Bipap auto sv users

Anyone else here with a Respironics Bipap auto sv? The nurse came to set me up today and a few things stood out. First my pressure is 30/10 WOW this is not going to be fun. Secondly where the humidifier meets the bipap there is a gap. She tried placing a coupling on it with a flapper and it wouldnt fit. I asked her for it but she said it wouldnt work. Right now I have a piece of tape there to stop any leaks due to the high pressure, but am I wrong or do you have a piece there on your bipap?

Coolsideofthepillow wrote:Anyone else here with a Respironics Bipap auto sv? The nurse came to set me up today and a few things stood out. First my pressure is 30/10 WOW this is not going to be fun. Secondly where the humidifier meets the bipap there is a gap. She tried placing a coupling on it with a flapper and it wouldnt fit. I asked her for it but she said it wouldnt work. Right now I have a piece of tape there to stop any leaks due to the high pressure, but am I wrong or do you have a piece there on your bipap?

30/10? I don't think so!

30 is probably your maximum pressure setting, which in this case is the machine's maximum output pressure. This is the highest pressure the machine is allowed to produce, when all of the other modes described below add together.

Your baseline pressure is Min EPAP, which is probably your 10 number. That is a reasonable value for Min EPAP.
Depending on your circumstances (what is your diagnosis?), you might have your max EPAP set the same as your Min EPAP (and Min PS =0), which would make the non-SV mode of your machine a straight CPAP. If Max EPAP is higher (and Min PS = 0), then your machine will behave like an APAP in the non-SV mode.

If Min PS is zero, you will not have billevel pressures (different IPAP and EPAP) during non-SV operation. This would be common for people who have uncomplicated compSAS (Complex Sleep Apnea Syndrome, where therapuetic pressures for your state are causing you to have excessive central apneas) Otherwise, you will have bilevel pressure support on each breath. You also have some user-adjustable bilevel support with the BiFlex feature of the machine.

Max PS is where this machine gets interesting. This is the 'Servo Ventilator' mode of this machine. This is the IPAP pressure the machine will quickly boost you to, if your breath volume decreases below that of a 4 minute moving average. It will boost the pressure 3 cm/breath for up to (I think) three breaths, and will automatically time the breaths (Called 'backup breaths', see next paragraph). The big pressure difference between IPAP and EPAP is designed to encourage you to breathe on your own. (This machine is not a true ventilator, and cannot breathe for you.)

Lastly, there is the 'rate'. If this is set to 'auto', the machine calculates your back-up breath rate for you. Some doctors will set this to a manual rate, which is typically 2 BPM below you normal, natural breathing rate while asleep. Then, there is Ti, or 'inspiratory time', which is the amount of time in each breath, when the machine is doing its SV thing, that IPAP is supplied to the patient.

This is very complex machine, and adjusting things on your own is not advisable until you really understand what this all means. And you need to keep your Doctor in the loop.

I do not have one of these machines, but hopefully will by the end of the week. (CompSAS in my case.)

I do not know about a piece in between the machine and the humidifier. But logic dictates that there is some sort of elastomeric coupling between the machine and the tank that may be missing.

Coolsideofthepillow wrote:Anyone else here with a Respironics Bipap auto sv? The nurse came to set me up today and a few things stood out. First my pressure is 30/10 WOW this is not going to be fun. Secondly where the humidifier meets the bipap there is a gap. She tried placing a coupling on it with a flapper and it wouldnt fit. I asked her for it but she said it wouldnt work. Right now I have a piece of tape there to stop any leaks due to the high pressure, but am I wrong or do you have a piece there on your bipap?

If I understand you correctly, you need a flapper valve. Here it is, along with a funnel and valve cover:
https://www.cpap.com/productpage/flappe ... ifier.html

The valve will wear over time, so you will want to keep an extra or 2 around, but the DME provider needs to be sure you have one to begin with. Don't let them forget to take care of this.

Best wishes,
Tony

Hi, I have one of the Auto SV machines. I have the small valve ( I'll call it a check valve) in the inlet of the humidifier. The flapper goes in first . The other end of the flapper valve then fits onto the output orifice of the machine. Probably not a good explanation but it appears to work to prevent water from the humidifier from getting back into the machine and also provide the coupling between the humidifier and the auto sv. I wouldn't bet the health of the machine on this valve though. I wouldn't move the machine much with water in the humidifier.

My setting are different from yours of course, but the machine is a great machine. I will take some getting use to in all likely hood. I have had mine for a few weeks and I am doing pretty well. At first , with the help of some of this forum's members explaining what the functions were, I changed the BPM to auto and this helped me get use to the machine. I have since changed it back to the prescribed numbers. Hope you have great results from yours.

Bob

Yep a flapper valve. I will call the dme today to get one. I appreciate all of the responses as the more I read the more I understand. As for pressure I am prescribed 30/10. So will my levels fluctuate throughout the night and the machine auto adjust?

Guest wrote:... So will my levels fluctuate throughout the night and the machine auto adjust? ...

Yes. Timbalionguy provided a great explanation of the unit. The ASV (Adaptive Servo-Ventilation) units are used to address issues such as CompSAS, Central Sleep Apnea, and Periodic Breathing. You might find the following information from helpful.

Links to Central Apnea
viewtopic.php?p=457566

Down toward the bottom of the post, you will see some articles on Adaptive Servo-Ventilation.

Please be aware that it takes some time to adjust to one of these units. If you have central apnea, it is possible you stop breathing more frequently during the transition from wakefulness to sleep. When that happens the machine will ramp up the pressure to help stabilize your breathing. You will suddenly find yourself facing a pretty stiff wind. It will take some time to adjust to that. However, I can assure you that you will reach a point where you hardly notice it. But you will need to be patient during the adjustment period.

If this is your first xPAP unit, you will have the additional challenge of adjusting to the use of a mask and the pressure. It does take some time to adjust to these contraptions. However, if it helps improve your sleep you will long to sleep with the unit. Not fun using it. But the improved sleep is wonderful.