bipap ?

I started a thread yesterday, but I didn't want this getting lost.

I now have a PR System one bipap 660.

I want to be able to take a full breath before the EPAP kicks in.

with that said, what do the following features do:

biflex as opposed to rise time

auto on and auto off (these are features available in the admin menu)

Systetm One Resistance (also a feature that is only available in admin menu)

The feature functions are described in the users manual. What is it beyond this description you need to know?

Bi-Flex
- The Bi-Flex comfort feature allows you to adjust the level of air pressure relief that you feel when you
exhale during therapy. Your home care provider can enable, lock or disable this feature. When your provider
enables Bi-Flex, a level will already be set for you on the device. If this is not comfortable, you can increase or
decrease the setting. The setting of 1 provides a small amount of pressure relief, with higher numbers providing
additional relief. If the provider has disabled this feature, this setting will not display.
note: This same setting is also available under the “Setup” screen.

•Rise time
- The Rise time comfort feature is the time it takes for the device to change from EPAP to IPAP. If
Rise time is prescribed for you, you can adjust the Rise time from 0 to 3 to find the setting that provides you with
the most comfort. A setting of 0 is the fastest Rise time, while 3 is the slowest. This setting will not display if your
provider has not enabled Rise time on your device.
note: This same setting is also available under the “Setup” screen

Sleeprider wrote:The feature functions are described in the users manual. What is it beyond this description you need to know?

Bi-Flex
- The Bi-Flex comfort feature allows you to adjust the level of air pressure relief that you feel when you
exhale during therapy. Your home care provider can enable, lock or disable this feature. When your provider
enables Bi-Flex, a level will already be set for you on the device. If this is not comfortable, you can increase or
decrease the setting. The setting of 1 provides a small amount of pressure relief, with higher numbers providing
additional relief. If the provider has disabled this feature, this setting will not display.
note: This same setting is also available under the “Setup” screen.

•Rise time
- The Rise time comfort feature is the time it takes for the device to change from EPAP to IPAP. If
Rise time is prescribed for you, you can adjust the Rise time from 0 to 3 to find the setting that provides you with
the most comfort. A setting of 0 is the fastest Rise time, while 3 is the slowest. This setting will not display if your
provider has not enabled Rise time on your device.
note: This same setting is also available under the “Setup” screen

Thanks SleepRider for the quick response. can you tell me if any of those features would allow me to take a full inhalation breath before going to EPAP mode?

I know how to get into the admin settings and adjust it. I just don't know if any of them will provide what I want.

Last night I couldn't take a full breath without the pressure lowering.

araris wrote:I started a thread yesterday, but I didn't want this getting lost.

instead of making multiple posts on the same subject, next time just post on the other thread, it pops back up to the top, and, it keeps all the thoughts in a more easy to follow list....

just a tip

What pressure support or IPAP-EPAP are you using? I use 0 for rise time and 2 on bi-flex. That is just based on trying out alternative settings and finding what works for me. The fact you use a full face mask may mean pressure transitions are dampened a bit for you compared to the nasal pillows use. The zero rise time gives me a pretty quick boost at the end of exhalation, and that's more what I'm looking for. Adequate IPAP should give you the ventilation you seem to want. It's not like it lets off pressure until you exhale.

palerider wrote:

araris wrote:I started a thread yesterday, but I didn't want this getting lost.

instead of making multiple posts on the same subject, next time just post on the other thread, it pops back up to the top, and, it keeps all the thoughts in a more easy to follow list....

just a tip

I know that I should have. Apologies. I asked questions (different questions) earlier in that thread and I didn't get any responses. I was being impatient.

Sleeprider wrote:What pressure support or IPAP-EPAP are you using? I use 0 for rise time and 2 on bi-flex. That is just based on trying out alternative settings and finding what works for me. The fact you use a full face mask may mean pressure transitions are dampened a bit for you compared to the nasal pillows use. The zero rise time gives me a pretty quick boost at the end of exhalation, and that's more what I'm looking for. Adequate IPAP should give you the ventilation you seem to want. It's not like it lets off pressure until you exhale.

Pressure support? I'm have ipap set to 11 and epap set to 8, Is this what you mean?

The bipap is letting off the pressure before I finish a full breath. As I am inhaling, I'll get maybe a half breath before the pressure drops down.

Thanks for your help btw.

I'll make certain that the rise is set to zero. Is there anything that will make certain that the Epap does not kick in until I have taken a full breath?

araris wrote:

Sleeprider wrote:What pressure support or IPAP-EPAP are you using? I use 0 for rise time and 2 on bi-flex. That is just based on trying out alternative settings and finding what works for me. ... It's not like it lets off pressure until you exhale.

Pressure support? I'm have ipap set to 11 and epap set to 8, Is this what you mean?

sleeprider is confusing the issue by using terminology that isn't appropriate to your machine.

pressure support is the difference in epap and ipap, but is usually only a setting on machines that have variable epap. yours, with fixed epap and fixed ipap, doesn't have a pressure support setting.

araris wrote:The bipap is letting off the pressure before I finish a full breath. As I am inhaling, I'll get maybe a half breath before the pressure drops down.

as I mentioned in the other thread, the time for inhalation is called "Ti", that's the time it stays at ipap. there is a max Ti time on your machine (called TiMax), and you cannot change it. after TiMax expires, the pressure reverts to epap.

the Ti timer may not start until the rise time is completed, in which case setting the rise time to 3 may give you a bit more time for inhale (0=150ms, 3=400ms, nearly another half second).

the resmed machines have settable TiMin and TiMax and are thus more customizable. (default TiMax on the resmed is 2 seconds, I have mine set to 3)

you can get an indication of what the hard set TiMax is on your machine by looking at the inspiration time chart in sleepyhead.

It's still pressure support. If you're not getting a full inhale, you may have some resistance (hard to say without seeing data). A higher IPAP/EPAP differential can improve ventilation. Too much ventilation can cause centrals, but that's not your problem. Try a bit more IPAP and see if it feels better. You still need to initiate the breath, but higher pressure should help you complete inhalation faster.

the resmed machines have settable TiMin and TiMax and are thus more customizable. (default TiMax on the resmed is 2 seconds, I have mine set to 3)

So who is bringing up terms not relevant to his machine? It's all good information, and this thread is not about us.

Sleeprider wrote:It's still pressure support.

yes yes, you carry on confusing the new guy...

Sleeprider wrote: but higher pressure should help you complete inhalation faster.

hehe.

Sleeprider wrote:So who is bringing up terms not relevant to his machine? It's all good information, and this thread is not about us.

you're right, too early to be bringing up alternatives that would suit his perceived needs better.

If the settings of 8 EPAP and 11 IPAP (I have no idea if you are using BiFlex or Rise Time which you need to try all the settings)
is too dramatic for now....try 8 EPAP and 9 IPAP and see how it goes.

Nowhere near giving up on the bipap yet because I know from reading people's posts on the board that it can take some getting used to just like a cpap.

However, I am disheartened, mostly because I was hoping that this would instantly fix my issues. I was definitely being naive (sp). The cpap took me a long time to adjust to and I should expect to put in the same kind of determination with the bipap.


So far after two nights, I have been able to keep the bipap on for a total of three and a half hours before switching back to my old machine. I'm just having a hard time trying to fall asleep with the pressure cutting out before i get a full breath. I'm going to do as Pugsy suggests and and set the ipap to 8 and the epap 9.(implied part then slowly increase the pressure after I can sleep with the settings like that.

would love to have more suggestions ladies and gentlemen if you have any. I truly appreciate this board and all of it's knowledgeable members.

Please tell me exactly what other settings you are using.
BiFlex???
Rise Time...rise time is only available when BiFlex is turned off.

BiFlex can impact the response time and that's why I keep asking about it. I don't know if you are using a setting that could be improved upon to help you out or not.

You really need to try ALL the BiFlex settings to see if it helps or not and if it doesn't then try all the Rise Time settings.
Do it while awake and watching TV so not under the gun to get to sleep.

Pugsy wrote:Please tell me exactly what other settings you are using.
BiFlex???
Rise Time...rise time is only available when BiFlex is turned off.

BiFlex can impact the response time and that's why I keep asking about it. I don't know if you are using a setting that could be improved upon to help you out or not.

You really need to try ALL the BiFlex settings to see if it helps or not and if it doesn't then try all the Rise Time settings.
Do it while awake and watching TV so not under the gun to get to sleep.

I have used the rise time but not the Biflex.

That is good advice. I'll play with it today.

araris wrote:However, I am disheartened, mostly because I was hoping that this would instantly fix my issues. I was definitely being naive (sp).

Yep, I tried to tell you in this thread of yours - viewtopic/t103947/viewtopic.php?f=1&t=1 ... 45#p976445

ChicagoGranny wrote:
I would advise posting some of your daily detail screens here for review by members. Let's make sure your therapy is effective and you have the pressure settings right before making any expensive moves.

Did you post screen shots of your previous therapy before you ran out and spent a lot of money on a BiPAP? Noooo, you did not.

I guess I should have screamed at you.