odd experience during first BiPAP night

WillSucceed wrote:

I don't feel right even posting this, but couldn't help myself. No offense to Will or Lori intended (you are terrific posters), but reading these, I kinda wished that guest's post had simply been ignored rather than commented on.

Oh for heaven's sake! As I read the 'I have the answer but am too lazy to type it' post I just felt annoyed. I thought to myself that it was pretty insensitive to comment that an answer was known, but would not be shared due to feeling "lazy." This is why I commented as I did. Well, maybe I've finally learned my lesson -I'il keep my opinion to myself.

Haha! Gee, Will. Don't let me stop you from expressing yourself. Honest.

To steal my own stupid words, this is a discussion board. Otherwise we'd all be people wearing cyber duct tape and adding smilies in place of all of our typed words. What's the point of that? I'm sorry. I didn't mean to offend you. Actually, I thank you, for it got me thinking (always a dangerous thing) about concepts and stuff. Don't you think that expressing yourself here helps you? I do. This board helps me learn more about others and myself. So please don't stop expressing yourself. Hey, there's room for even me, isn't there?


Linda

And like I told WillSucceed in my PM to him, I value his opinions as one of the best sources on this site and it was not HIS error, but perhaps some misinformation from the RT that told this to him. Okay, so you left out the word "Auto" in front of "PEEP," but it happens. Your track record pretty darn good as far as I'm concerned. I am always so happy when I post a technical question to see that you have answered it because I always can rely on your information as accurate.

I am fortunate to have a bright young RRT living under my roof (did I say "living under my roof"? Can't get him to move out yet...) and that he is able to teach his mom a few things about CPAP and related topics. And I will continue to look to WS for invaluable input whenever I have a question or need to get some advice about this crazy ride we all are on together. Thanks, WS.

Momexp5,

I spoke to my son just now and asked him your question about how can CPAP help if you snore on inhalation if all it does is set an end exhalation pressure. This is what he said:

The reason CPAP helps on inspiration is because the positive airway pressure is keeping your airways open not only when you exhale, but all the time. There is a constant pressure of whatever the titrated pressure is in the airways, so it doesn't matter if you're breathing in or out. The pressure remains positive; hence, continuous positive airway pressure, CPAP. It is "constantly" keeping your airways open. BiPAP, however, is for people who cannot tolerate CPAP, which is why your doctor did not make a mistake when he chose BiPAP for you.

I guess sometimes on the surface, to the untrained like myself, we can't understand how end pressure set for exhalation could affect inhalation, too. But now they he's explained that it keeps the pressure constant to whatever your titrated pressure is, it does really make sense.

Hope that answered your question. It answered it for me.

I changed the Rise Time from 1 to 2.. I am going to try 3 tonight to see if it is any better. I'm only getting 2/2.5 hours on the mask at any one time. I am actually waking up more at night now.. More time to get used it I guess.

Sleepless on LI wrote:If I'm remembering this right, with CPAP, you inhale as far as your lungs can take an inhalation. But on BiPAP, you are restricted to what the machine is set for on iPAP.

BiLevel-PAP doesn't restrict you to inhaling only at IPAP- you can continue to inhale at the lower EPAP pressure if the machine switches to it prematurely. It feels weird when it happens, but is very doable considering we inhale without PAP pressure during the day.


for momexp5-
I've been on BiPAP ST for almost 2 years. I remember early on having to relax & take a few deep & slow breaths when I would first put the mask on each night. It does take a few breaths for the machine to recognize your breathing pattern- its not 'learning' the breathing pattern/rate so to be speak, but more to recognize when you switch from inhale to exhale. You and the BiPAP are dance parteners- you are in the lead. Ideally the BiLevelPAP should be gracefully following your lead; but sometime the grace is lacking and the dancers end up stepping on each other toes...or in this case, cutting out too soon. If you don't relax and take some slow breaths it is easy to play catch up...but since the machine is trying to follow you it ends up looking more like a dog chasing its own tail. The most important thing to remember with BiPAPs is that if it feels out of synch at any point is to not painic and to just take a few slow breaths. If it continues then you need to talk to your DME about checking all the settings- BiPAPs have more settings then just the pressures that may need tweaking.

I have a Respironics Synchrony BiPAP ST so some of the options are different but I would recomend setting the rise time as high as possible- on mine its 1-6 and I like it best at 6, 3 is okay and 1 is uncomfortable. I don't have BiFlex, but you may want to try it at a level 1 to start- it is suppose to help when you switch from IPAP to EPAP.

christinequilts wrote: BiLevel-PAP doesn't restrict you to inhaling only at IPAP- you can continue to inhale at the lower EPAP pressure if the machine switches to it prematurely. It feels weird when it happens, but is very doable considering we inhale without PAP pressure during the day.

I've been on BiPAP ST for almost 2 years. I remember early on having to relax & take a few deep & slow breaths when I would first put the mask on each night. It does take a few breaths for the machine to recognize your breathing pattern- its not 'learning' the breathing pattern/rate so to be speak, but more to recognize when you switch from inhale to exhale. You and the BiPAP are dance parteners- you are in the lead. Ideally the BiLevelPAP should be gracefully following your lead; but sometime the grace is lacking and the dancers end up stepping on each other toes...or in this case, cutting out too soon. If you don't relax and take some slow breaths it is easy to play catch up...but since the machine is trying to follow you it ends up looking more like a dog chasing its own tail. The most important thing to remember with BiPAPs is that if it feels out of synch at any point is to not painic and to just take a few slow breaths. If it continues then you need to talk to your DME about checking all the settings- BiPAPs have more settings then just the pressures that may need tweaking.

Wow, Christine, your description is so dead on to what I'm experiencing, you're making me think it's a typical process Yup, like dancing and stepping on toes. I'll do the slow breaths and take your advice about the rise time, too - will report back

Good answer christinequilts. I've been on bipap for 4 years now. You have to see the machine as a diaphram, if you hesitate in your breathing, it reads it as you are exhaling. Mine rarely does start epap before I finish the ipap, but if it does, I always just take several deep, continuous breaths and exhales and then gradually lower them to a normal breathing level and shazam, it follows me perfectly. Trick is don't hesitate on the inhale to start with until the bipap sets the rhythm. Good luck....8/4 is low, mine is 12/8

momexp5-


Its not anything I even notice anymore...except when I switched to my backup machine for a few nights. I definantly felt like I was dancing with a new dance partener who couldn't follow my lead as well as my old dance partener. A couple nights and it was like everything was perfect again- even though my backup BiPAP is an old Respironics BiPAP STD that is built like a tank. ST's add the fun of kicking into the timed backup if you take too long to start the next breath too, so we can really get out of step at times. One problem with a set breaths per minute on STs is that yes, we may take 12 breaths per minute, but they are not all exactly 5 seconds long...some might be 4 & others 6-7 seconds, but the machine wants everything to be perfect...real pain if they set the backup rate too close your regular breathing rate.

The most important thing to remember if your machine does get out of step is to not panic...just take a few slow breaths- both you and your BiPAP need them.