BiPap pressure help? Newbie witj Bipaps

Hello, We got a new Respironics Harmony BiPAP for my mother. It has S/T settings(S/T is what is for my mother from the beginning . It was S/T when we had old model Bipap). And when I put on the mask on her the tighter the mask the more pressure it shows. Like when I put it normal its like 12-15.5 and when it is tight (So tight that it hurts her) then pressure is 12-18.5. Most of the nights the alarm goes on and off like 2-3 times the whole night and red light turns on. Since two nights she wet the bed. Now I don't understand whats the problem ...I am inexperienced with Bipaps and I am only 16 so plz help me figuring out the problem here...
And what is the normal pressure ?? Or is it different for different patients???
Thanks in advance

First - Pressure is different for every patient, according to their study results and doctor's prescription. But I'm more concerned that her mask is so tight that she cries! For one thing, over-tightening flattens the 'cushion' part of the mask - the very thin soft part against her face that needs to inflate to do its job. The pressure rises in an effort to counteract the over-tightening, so don't make it so tight - though I understand you may be trying to stop leaks. Over-tightening can create new leaks as the mask seal gets distorted. If the mask doesn't fit properly (or stop large leaks - a few tiny ones are not a problem and are expected) she needs to find one that fits better, or is at least the right size for her - there are very many available and she should always try them lying down as people's faces change and relax away from the mask in places when lying down.

Do you not have any help in dealing with your mother's care? It's very important that someone with good information who fully understands things is on top of her care. We will answer your questions and try to guide you from here as well as we can. Unfortunately too many doctors do not understand about the equipment, only the diagnosis, etc. Please continue to write (in this same thread so we can follow things) and we will help as much as possible. And please loosen that mask for now!

Ok..I'm gonna loose the mask tonight and the pressure settings and everything were done by the person who sold thhis to us he has been selling these from a while so he is experienced and he adjusted the settings. And sometimes we ask him if any problem occurs...So I should put the mask normally without extra tightning and shouldn't care about the pressure staying 12-15 right?? There is also some leakage from the point where the pipe and the mask are attached( Mask is detachable from pipe. )
So that leakage is also normal ??

No ..I don't have any help from someone who has knowledge about these..My big brother used to be one to do her BiPAP and stuff but now he is busy on job thats why I do it ( But he is also much like me just that he has taken care of her for a long time ). And the person who sells these sometimes we contact him for help, I think he is experienced and some knowlegde maybe but he also doesn't understands everything. Also the alarm sounding is it related to pressure or leakage??

The hose leak could be fixed with duct tape (wide, sticky tape). And you can buy new hoses very cheaply, though I don't know how that works where you live.

Why are you concerned about where the settings are - forget for now that the pressure goes high when the mask is too tight - is there another reason you are concerned about the pressure? Do the pressure settings agree with what the doctor ordered?

You need to find more help locally (what country are you in?) because your mother's health depends on it.

Do you have copies of her sleep study results? And what about using software now to see what numbers do overnight?

The alarm may be about her oxygen dropping momentarily, and that has to be measured... is there nowhere there where you can get better information?

There is no reason for me asking about the pressure just wanted to know if it was normal and ok I will fix the hose leak.
But there is northing like her sleep reports or anything...We just put her on BiPAP on night and remove it in morning.
Before she was on vent and oxygen but now she just needs the BiPAP. Live in Pakistan..She has been like this for 4-5 years and bigger brother took care but since new mask and BiPAP came I am taking care of her BiPAP.
Now the pressure order agreeing with doctor's order hmm that I'm gonna ask my bigger brother when he is back from work.
I'm not 100% sure without asking my brother but I think the first time she was put on BiPAP she was recommended these settings and I don't think they were ever changed after that.

Software for her nights result .....Is that like some other monitor/machine or it can checked from the BiPAP screen??

I don't know the laws there of course, but in N. America, you are entitled to your medical records by law... you get them from the doctor or hospital, and it would be a very good idea if you can get her sleep study results and a copy of her prescribed settings from the doctor (or someone) because it would give us more information to help with.

Oh I see. Ok, I'm gonna discuss it with my family about her prescribed settings and sleep study results. Thank you for your help till now.

Hamza wrote:Ok..I'm gonna loose the mask tonight and the pressure settings and everything were done by the person who sold thhis to us he has been selling these from a while so he is experienced and he adjusted the settings. And sometimes we ask him if any problem occurs...So I should put the mask normally without extra tightning and shouldn't care about the pressure staying 12-15 right?? There is also some leakage from the point where the pipe and the mask are attached( Mask is detachable from pipe. )
So that leakage is also normal ??

What kind of a mask is your mom using? This is important for us to know in order to help you figure out whether the leaking you are talking about is normal.

All masks have some kind of system for venting the exhaled air so that the user does not rebreathe the CO2 the patient exhales. For most masks, the venting is done through small holes some where on the mask OR on the tube that connects the pipe (hose) to the mask itself. And so it's very important to make sure that the leaking you are talking about is NOT simply air being intentionally vented from the mask itself.

Second: As Julie has explained, the mask needs to NOT be tightened too much. And it sounds as though you are overtightening the mask in an effort to eliminate the leaks. That's never a good idea: If the mask is on too tight, not only can that lead to additional leaking, but it also can lead to some pretty serious discomfort. And that discomfort can lead to fragmented sleep, which is also not good.

Finally, I do want you to encourage you to ask your family about your mom's sleep test results and the prescribed pressure range. The BiPAP S/T is a machine is usually prescribed for people with very specific sleep problems.

Hamza wrote:There is also some leakage from the point where the pipe and the mask are attached( Mask is detachable from pipe. )
So that leakage is also normal ??

Each mask has a vent so your mother's breathed out air can escape. If there are tiny holes that the air comes out they are made to be there and you do not want to cover them.

Hi - they're correct about the vent holes... not to cover those with tape. I thought you were referring to a tear in the plastic where the hose connects, but if not, then forget the tape.

robysue wrote:

Hamza wrote:Ok..I'm gonna loose the mask tonight and the pressure settings and everything were done by the person who sold thhis to us he has been selling these from a while so he is experienced and he adjusted the settings. And sometimes we ask him if any problem occurs...So I should put the mask normally without extra tightning and shouldn't care about the pressure staying 12-15 right?? There is also some leakage from the point where the pipe and the mask are attached( Mask is detachable from pipe. )
So that leakage is also normal ??

What kind of a mask is your mom using? This is important for us to know in order to help you figure out whether the leaking you are talking about is normal.

All masks have some kind of system for venting the exhaled air so that the user does not rebreathe the CO2 the patient exhales. For most masks, the venting is done through small holes some where on the mask OR on the tube that connects the pipe (hose) to the mask itself. And so it's very important to make sure that the leaking you are talking about is NOT simply air being intentionally vented from the mask itself.

Second: As Julie has explained, the mask needs to NOT be tightened too much. And it sounds as though you are overtightening the mask in an effort to eliminate the leaks. That's never a good idea: If the mask is on too tight, not only can that lead to additional leaking, but it also can lead to some pretty serious discomfort. And that discomfort can lead to fragmented sleep, which is also not good.

Finally, I do want you to encourage you to ask your family about your mom's sleep test results and the prescribed pressure range. The BiPAP S/T is a machine is usually prescribed for people with very specific sleep problems.

I'm not sure about the type of this mask. But its just covers like simple oxygen masks..The upper point is between the eyebrows and lower part is placed on chin. It is not full face or nasal mask...It covers mouth and nose.
The leakage I was talking about weren't those small holes, It is the hose ...some air is coming out from the connnection of pipe and mask.

Not really eyebrows the top part is basically between eyes ...

Hamza wrote: I'm not sure about the type of this mask. But its just covers like simple oxygen masks..The upper point is between the eyebrows and lower part is placed on chin. It is not full face or nasal mask...It covers mouth and nose.

Masks that cover both the mouth and the nose are referred to as full face masks (FFM) around here. One that covers the entire face is called a total face mask. So your mom has what is known as a full face mask.

The leakage I was talking about weren't those small holes, It is the hose ...some air is coming out from the connnection of pipe and mask.

Need a bit more information.

The mask has some kind of a plastic elbow (where the small holes are). And then there is often a short plastic tube that fits over the elbow and into the end of the large hose (pipe). Is the air leaking between the large hose and the short plastic tube OR is the air leaking between the elbow and the short plastic tube? Or is the air leaking from the large hose right where the large hose coupling joins the hose? (Is the hose torn right at the coupling?)

The first thing to do is to inspect the large hose very carefully to make sure it is not torn right at the coupling. If you find a tear or a hole in the hose, it really should be replaced, but you can put some duct tape around it until you get a new hose.

If the large hose has no tears or small holes, the next thing to do is to pull the mask off the hose completely. And then reattach the mask very firmly to the end of the hose. If mask coupling and hose couplings are not firmly pushed together, air can leak out there.

Also---how old is the hose and how old is the mask? If either is more than 6 months old, the problem may be that the mask and/or the hose is simply worn out and the couplings have become loose. In that case, the mask and/or the hose should be replaced.