Todays chart - increasing the epap to 12 has not improved the AHI score.
I am satisfied that taking the average Ipap to 16 CMS is counterproductive (mildly) and thus will now drop epap back to 11 CMS and IpapMin back to 13 and monitor this for a few days.
http://www.internetage.com/cpapdata/dsm ... 5apr08.pdf Bipap Data
http://www.internetage.com/cpapdata/dsm ... pr08-2.jpg 24-25 April 08.
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SWS,
The big problem I had in trying - Bipap Pro II (2 of), Bipap S/T (grey), Bipap Auto(non SV model) was that epap would switch to ipap part way through my breathing in. Interestingly there were many other posters over the past 3 years who came to cpaptalk and said very similar things but the topic never got dealt with. Someone would inevitably say "I have one of them & it doesn't do that for me" (not a very reassuring scientific contribution ).
So, I could not get any of these machines to adjust in any way that felt comfortable & ended up being very dissapointed. But, if I breathed through my mouth, this premature ipap/epap switch was much less likely to happen. The big clue to me was the difference in air flow through nose vs mouth. That pointed to the Bipaps mentioned, having some airflow algorithm that was troubled by lower airflows. Here I was taking long slow breaths through my nose & the machine couldn't cope.
All Bipaps have a 3 sec limit on breathing in.. There I was exceeding that regularly.
I had many machines to compare these Bipaps with & no other brand exhibited this type of ipap/epap switching. Interestingly 2 early Bipaps I own didn't do this premature ipap/epap switching & they are the Quartet Clinical System (a large 4 function machine - cpap, auto, bipap, split night) and the big square box Bipap S/T (prior to the intro of AutoTrak which IIRC first appeared in the Bipap-30 S & S/T models).
The other Bilevels that didn't do the early ipap/epap switch were the Healthdyne Bilevel, the Vpap III S & S/T models, the PB320 Bilevel, and my trusty PB330 Bilevel. They all did the ipap to epap transition on the smallest of airflow change. I have long believed that the other Bipaps mentioned above had a design limitation (to me a flaw) that meant they would only
work for people who did not score high hypopneas. But the Bipap S/T has always been sold as a machine that could deal with CAs so hypopneas should have been easy. My belief re this design 'limitation' is that Bipaps (until the AutoSV came along) are poor at differentiating fixed leak vs accidental leak & thus get tangled up when someone breaths slowly through their nose & thus switch too early.
BUT the Bipap AutoSV is totally different & has very smooth transitions. Wonderful !.
One change for me since I started cpap is I no longer try to just nasal breathe. Now I breathe through what ever works & can & will in the same night -
- Breathe in & out through nose
- Breathe in & out through mouth
- Breathe in through nose & out thru mouth
- Occasionally will breathe in through mouth & out thru nose.
- And sometimes will breathe in through both nose & mouth & out through mouth.
It has taken a long while to adapt to doing this & it is my way of dealing with on/off periods of nasal congestion.
At the moment I am not having any serious nasal trouble but still do a puff of Nasonex but not religiously whereas on some occasions I will use Nasonex and Otrivin at the same time (Otrivin works very quickly but can only be used for about 4-5 nights in a row).
Bipap Auto (non SV 'tank' model)
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I may well switch to the Bipap Auto (non SV model) tonight & post a nights data from it. It would be a very interesting comparison. If I can test breathe satisfactorily with its cycling I'll give it a go allowing my new skill at concurrent nose/mouth breathing.
DSM
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CPAPopedia Keywords Contained In This Post (Click For Definition):
bipap,
CPAP,
AHI,
auto
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CPAPopedia Keywords Contained In This Post (Click For Definition):
bipap,
CPAP,
AHI,
auto
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CPAPopedia Keywords Contained In This Post (Click For Definition):
bipap,
CPAP,
AHI,
auto