Help? Don't trust new BIPAP AVAPS settings

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Ron N Berkeley
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Joined: Sat Aug 09, 2014 2:52 pm

Help? Don't trust new BIPAP AVAPS settings

Post by Ron N Berkeley » Mon Aug 18, 2014 5:01 pm

Help! Newbie here delighted to find this site.

I just had a sleep study and was shifted from BIPAP to a PR BIPAP AVAPS 1160P. I don't completely trust the settings the sleep doc recommended, specifically the backup breath rate of ZERO and Inspiration Time of 3 seconds. Does this make sense to anybody? I don't see anyone else on this board or the apneaboard with similarly odd parameters. my other settings are: S/T Mode, AVAPS on, EPAP 10, min IPAP 14, max iPAP 25. Rise Time 3, Tidal Volume 420.

According to the provider's manual, a backup rate of zero means there would be no timed machine triggered breaths. Is there a default breath rate if set at zero? Nothing is posted in the providers manual. My wife says that when I'm sound asleep and my Volume (Vte), the machine seems to keep blowing at the higher variable iPAP level for way too long. Is this because the Inspiration time is set at 3 seconds. Is that much longer than it should be?

The switch to the AVAPS was made because of suspected hypoventilation at night and hypoxia during the day and night.

Thanks much! ron

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Mask: Simplus Full Face CPAP Mask with Headgear
Additional Comments: AVAPS mode S/T ipap max 25, ipap min 13, epap 10, bpm 0, Ti 3, Rise time 3, Tidal v 420

sawinglogz
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Re: Help? Don't trust new BIPAP AVAPS settings

Post by sawinglogz » Mon Aug 18, 2014 7:00 pm

I haven't researched the particular settings fully, but my recollection is that AVAPS units decide when you need to breathe based on the volume that you're inhaling/exhaling, rather than by timing. In contrast, ASV units do it purely based on timing. The latter is great for central apnea, but bad for COPD and other things where you might just breathe more and more slowly until you're not getting enough air.

So it may be that setting it with a backup "rate" of zero means that it's only making you breathe based on the volume and nothing else. But I'm not positive.

Usually the inspiration time is a maximum, not a a fixed or minimum, but again, it's possible that's different for AVAPS.

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Mask: Mirage Liberty™ Full Face CPAP Mask with Nasal Pillows With Headgear
Additional Comments: EEP=5-15, PSmin=4, PSmax=19, Max=25 cm H2O, SleepyHead software

aytikvjo
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Joined: Tue Apr 01, 2014 7:13 pm
Location: Chicago, IL

Re: Help? Don't trust new BIPAP AVAPS settings

Post by aytikvjo » Mon Aug 18, 2014 7:26 pm

If he's setting BPM to zero then the machine will never trigger a mandatory breath. This means that the inspiratory time value will never be used (i.e. it could be set to anything and it won't matter).

It's odd that he specified zero backup rate, as this is one of the major selling points in this class of machines.

I'd watch your data and see if you have many centrals. Setting the BPM to a relatively standard rate of 12 or so won't hurt anything, but you can always ask the doctor.

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Madalot
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Re: Help? Don't trust new BIPAP AVAPS settings

Post by Madalot » Tue Aug 19, 2014 4:51 am

I question the BPM at 0 as well. I'd definitely check with your doctor on this.

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Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
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Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Ron N Berkeley
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Joined: Sat Aug 09, 2014 2:52 pm

Re: Help? Don't trust new BIPAP AVAPS settings

Post by Ron N Berkeley » Tue Aug 19, 2014 6:22 pm

Many thanks to all! Armed with your feedback, I will again confer with the doc about these settings.

_________________
Mask: Simplus Full Face CPAP Mask with Headgear
Additional Comments: AVAPS mode S/T ipap max 25, ipap min 13, epap 10, bpm 0, Ti 3, Rise time 3, Tidal v 420