Transition from CPAP to BIPAP

I'm struggling with all aspects of this change ... events are increasing - pain in the neck again - not feeling refreshed.... so if the events are increasing so too is the o2 desaturations I bet. One week in..... need to keep plugging. Merry Christmas

I was in the same boat as you are. I stayed on bipap until the soreness in my chest went away... then went back to cpap mode. Don't like a machine tryin' to breath for me!

Sheriff

Sheriff - isn't that a bit discouraging for someone who maybe needs to be on bipap?

It's not discouraging to me..... I listen and really learned more about this whole "sleep" process from each of you. That's how I tweaked the cpap for such a successful turnaround. I didn't have a titration process with the bipap ... so tweaks will be needed. Some will work and some won't .... but I'm good with that. My personal problem is more with the o2 desats and I don't think any of these paps are gonna cure me of the my shallow breathing .. I'm much more aware and trying to JUST BREATHE DEEP!!!!

Have you been checked out for e.g. emphysema?

bmc23 wrote:It's not discouraging to me..... I listen and really learned more about this whole "sleep" process from each of you. That's how I tweaked the cpap for such a successful turnaround. I didn't have a titration process with the bipap ... so tweaks will be needed. Some will work and some won't .... but I'm good with that. My personal problem is more with the o2 desats and I don't think any of these paps are gonna cure me of the my shallow breathing .. I'm much more aware and trying to JUST BREATHE DEEP!!!!

I am transitioning from APAP to BIPAP. My problem is that I get nervous and I find that the machine is trying to breath for me. Just like Sheriff wrote!!! The machine’s switching from IPAP to EPAP is a problem, or at least I think it is. The anxiety is making me take deeper breathes and these are irregular. It is confusing the machine because my breathing is irregular and before reaching the nadir of inhaling the machine sense a slower inhale and causes the software to switch to EPAP. I have adjusted my “time rise” to make up for this and I am finally sleeping OK. With APAP I had a pressure of 10. With BIPAP I need to start at 9/9; then 10/9; now I am at 12/8. The BIPAP is much more aggressive and 10 in APAP is certainly not 10 in BIPAP. Each week is better than the last and the therapy is better than APAP; but the adjustment is real hell! I do not think that titration would have helped me.

Julie wrote:Sheriff - isn't that a bit discouraging for someone who maybe needs to be on bipap?

nope...

Pesser wrote:

bmc23 wrote:It's not discouraging to me..... I listen and really learned more about this whole "sleep" process from each of you. That's how I tweaked the cpap for such a successful turnaround. I didn't have a titration process with the bipap ... so tweaks will be needed. Some will work and some won't .... but I'm good with that. My personal problem is more with the o2 desats and I don't think any of these paps are gonna cure me of the my shallow breathing .. I'm much more aware and trying to JUST BREATHE DEEP!!!!

I am transitioning from APAP to BIPAP. My problem is that I get nervous and I find that the machine is trying to breath for me. Just like Sheriff wrote!!! The machine’s switching from IPAP to EPAP is a problem, or at least I think it is. The anxiety is making me take deeper breathes and these are irregular. It is confusing the machine because my breathing is irregular and before reaching the nadir of inhaling the machine sense a slower inhale and causes the software to switch to EPAP. I have adjusted my “time rise” to make up for this and I am finally sleeping OK. With APAP I had a pressure of 10. With BIPAP I need to start at 9/9; then 10/9; now I am at 12/8. The BIPAP is much more aggressive and 10 in APAP is certainly not 10 in BIPAP. Each week is better than the last and the therapy is better than APAP; but the adjustment is real hell! I do not think that titration would have helped me.

What is the time rise adjustment? What does this adjustment say on the machine?

Pesser wrote:. The BIPAP is much more aggressive and 10 in APAP is certainly not 10 in BIPAP.

then one or the other machine is either broken,or set up wrong, because 10cm h2o pressure is 10cm h2o pressure, period.

Sheriff Buford wrote:

Pesser wrote:

bmc23 wrote:It's not discouraging to me..... I listen and really learned more about this whole "sleep" process from each of you. That's how I tweaked the cpap for such a successful turnaround. I didn't have a titration process with the bipap ... so tweaks will be needed. Some will work and some won't .... but I'm good with that. My personal problem is more with the o2 desats and I don't think any of these paps are gonna cure me of the my shallow breathing .. I'm much more aware and trying to JUST BREATHE DEEP!!!!

I am transitioning from APAP to BIPAP. My problem is that I get nervous and I find that the machine is trying to breath for me. Just like Sheriff wrote!!! The machine’s switching from IPAP to EPAP is a problem, or at least I think it is. The anxiety is making me take deeper breathes and these are irregular. It is confusing the machine because my breathing is irregular and before reaching the nadir of inhaling the machine sense a slower inhale and causes the software to switch to EPAP. I have adjusted my “time rise” to make up for this and I am finally sleeping OK. With APAP I had a pressure of 10. With BIPAP I need to start at 9/9; then 10/9; now I am at 12/8. The BIPAP is much more aggressive and 10 in APAP is certainly not 10 in BIPAP. Each week is better than the last and the therapy is better than APAP; but the adjustment is real hell! I do not think that titration would have helped me.

What is the time rise adjustment? What does this adjustment say on the machine?

Time rise is the amount of time of transition from IPAP to EPAP. In the clinical menu you disable the the biflex. When that happens the time rise window appears.

palerider wrote:

Pesser wrote:. The BIPAP is much more aggressive and 10 in APAP is certainly not 10 in BIPAP.

then one or the other machine is either broken,or set up wrong, because 10cm h2o pressure is 10cm h2o pressure, period.

You're right about the pressure and the period. The feel is entirely different because of that split second of transition from IPAP to EPAP. When one is relaxed you don't "feel" this difference. On APAP this is no transition in pressure. I never noticed a difference in "feel". On BIPAP sometimes when breathing aggressively the machine gets aggressive too!

Pesser wrote: Time rise is the amount of time of transition from IPAP to EPAP.

it's the time to change from EPAP to IPAP.

palerider wrote:

Pesser wrote: Time rise is the amount of time of transition from IPAP to EPAP.

it's the time to change from EPAP to IPAP.

You're right again!.........Darn!!!!!!!!!!!!! Do you keep a data base of all possible Q&A? Anyway the problem I see with BIPAP is this: The two major companies (Resmed and Respironics) make exceptionally good machines. The more we demand of them the more sophisticated they are and consequently the more sensitive to all types of breathing. It’s hard to know if your machine is re-acting in the manner intended by the manufacturer. Testing the unit to make sure that it is not working against you is a problem best solved by the manufacturer (at least I think so). To that end I have contacted the company when registering the product. I await for their answer. My question is whether it is normal for the unit to get confused or switch to EPAP prematurely if a slight breathing difference occurs. The unit is very sensitive and it may easily be the case that the software can be made more tolerant of breathing irregularity. Making it more tolerate may be a problem in itself. I pretty sure I’ll get some kind of answer in the coming week.

Pesser wrote:

palerider wrote:

Pesser wrote: Time rise is the amount of time of transition from IPAP to EPAP.

it's the time to change from EPAP to IPAP.

You're right again!.........Darn!!!!!!!!!!!!! Do you keep a data base of all possible Q&A?

nope, just what's in my head (and what I google up now and then). easy enough to get them mixed up, but I wanted to correct it in case it confused someone

Pesser wrote: jAnyway the problem I see with BIPAP is this: The two major companies (Resmed and Respironics) make exceptionally good machines. The more we demand of them the more sophisticated they are and consequently the more sensitive to all types of breathing. It’s hard to know if your machine is re-acting in the manner intended by the manufacturer. Testing the unit to make sure that it is not working against you is a problem best solved by the manufacturer (at least I think so). To that end I have contacted the company when registering the product. I await for their answer. My question is whether it is normal for the unit to get confused or switch to EPAP prematurely if a slight breathing difference occurs. The unit is very sensitive and it may easily be the case that the software can be made more tolerant of breathing irregularity. Making it more tolerate may be a problem in itself. I pretty sure I’ll get some kind of answer in the coming week.

the adjustable trigger and cycle sensitivity are unique to resmed, I believe, they claim that the settable Ti time is unique.