How to set BiPAP

thanks... bunches... Sheriff

If you decide to try the bilevel mode at sometime you might find it helps the acid reflux due to the lower EPAP pressures.

OkyDoky wrote:If you decide to try the bilevel mode at sometime you might find it helps the acid reflux due to the lower EPAP pressures.

agreed, vauto mode is quite nice, and you may like it better than your autoset! I did.

Sheriff Buford wrote:The PS range is from 0 to 10 cm/H2O. So I can set the PS to zero. What about the Ti min, Ti max, Rise time, triggers and cycle? Minimum?
Sheriff

Ghosts advice is spot on. TiMin/Max rise and trigger are things you can leave set to medium, unless you end up wanting to change them. I ended up increasing TiMax because I found, looking at my data, that a lot of my slower breathing was getting cut off with the 2second default setting. I also increased trigger to very high, to help me with some times when I'd see on the data that I'd start to inhale, a couple times, without the machine sensing it, then I'd have an apnea. making the trigger sensitivity higher made the machine help me more in those cases.

set the PS to whatever your EPR is. many people that have used a vpap end up liking a bit more pressure support after they experiment with it, and the different pressures between inhale and exhale seem to help relieve air swallowing symptoms for some folks.

I bought a vpap auto while looking for an autoset, simply because it CAN act like an autoset, or more, if you want it to.

Sleeprider wrote:I agree with OkyDoky. If you are having problems with your current CPAP, you are going to love BiPAP, but you will need to set it in Auto BiPAP mode to take advantage of the separate exhale and inhale pressures. Given your current CPAP setting of 11.0, the following settings should be a good start for you:
EPAP min 8.0
PS min 2.0
PSmax 4.0
IPAP max 16

With these settings, the machine will start with IPAP/EPAP pressure of 10 /8.0 and will automatically increase pressures as needed. Optimization of this pressure, depends on what you observe. If you have obstructive events, you will raise EPAP. If you want more pressure difference between exhale and inhale for comfort, then you increase PSmin. Give it some time, but I think you're really going to like this. To access the clinical menu, just follow these instructions: http://www.apneaboard.com/pr-system-one ... structions

I am going to try this setting. I did get into the programming but the PS min was not an option. Everything else I put exactly what you said. Any idea why this setting was not available.

Roger

K5MOW wrote:

Sleeprider wrote:I agree with OkyDoky. If you are having problems with your current CPAP, you are going to love BiPAP, but you will need to set it in Auto BiPAP mode to take advantage of the separate exhale and inhale pressures. Given your current CPAP setting of 11.0, the following settings should be a good start for you:
EPAP min 8.0

I am going to try this setting. I did get into the programming but the PS min was not an option. Everything else I put exactly what you said. Any idea why this setting was not available.

I wouldn't go with such a large drop in EPAP, since you're used to 11, I'd try 10 for epap, and check the data tomorrow... smaller changes would be better.

I would like to thank everyone for all their help. I did set up the machine as suggested here and had a good night. I hope my insurance company approves my new machine and can use this one as a back up. But only time will tell should find out in a couple of days from Aprea.

Roger

palerider wrote:I bought a vpap auto while looking for an autoset, simply because it CAN act like an autoset, or more, if you want it to.

Yea... if you know what you are looking at, what you are looking for and what all this stuff means. Lets face it: "mamma didn't teach us no book lernin'"
So... if I want my VPAP Auto to run like an autoset (11 low pressure and 18 upper pressure), I set my settings:
Max IPAP: 18
Min EPAP: 11
PS: 0
Ti Max: min (.1)
Ti min: min (.1)
Trigger: Very low (which is the minimum)
Cycle: Very low (which is the minimum)

Would the above settings make the machine act like an Autoset?
Would I see a difference in the Ti's, Trigger and Cycle in the default settings as opposed to the minimum settings?

Thanks, Pale!

Sheriff

PS: I called Resmed yesterday and they said only my doctor or DME could make the changes. I told them my doctor was a General practitioner and my DME was Crapria. He said Crapria is their biggest client. I said, so?? Just because they buy this stuff from you doesn't mean they know anything about them. I told them Crapria doesn't know the difference from a nasal mask and a full face mask.... the young man hung up on me.

Sheriff

Sheriff Buford wrote:

palerider wrote:I bought a vpap auto while looking for an autoset, simply because it CAN act like an autoset, or more, if you want it to.

Yea... if you know what you are looking at, what you are looking for and what all this stuff means. Lets face it: "mamma didn't teach us no book lernin'"

Actually, Good Sir, at the time I bought it, I didn't know anything about the vpap auto, but the guy I bought it from (A DME selling used equipment on the side) promised me it could be set up like an autoset, so I bought it, and started learning. now, I'd take the vpap auto over an autoset anytime.

Sheriff Buford wrote:So... if I want my VPAP Auto to run like an autoset (11 low pressure and 18 upper pressure), I set my settings:
Max IPAP: 18
Min EPAP: 11
PS: 0
Ti Max: min (.1)
Ti min: min (.1)
Trigger: Very low (which is the minimum)
Cycle: Very low (which is the minimum)

Would the above settings make the machine act like an Autoset?
Would I see a difference in the Ti's, Trigger and Cycle in the default settings as opposed to the minimum settings?

IF your autoset has it's EPR set to zero, then the first three setting will make the vpap auto act like the autoset.

however, leave the Ti, trigger and cycle settings at default, NOT minimum (not that it should make a difference with a PS of 0, but you might want to try a different PS at some point, and those settings above would confuse the issue).
TiMax: 2, TiMin .3, trigger: med, cycle: med. and the machine in vauto mode.

TiMax: is the maximum amount of time that the machine would give you the higher inhale pressure (epap+ps)
TiMin: is the MINIMUM amount of time that the machine stays at the higher pressure.
Trigger: is how sensitive the machine is, when you start to inhale, to switching to the higher pressure... ie, a low trigger setting means you have to take more of an inhale breath before the machine switches to ipap pressure, and a high trigger means it will switch faster, with less of a inhale from you.
cycle: is how sensitive it is to the END of your inhale, start of exhale, to switch back to the lower pressure.

those four settings are used to customize the pressure delivery for people that have other lung problems besides sleep apnea, like COPD, restrictive, or obstructive lung conditions, these things can make it hard for people to inhale enough, but they can exhale fine, or the reverse, where they can inhale fine, but it's hard for them to exhale. by adjusting those settings, you can make the machine help out with those differing conditions. like either giving you a long long inhale time and quick exhale, (if it's hard to breath in) or a quick puff of air, and lots of time to exhale, (if it's hard to exhale)

hopefully, that makes it more clear... it took me a fair amount of studying the manual (and titration guide) to figure out what, and WHY, those setting do, and when it's appropriate to tinker with them.

the really nice thing about vauto mode is that, with those settings, you can tailor the way the machine behaves so it feels *just right* to you, but you don't HAVE to make changes unless you'd like to.

as I mentioned, sometimes people that have had the air swallowing problem you've had, experience even more relief with bilevel, (PS greater than 0) by having higher ipap pressures to take care of snores, flow limitations, hypopneas, and lower pressure on exhale, which gives relief of the gas pressure that would end up going into the stomach.

however, one step at a time, we can easily get it working just like your autoset, and if you end up needing, or wanting more, we can do that too

let me know if there's anything I didn't explain well enough, or, even anything you're curious about..

Sheriff Buford wrote:PS: I called Resmed yesterday and they said only my doctor or DME could make the changes. I told them my doctor was a General practitioner and my DME was Crapria. He said Crapria is their biggest client. I said, so?? Just because they buy this stuff from you doesn't mean they know anything about them. I told them Crapria doesn't know the difference from a nasal mask and a full face mask.... the young man hung up on me.

Sheriff

*LOLS* the medical world is FULL of CYA.

Thanks, Pale! That's alot to chew on, but I pretty well get it. I'll set the ti's and triggers to defalt.

Thanks fellow Texican! May your hitch have a lot of gitti ups!

Sheriff

Sheriff Buford wrote:Thanks, Pale! That's alot to chew on, but I pretty well get it. I'll set the ti's and triggers to defalt.

Thanks fellow Texican! May your hitch have a lot of gitti ups!

I'm happy to help. there ARE a lot of settings in the S and Vauto modes, and while it looks quite confusing at first (at least, it did to me!), there is nothing that's really complicated, once you start to wrap your head around them, they're actually pretty simple, and you'll feel comfortable with the machine in no time.