I would like to know more about how an auto bipap works.
let me put my bottom line questions first if you don't have time to read explanation
the 2 bottom line questions--in addition to how does an auto bipap work are
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
2 and if it is not set to numbers , does it go real low like ramp until I have an apnea event??
My provider said the doctor didn't seem to set it to run in auto mod as he set it at 14/10 even though I have apnea at 16 and 17 and initially was going to put me on bipap setting of 18/14 (cause I was retaining carbon dioxide in my lungs) till I requested the auto bipap as people here thought it might be better.
I am shocked he set it so low and real worried..if is so low as I felt suffocating feelings when the cpap at the sleep study was under 15. I am worried I won't be able to breathe right with it so low when I am awake(chest hurts and suffocating sensations..hard to breathe at ramp or low pressures).
Also will it not go above 14 the way he has it. The provider said it can function as a bipap or an autopap.
I thought it functioned as a kind of auto bipap..setting it maybe at 3 below 14 (his initial recommendation) and 3 above his high recommendation of 18 at maybe 21 and then if it I have an event at 18, it will self adjust higher. An I wrong in thinking this..like if he thought the bipap was best at 18/14, one might set this autobipap at 11/21 to give it a range. So
the bottom line question--
if it is set to numbers, can it not go beyond those numbers and is essentially a bipap
and if it is not set to numbers, does it go real low like ramp until I have an apnea event??
The provider I think will show me how to set it if I ask him, but I have no idea how it works or what settings should be (one girl did give me a suggestion but it was over my head as I am knew to knowing terms and things)
Please help..it is possible his assistant who told me this was the setting got it wrong..maybe she was reading the bottom numbers or something but I can't understand why he has it so low if I needed 18 initially.
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can't understand how an auto bipap works..appreciate help
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
Re: can't understand how an auto bipap works..appreciate hel
sleepyjane wrote:I would like to know more about how an auto bipap works.
let me put my bottom line questions first if you don't have time to read explanation
the 2 bottom line questions--in addition to how does an auto bipap work are
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
###
You can't set an Auto Bipap to a preset ipap & epap pressure. You can set the min epap pressure & the Bipap Auto will then set the ipap to 2 cms above that. Then as the night progresses & if any ipap events are detected, it raises the ipap cms setting also if any epap events are detected it will raise epap cms + if it hasn't changed will maintain the min 2cms ipap-epap gap, but if ipap has already gone higher due to detected ipap events, it should maintain the current gap (but on this particular issue I am not 100% sure) - There is a max ipap-epap gap that can be set but no minimum gap (this part makes the Bipap Auto algorithm just a bit confusing for most of us).
The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode.
###
2 and if it is not set to numbers , does it go real low like ramp until I have an apnea event??
###
It stays at epap set to your min epap & with ipap = epep + 2 until either an epap event or an ipap event causes either to go up. If epap goes up, it (IIRC) also adjusts ipap up the same amount (as I understand it).
###
My provider said the doctor didn't seem to set it to run in auto mod as he set it at 14/10 even though I have apnea at 16 and 17 and initially was going to put me on bipap setting of 18/14 (cause I was retaining carbon dioxide in my lungs) till I requested the auto bipap as people here thought it might be better.
###
"people here thought it might be better" ? - were 'these people' respiratory professionals or merely ordinary xpapers here merely expressing a best guess opinion based on what they have been told ?
###
I am shocked he set it so low and real worried..if is so low as I felt suffocating feelings when the cpap at the sleep study was under 15. I am worried I won't be able to breathe right with it so low when I am awake(chest hurts and suffocating sensations..hard to breathe at ramp or low pressures).
###
It is really hard to know what the causes of chest pains are & that can just as easily be too much pressure to a new cpaper as any other cause. I doubt hat too low pressure is in anyway a problem in this regard.
###
Also will it not go above 14 the way he has it. The provider said it can function as a bipap or an autopap.
###
IIRC it will go above 14 (ipap) if the machine detects ipap events that justify it doing so.
###
I thought it functioned as a kind of auto bipap..setting it maybe at 3 below 14 (his initial recommendation) and 3 above his high recommendation of 18 at maybe 21 and then if it I have an event at 18, it will self adjust higher. An I wrong in thinking this..like if he thought the bipap was best at 18/14, one might set this autobipap at 11/21 to give it a range. So
###
Nup in Bipap Auto mode you do not get to set the ipap setting, it starts off at 'min epap' + 2 cms & then roams up & down based on detection of epap & ipap events.
###
the bottom line question--
if it is set to numbers, can it not go beyond those numbers and is essentially a bipap
###
hopefully answered above
###
and if it is not set to numbers, does it go real low like ramp until I have an apnea event??
###
hopefully answered above
###
The provider I think will show me how to set it if I ask him, but I have no idea how it works or what settings should be (one girl did give me a suggestion but it was over my head as I am knew to knowing terms and things)
###
This machine is in Auto Bipap mode definitely a complex one & is going to be a challnge to understand by someone not already familiar with Bilevel machines & how they work. I know bilevel machines intimately but must confess that the Bipap Auto still has mysteries for me. It is a very innovative design.
###
Please help..it is possible his assistant who told me this was the setting got it wrong..maybe she was reading the bottom numbers or something but I can't understand why he has it so low if I needed 18 initially.
###
Nup, I believe the assistant set the initial settings (Bipap Auto) as normal on the basis that if the machine detected events that justify raising either the ipap or epap, it would do so as needed. You really need to be able to analyse the nightly data from this machine to understand what it is doing for you in auto mode. Can you do this ?.
###
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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, CPAP, Ramp, auto
Cheers
& good luck.
DSM
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, CPAP, Ramp, auto
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
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NightHawkeye
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
nighthawk,
No..not yet. The office has just shown a letter I wrote requesting if I could switch from autopap with c flex to autobipap. After my first sleep study in five years, he was going to switch me from cpap to bipap.
I had never heard of autopap or bipap until about 2 1/2 weeks ago on here. So I have very little understanding of how it works or what it means that he set it to 14/10 instead of the 18/14 he was going to set it at with bipap.
Even though my provider will likely show me how to alter settings, I don't expect it will be the same as going up a few notches on cpap.
I am really hoping my many long-term symptoms of sleep deprivation stemming from my 3 sleep disorders will help me for the first time since starting on the machine about 15 years ago. At the same time I am worried by these figures of 14/10 the assisitant told me it was to be set at since I feel suffocating sensations if pressure is lower than 15.
Tell me --I have heard people say that one needs to buy the software or something in order to read their own results of the night..where do you buy these from and about how much are there (I will be getting one of the respironics machines this week likely as soon as they get the fax from doctor and set appointment up.
_________________
No..not yet. The office has just shown a letter I wrote requesting if I could switch from autopap with c flex to autobipap. After my first sleep study in five years, he was going to switch me from cpap to bipap.
I had never heard of autopap or bipap until about 2 1/2 weeks ago on here. So I have very little understanding of how it works or what it means that he set it to 14/10 instead of the 18/14 he was going to set it at with bipap.
Even though my provider will likely show me how to alter settings, I don't expect it will be the same as going up a few notches on cpap.
I am really hoping my many long-term symptoms of sleep deprivation stemming from my 3 sleep disorders will help me for the first time since starting on the machine about 15 years ago. At the same time I am worried by these figures of 14/10 the assisitant told me it was to be set at since I feel suffocating sensations if pressure is lower than 15.
Tell me --I have heard people say that one needs to buy the software or something in order to read their own results of the night..where do you buy these from and about how much are there (I will be getting one of the respironics machines this week likely as soon as they get the fax from doctor and set appointment up.
_________________
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
DSM,
Thank you SO much for all your help and explanations. I do still have some confusion which maybe you or someone can clear up and also replies.
I will address the comments you made in separate post if they require replies.
First thing you said is
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
###
You can't set an Auto Bipap to a preset ipap & epap pressure. You can set the min epap pressure & the Bipap Auto will then set the ipap to 2 cms above that. Then as the night progresses & if any ipap events are detected, it raises the ipap cms setting also if any epap events are detected it will raise epap cms + if it hasn't changed will maintain the min 2cms ipap-epap gap, but if ipap has already gone higher due to detected ipap events, it should maintain the current gap (but on this particular issue I am not 100% sure) - There is a max ipap-epap gap that can be set but no minimum gap (this part makes the Bipap Auto algorithm just a bit confusing for most of us).
The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode.
If I am understanding you correctly, although one can't set minimum and maximum inhale and exhale pressures like a bipap, one can set the minimum to the exhale one wants..and then inhale will go 2 numbers up. So if he sets epap (does this mean exhale and inhale (ipap) pressure numbers?) to say 10, the inhale will automatically go to 12.
Is it possible he is setting at a 4 point gap between two since it is to be 14/10 (it seems like you are saying in automatic mode it will only set a gap of 2 numbers difference so this is not likely what he is doing).
Since my provider said, he thinks it is not sett on auto due to the number but merely to regular bipap..still this makes no sense why he would tell me less than 2 weeks ago he was giving me bipap of 18/14 and then set this at 14/10 (if its bipap mode like provider thought)
But reading the 2nd part of your explanation it seems a maximum gap can be set so maybe he is gaping it 4 points..starting out low and thinking that if I have apnea, it will rise. I am still confused but it is somewhat clearer. I am just worried I will have a hard time breathing staring out so low,,,it will seem like ramp which is horrible after many years of bipap or cpap.
Thank you SO much for all your help and explanations. I do still have some confusion which maybe you or someone can clear up and also replies.
I will address the comments you made in separate post if they require replies.
First thing you said is
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
###
You can't set an Auto Bipap to a preset ipap & epap pressure. You can set the min epap pressure & the Bipap Auto will then set the ipap to 2 cms above that. Then as the night progresses & if any ipap events are detected, it raises the ipap cms setting also if any epap events are detected it will raise epap cms + if it hasn't changed will maintain the min 2cms ipap-epap gap, but if ipap has already gone higher due to detected ipap events, it should maintain the current gap (but on this particular issue I am not 100% sure) - There is a max ipap-epap gap that can be set but no minimum gap (this part makes the Bipap Auto algorithm just a bit confusing for most of us).
The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode.
If I am understanding you correctly, although one can't set minimum and maximum inhale and exhale pressures like a bipap, one can set the minimum to the exhale one wants..and then inhale will go 2 numbers up. So if he sets epap (does this mean exhale and inhale (ipap) pressure numbers?) to say 10, the inhale will automatically go to 12.
Is it possible he is setting at a 4 point gap between two since it is to be 14/10 (it seems like you are saying in automatic mode it will only set a gap of 2 numbers difference so this is not likely what he is doing).
Since my provider said, he thinks it is not sett on auto due to the number but merely to regular bipap..still this makes no sense why he would tell me less than 2 weeks ago he was giving me bipap of 18/14 and then set this at 14/10 (if its bipap mode like provider thought)
But reading the 2nd part of your explanation it seems a maximum gap can be set so maybe he is gaping it 4 points..starting out low and thinking that if I have apnea, it will rise. I am still confused but it is somewhat clearer. I am just worried I will have a hard time breathing staring out so low,,,it will seem like ramp which is horrible after many years of bipap or cpap.
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
dsm.. I said and you replied this
My provider said the doctor didn't seem to set it to run in auto mod as he set it at 14/10 even though I have apnea at 16 and 17 and initially was going to put me on bipap setting of 18/14 (cause I was retaining carbon dioxide in my lungs) till I requested the auto bipap as people here thought it might be better.
###
"people here thought it might be better" ? - were 'these people' respiratory professionals or merely ordinary xpapers here merely expressing a best guess opinion based on what they have been told ?
I guess it would be ordinary xpapers merely expressing a best guess opinion based on their personal experiences and the experiences having similarities to mine.
When I first got on here I posted the thread please help I am so desperate. When I described the higher pressures, mouth breathing, continuous symptoms of sleep deprivation, etc, people on here who are fellow patients said that they were greatly helped with the auto pap..three or four people agreed and said this was good advise. I had never heard of auto pap before, so that when doctor said for my new machine (old cpap broke), he was putting me on bipap due to retention of CO2 and upping the pressure 2 points over old pressure but really it was 3 points higher as pressure was 26 but machine only went to 15.
I then mentioned to doctor that I was desperate having been clinical depressed over 25 years, suffering many emotional, mental, and physical things associated with sleep deprivation and suicidal 15 years every day.
He replied at the request from me to try autopap with c flex (you don't want that..it will be changing the pressure all night and fragmenting your sleep," I replied oh well the people with similar problems all said how much it helped them. Doctor then suddenly switched his mind saying let's try it/ I replied, "I don't want to use autopap if you don't think it is the best things just based on what these people said but what you really think is best. His reply "let try it"..the company will possibly exchange it after 3 or 4 weeks it is isn't helping.
However, since I also was told I had 10 leg jerks from periodic limb movement disorder and I don;'t want to take the drugs, I am not sure if I will know if auto machine is working as I still have other disorder waking me up. It was then in reflection I worried maybe if I am retaining this carbon dioxide cause the high pressure doesn't allow me to fully exhale (which is what doctor said)..maybe the bipap would have been better. It was then I found out about auto bipap which seem the perfect thing..best of both world..adjusting to apnea and lowering the exhale. That's when I wrote him..ten days later I hadn't heard anything and then finally got to speak to assistant but she really knew very little..didn't even know what index meant on sleep study so maybe she said the wrong pressure. I will know more when provider gets the fax with prescription.
So yes, non professionals advised me but doctor thought on the 2nd pass that it was worth trying. I think the insurance rents machine 6 months and after that purchases so I likely can exchange it as it will be rented at first.
My provider said the doctor didn't seem to set it to run in auto mod as he set it at 14/10 even though I have apnea at 16 and 17 and initially was going to put me on bipap setting of 18/14 (cause I was retaining carbon dioxide in my lungs) till I requested the auto bipap as people here thought it might be better.
###
"people here thought it might be better" ? - were 'these people' respiratory professionals or merely ordinary xpapers here merely expressing a best guess opinion based on what they have been told ?
I guess it would be ordinary xpapers merely expressing a best guess opinion based on their personal experiences and the experiences having similarities to mine.
When I first got on here I posted the thread please help I am so desperate. When I described the higher pressures, mouth breathing, continuous symptoms of sleep deprivation, etc, people on here who are fellow patients said that they were greatly helped with the auto pap..three or four people agreed and said this was good advise. I had never heard of auto pap before, so that when doctor said for my new machine (old cpap broke), he was putting me on bipap due to retention of CO2 and upping the pressure 2 points over old pressure but really it was 3 points higher as pressure was 26 but machine only went to 15.
I then mentioned to doctor that I was desperate having been clinical depressed over 25 years, suffering many emotional, mental, and physical things associated with sleep deprivation and suicidal 15 years every day.
He replied at the request from me to try autopap with c flex (you don't want that..it will be changing the pressure all night and fragmenting your sleep," I replied oh well the people with similar problems all said how much it helped them. Doctor then suddenly switched his mind saying let's try it/ I replied, "I don't want to use autopap if you don't think it is the best things just based on what these people said but what you really think is best. His reply "let try it"..the company will possibly exchange it after 3 or 4 weeks it is isn't helping.
However, since I also was told I had 10 leg jerks from periodic limb movement disorder and I don;'t want to take the drugs, I am not sure if I will know if auto machine is working as I still have other disorder waking me up. It was then in reflection I worried maybe if I am retaining this carbon dioxide cause the high pressure doesn't allow me to fully exhale (which is what doctor said)..maybe the bipap would have been better. It was then I found out about auto bipap which seem the perfect thing..best of both world..adjusting to apnea and lowering the exhale. That's when I wrote him..ten days later I hadn't heard anything and then finally got to speak to assistant but she really knew very little..didn't even know what index meant on sleep study so maybe she said the wrong pressure. I will know more when provider gets the fax with prescription.
So yes, non professionals advised me but doctor thought on the 2nd pass that it was worth trying. I think the insurance rents machine 6 months and after that purchases so I likely can exchange it as it will be rented at first.
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
###
It stays at epap set to your min epap & with ipap = epep + 2 until either an epap event or an ipap event causes either to go up. If epap goes up, it (IIRC) also adjusts ipap up the same amount (as I understand it).
###
I think you are saying that if the minimum exhale pressure (epap?) is set to 10 for instance, the machine will not go lower than ten and will stay at ten unless apnea moves it up to say 15 and then it will be set to 15 (ipap) and 13 (epep) and stay there the rest of the night unless I have an apnea at that setting and then it will go still higher maintaining a 2 point spread gap. Am I understanding this correctly?
It stays at epap set to your min epap & with ipap = epep + 2 until either an epap event or an ipap event causes either to go up. If epap goes up, it (IIRC) also adjusts ipap up the same amount (as I understand it).
###
I think you are saying that if the minimum exhale pressure (epap?) is set to 10 for instance, the machine will not go lower than ten and will stay at ten unless apnea moves it up to say 15 and then it will be set to 15 (ipap) and 13 (epep) and stay there the rest of the night unless I have an apnea at that setting and then it will go still higher maintaining a 2 point spread gap. Am I understanding this correctly?
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
re-
I am shocked he set it so low and real worried..if is so low as I felt suffocating feelings when the cpap at the sleep study was under 15. I am worried I won't be able to breathe right with it so low when I am awake(chest hurts and suffocating sensations..hard to breathe at ramp or low pressures).
###
It is really hard to know what the causes of chest pains are & that can just as easily be too much pressure to a new cpaper as any other cause. I doubt hat too low pressure is in anyway a problem in this regard.
###
No, dsm, I am not a new cpaper having been on either cpap or bipap about 15 years. But since I have been set at 15 (the maximum my old machine went) for at least 6 years or so, I have gotten used to breathing with this pressure and cant use ramp at all...but when I did sleep study three weeks ago, he ordered it started at 10 even though he had me listed at 16 (machine only went to 15) and I could not breathe at 10 and felt suffocating sensations and chest pains and complained and said couldn't stand it and they set to 12..same thing..14 same thing and 15 was OK and did not feel suffocating or pain.
I had been on 20 last 4 weeks as got a machine and gradually set it up to 20 myself to see if it helped. So it wasn't the pressure feeling awful as I was new, but I guess rather that I was acclimated to the higher pressures so that the low one felt like I wasn't getting enough air..kind of like when the power goes out and you wake up finding it hard to breathe with mask on but machine off.
I am shocked he set it so low and real worried..if is so low as I felt suffocating feelings when the cpap at the sleep study was under 15. I am worried I won't be able to breathe right with it so low when I am awake(chest hurts and suffocating sensations..hard to breathe at ramp or low pressures).
###
It is really hard to know what the causes of chest pains are & that can just as easily be too much pressure to a new cpaper as any other cause. I doubt hat too low pressure is in anyway a problem in this regard.
###
No, dsm, I am not a new cpaper having been on either cpap or bipap about 15 years. But since I have been set at 15 (the maximum my old machine went) for at least 6 years or so, I have gotten used to breathing with this pressure and cant use ramp at all...but when I did sleep study three weeks ago, he ordered it started at 10 even though he had me listed at 16 (machine only went to 15) and I could not breathe at 10 and felt suffocating sensations and chest pains and complained and said couldn't stand it and they set to 12..same thing..14 same thing and 15 was OK and did not feel suffocating or pain.
I had been on 20 last 4 weeks as got a machine and gradually set it up to 20 myself to see if it helped. So it wasn't the pressure feeling awful as I was new, but I guess rather that I was acclimated to the higher pressures so that the low one felt like I wasn't getting enough air..kind of like when the power goes out and you wake up finding it hard to breathe with mask on but machine off.
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
####The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode
does the machine function as a plain bipap..see the provider told me wrong saying ti works as a cpap (or automatically), but it would be better if it worked as a bipap if I didn't use as automatic..so it does works as straight cpap or straight bipap??
does the machine function as a plain bipap..see the provider told me wrong saying ti works as a cpap (or automatically), but it would be better if it worked as a bipap if I didn't use as automatic..so it does works as straight cpap or straight bipap??
I got my card reader and software from cpap.com. It was well worth the investment!
Brenda
Brenda
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
###
Nup in Bipap Auto mode you do not get to set the ipap setting, it starts off at 'min epap' + 2 cms & then roams up & down based on detection of epap & ipap events.
###
Isn't it odd then if one can only set the lowest (or exhale/epap) setting that his assistant gave two numbers (both 10 and 14)..maybe he did give wrong thing like provider said having it function as straight bipap..
I would think if he was going to set me initially on bipap at 14/18, then that 14 should be the epap setting rather than 10 as then the ipap will be at least 16 which was my old setting even though the study showed I had apnea at 16 and 17 and that is why he set the high number at 18 initially..16 ipap and 14 epap to start with sounds a lot better and less scary to m than 10..does setting epap at 14 make sense with my requirements..then I will not feel suffocated since I don't feel that at 16 and if epap is 14 then machine will set ipap at 16 unless I have apnea at 16 and then it will adjust upward.
Your explanation helped me so much..about not being able to set ipap (which I assumed means inhale pressure) if I am understanding your explanation correctly. (that is if it's set to epap 14, ipap will be at 16 automatically as it is 2 higher and if I have apnea or hypopnea at that setting ipap will rise and the epap will go 2 numbers under whatever it self adjusts at.
Nup in Bipap Auto mode you do not get to set the ipap setting, it starts off at 'min epap' + 2 cms & then roams up & down based on detection of epap & ipap events.
###
Isn't it odd then if one can only set the lowest (or exhale/epap) setting that his assistant gave two numbers (both 10 and 14)..maybe he did give wrong thing like provider said having it function as straight bipap..
I would think if he was going to set me initially on bipap at 14/18, then that 14 should be the epap setting rather than 10 as then the ipap will be at least 16 which was my old setting even though the study showed I had apnea at 16 and 17 and that is why he set the high number at 18 initially..16 ipap and 14 epap to start with sounds a lot better and less scary to m than 10..does setting epap at 14 make sense with my requirements..then I will not feel suffocated since I don't feel that at 16 and if epap is 14 then machine will set ipap at 16 unless I have apnea at 16 and then it will adjust upward.
Your explanation helped me so much..about not being able to set ipap (which I assumed means inhale pressure) if I am understanding your explanation correctly. (that is if it's set to epap 14, ipap will be at 16 automatically as it is 2 higher and if I have apnea or hypopnea at that setting ipap will rise and the epap will go 2 numbers under whatever it self adjusts at.
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sleepyjane
- Posts: 176
- Joined: Tue Feb 27, 2007 1:43 am
###
Nup, I believe the assistant set the initial settings (Bipap Auto) as normal on the basis that if the machine detected events that justify raising either the ipap or epap, it would do so as needed. You really need to be able to analyse the nightly data from this machine to understand what it is doing for you in auto mode. Can you do this ?.
###
It doesn't seems like he read the part of the sleep study where she wrote a note that I felt suffocated at lower pressures and they had to begin study at 15 instead of 10 like he initially said.
When you talk about analysing the data, I am assuming it has a smart card (also just learned about this last three weeks on here)..what is required to read it? software? How does one know how to interpret what it says and I guess insurance doesn't cover it I saw someone say. Is it expensive and is software all that is required? where do you get this software and do you need a prescription.
I thank you so very much, DSM, for all your help and thanks too if you answer my new post..this will help so much when my provider comes and also when I see the assistant in a week or so for a consultation if I understand and then can ask reasonable questions.
Nup, I believe the assistant set the initial settings (Bipap Auto) as normal on the basis that if the machine detected events that justify raising either the ipap or epap, it would do so as needed. You really need to be able to analyse the nightly data from this machine to understand what it is doing for you in auto mode. Can you do this ?.
###
It doesn't seems like he read the part of the sleep study where she wrote a note that I felt suffocated at lower pressures and they had to begin study at 15 instead of 10 like he initially said.
When you talk about analysing the data, I am assuming it has a smart card (also just learned about this last three weeks on here)..what is required to read it? software? How does one know how to interpret what it says and I guess insurance doesn't cover it I saw someone say. Is it expensive and is software all that is required? where do you get this software and do you need a prescription.
I thank you so very much, DSM, for all your help and thanks too if you answer my new post..this will help so much when my provider comes and also when I see the assistant in a week or so for a consultation if I understand and then can ask reasonable questions.
[quote="sleepyjane"]DSM,
Thank you SO much for all your help and explanations. I do still have some confusion which maybe you or someone can clear up and also replies.
I will address the comments you made in separate post if they require replies.
First thing you said is
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
###
You can't set an Auto Bipap to a preset ipap & epap pressure. You can set the min epap pressure & the Bipap Auto will then set the ipap to 2 cms above that. Then as the night progresses & if any ipap events are detected, it raises the ipap cms setting also if any epap events are detected it will raise epap cms + if it hasn't changed will maintain the min 2cms ipap-epap gap, but if ipap has already gone higher due to detected ipap events, it should maintain the current gap (but on this particular issue I am not 100% sure) - There is a max ipap-epap gap that can be set but no minimum gap (this part makes the Bipap Auto algorithm just a bit confusing for most of us).
The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode.
If I am understanding you correctly, although one can't set minimum and maximum inhale and exhale pressures like a bipap, one can set the minimum to the exhale one wants..and then inhale will go 2 numbers up. So if he sets epap (does this mean exhale and inhale (ipap) pressure numbers?) to say 10, the inhale will automatically go to 12.
>>>
YES - Also you get to set a maximum ipap/epap gap so if you set 'min EPAP' to 10 then the machine will automatically set ipap to start at 12 & if you set A max gap (Max PS) to say 5 then ipap will not go more than 5 above the active epap (at any given time). Remember that epap & ipap can get adjusted independently based on epap events and ipap events.
2 cms will always remain the minimum gap & in this EXAMPL 5 the max.
You also get to set 'MaxIPAP' - this is the highest setting the machine in Auto mode, can roam to.
<<<
Is it possible he is setting at a 4 point gap between two since it is to be 14/10 (it seems like you are saying in automatic mode it will only set a gap of 2 numbers difference so this is not likely what he is doing).
>>
Am not sure what the 14/10 means in this instance. If it were in BIPAP mode (not Auto) I would take it to mean the ipap & epap.
<<
Since my provider said, he thinks it is not sett on auto due to the number but merely to regular bipap..still this makes no sense why he would tell me less than 2 weeks ago he was giving me bipap of 18/14 and then set this at 14/10 (if its bipap mode like provider thought)
>>
Is it possible he wasn't sure how to actually set the machine ?. If so it would be an honest mistake. I thought I knew how they worked until I got my hands on one & discovered it was nothing like I thought or expected.
<<<
But reading the 2nd part of your explanation it seems a maximum gap can be set so maybe he is gaping it 4 points..starting out low and thinking that if I have apnea, it will rise. I am still confused but it is somewhat clearer. I am just worried I will have a hard time breathing staring out so low,,,it will seem like ramp which is horrible after many years of bipap or cpap.
>>
In Auto mode, these are the settings (I am leaving BiFlex = 0)
1 ) MODE = ABPAP
2 ) Min EPAP = (say 10)
3 ) Max IPAP = (say 16)
4 ) Max PS = (say 4)
5 ) FLEX = 0
6 ) Risetime = (say 2)
7 ) Ramp Length = 0
8 ) Ramp Start = x.x
9 ) Patient Disconect = 0 (turns off the hose disconnect alarm)
The manual makes it very clear that 2,3 & 4 are highly interdependent.
"Consider the range of allowable pressures as bounded at the top by the max ipap setting and at the bottom by the min epap setting. While setting up one parameter, another may change according to the following set of rules:
- The device will not allow a Max PS setting outside the range of 3.0 to 8.0 cm H2O, and the device will prohibit other settings to ensure that this rule is not violated
- Within the range of 3.0 to 8.0 cm H2O, any setting can be chosen for Max PS, but it is further subject to the following rule: The Max PS setting cannot exceed Max IPAP setting minus Min EPAP setting.
- If the Min EPAP setting is incremented greater than Max IPAP setting minus Max PS setting, it will force the Max PS to decrease. The Max PS setting will only decrease down to the minimum setting of 3.0 cm H2O, so Min EPAP setting cannot be incremented greater than Max IPAP setting minus 3.0.
- If the Max IPAP setting is decremented less than Min EPAP setting plus Max PS setting, it will force the Max PS to decrease.The Max PS setting will only decrease down to the minimum setting of 3.0 cm H2O, so Min IPAP setting cannot be decremented less than Min EPAP setting plus 3.0.
-----------------------------------------------------------------------------
There now isn't that easy who ever said that understanding cpap machines required a PhD degree in the principles of manipulating sub atomic particles &in deep space
The one oddity to me is not being able to set a min PS - this machine starts ipap at 2 above Min EPAP but on my pressure guage this drops to 1.2 CMS - in fact when I 1st tried the machine I was convinced it was defective as there seemed to be littl difference between IPAP & EPAP - that was what prompted me to dig out my pressure guage & measure what I was experiencing. It turned out that the machine was working exactly as designed.
DSM
<<
Thank you SO much for all your help and explanations. I do still have some confusion which maybe you or someone can clear up and also replies.
I will address the comments you made in separate post if they require replies.
First thing you said is
1. if it is set to numbers, can it not go beyond those numbers and is essentially a bipap (example set to 14/10 will it not go above 14 even if you have an apnea?
###
You can't set an Auto Bipap to a preset ipap & epap pressure. You can set the min epap pressure & the Bipap Auto will then set the ipap to 2 cms above that. Then as the night progresses & if any ipap events are detected, it raises the ipap cms setting also if any epap events are detected it will raise epap cms + if it hasn't changed will maintain the min 2cms ipap-epap gap, but if ipap has already gone higher due to detected ipap events, it should maintain the current gap (but on this particular issue I am not 100% sure) - There is a max ipap-epap gap that can be set but no minimum gap (this part makes the Bipap Auto algorithm just a bit confusing for most of us).
The bottom line is *you* have no control over its min epap to ipap gap - only the max ipap-epap gap. Unless you switch over to plain bipap mode.
If I am understanding you correctly, although one can't set minimum and maximum inhale and exhale pressures like a bipap, one can set the minimum to the exhale one wants..and then inhale will go 2 numbers up. So if he sets epap (does this mean exhale and inhale (ipap) pressure numbers?) to say 10, the inhale will automatically go to 12.
>>>
YES - Also you get to set a maximum ipap/epap gap so if you set 'min EPAP' to 10 then the machine will automatically set ipap to start at 12 & if you set A max gap (Max PS) to say 5 then ipap will not go more than 5 above the active epap (at any given time). Remember that epap & ipap can get adjusted independently based on epap events and ipap events.
2 cms will always remain the minimum gap & in this EXAMPL 5 the max.
You also get to set 'MaxIPAP' - this is the highest setting the machine in Auto mode, can roam to.
<<<
Is it possible he is setting at a 4 point gap between two since it is to be 14/10 (it seems like you are saying in automatic mode it will only set a gap of 2 numbers difference so this is not likely what he is doing).
>>
Am not sure what the 14/10 means in this instance. If it were in BIPAP mode (not Auto) I would take it to mean the ipap & epap.
<<
Since my provider said, he thinks it is not sett on auto due to the number but merely to regular bipap..still this makes no sense why he would tell me less than 2 weeks ago he was giving me bipap of 18/14 and then set this at 14/10 (if its bipap mode like provider thought)
>>
Is it possible he wasn't sure how to actually set the machine ?. If so it would be an honest mistake. I thought I knew how they worked until I got my hands on one & discovered it was nothing like I thought or expected.
<<<
But reading the 2nd part of your explanation it seems a maximum gap can be set so maybe he is gaping it 4 points..starting out low and thinking that if I have apnea, it will rise. I am still confused but it is somewhat clearer. I am just worried I will have a hard time breathing staring out so low,,,it will seem like ramp which is horrible after many years of bipap or cpap.
>>
In Auto mode, these are the settings (I am leaving BiFlex = 0)
1 ) MODE = ABPAP
2 ) Min EPAP = (say 10)
3 ) Max IPAP = (say 16)
4 ) Max PS = (say 4)
5 ) FLEX = 0
6 ) Risetime = (say 2)
7 ) Ramp Length = 0
8 ) Ramp Start = x.x
9 ) Patient Disconect = 0 (turns off the hose disconnect alarm)
The manual makes it very clear that 2,3 & 4 are highly interdependent.
"Consider the range of allowable pressures as bounded at the top by the max ipap setting and at the bottom by the min epap setting. While setting up one parameter, another may change according to the following set of rules:
- The device will not allow a Max PS setting outside the range of 3.0 to 8.0 cm H2O, and the device will prohibit other settings to ensure that this rule is not violated
- Within the range of 3.0 to 8.0 cm H2O, any setting can be chosen for Max PS, but it is further subject to the following rule: The Max PS setting cannot exceed Max IPAP setting minus Min EPAP setting.
- If the Min EPAP setting is incremented greater than Max IPAP setting minus Max PS setting, it will force the Max PS to decrease. The Max PS setting will only decrease down to the minimum setting of 3.0 cm H2O, so Min EPAP setting cannot be incremented greater than Max IPAP setting minus 3.0.
- If the Max IPAP setting is decremented less than Min EPAP setting plus Max PS setting, it will force the Max PS to decrease.The Max PS setting will only decrease down to the minimum setting of 3.0 cm H2O, so Min IPAP setting cannot be decremented less than Min EPAP setting plus 3.0.
-----------------------------------------------------------------------------
There now isn't that easy who ever said that understanding cpap machines required a PhD degree in the principles of manipulating sub atomic particles &in deep space
The one oddity to me is not being able to set a min PS - this machine starts ipap at 2 above Min EPAP but on my pressure guage this drops to 1.2 CMS - in fact when I 1st tried the machine I was convinced it was defective as there seemed to be littl difference between IPAP & EPAP - that was what prompted me to dig out my pressure guage & measure what I was experiencing. It turned out that the machine was working exactly as designed.
DSM
<<
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
-
NightHawkeye
- Posts: 2431
- Joined: Thu Dec 29, 2005 11:55 am
- Location: Iowa - The Hawkeye State
One aspect about the BiPAP-auto which I think deserves repeating is the fact that the BiPAP-auto can be easily set to operate as a regular BiPAP. So, if the way you receive it does not work well for you, then you can just get it reset to operate as a standard BiPAP with pressures of 14/18 for instance.sleepyjane wrote:nighthawk,
No..not yet. The office has just shown a letter I wrote requesting if I could switch from autopap with c flex to autobipap. After my first sleep study in five years, he was going to switch me from cpap to bipap.
I had never heard of autopap or bipap until about 2 1/2 weeks ago on here. So I have very little understanding of how it works or what it means that he set it to 14/10 instead of the 18/14 he was going to set it at with bipap.
You can also set the BiPAP-auto to operate as a regular CPAP if that suits you better.
See, there's not much to worry about, really.
It's not really all that different, Sleepyjane. You needed to learn a few principles to adjust your CPAP machine properly. Those same principles apply to BiPAP, only with two pressures to adjust rather than one. Additionally, each machine manufacturer has their own somewhat unique terminology.sleepyjane wrote:Even though my provider will likely show me how to alter settings, I don't expect it will be the same as going up a few notches on cpap.
I hope the new machine works out for you, Sleepyjane. The best way to counteract incompetence on the part of your health care providers is for you to be informed, as you are clearly attempting to be, so that you have options available to you if your health care providers fail to deliver on their promises. Really, I don't think you'll find the BiPAP-auto difficult to adjust at all, or that you will be overly confused by it once you get your hands on it. I'd guess that the worst part is the abstractness associated with not being able to see one or adjust it.sleepyjane wrote:I am really hoping my many long-term symptoms of sleep deprivation stemming from my 3 sleep disorders will help me for the first time since starting on the machine about 15 years ago. At the same time I am worried by these figures of 14/10 the assisitant told me it was to be set at since I feel suffocating sensations if pressure is lower than 15.
Sleepyjane, here is a link for the software and reader at CPAP.com:sleepyjane wrote:Tell me --I have heard people say that one needs to buy the software or something in order to read their own results of the night..where do you buy these from and about how much are there (I will be getting one of the respironics machines this week likely as soon as they get the fax from doctor and set appointment up.
https://www.cpap.com/productpage-bundle ... undle.html
Regards,
Bill
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