Sleeprider: Thanks for coaching me in this new journey into BIPAP (no, I do not need BIPAP I think but I have one and would like to use this properly and enjoy the benefits of BIPAP)