HELP - BIPAP NOT DOING IT FOR ME.

[paulcarpenter]

Perhaps someone can assist me. I was diagnosed ten years ago. I was prescribed a Vpap 2, an old dinosaur machine they tell me, and it was set to 24/20, as I was 98th percentile severity. It would give me my upper limit on inspiration, but halfway through my expiration, it would kick in again and my lungs stayed open with more air than my present bipap, which only gives me the inspiritatory pressure when I exhale fully. That said, it is difficult for me to fall asleep, as I have to continuously monitor my breathing as I feel I'm smothering. Doing so allows my brain to churn on other things, and therefore harder to sleep. The humidifier runs out of water before morning, and I wake up through the night with my tongue stuck to the roof of my mouth. Yes, I have the heated hose. My old machine had two external reservoirs with two heaters to accommodate me. When the machine crapped out, it went from whatever it was to a regular cpap or perhaps a bipap, but without the features I needed. I sent it in for repair, but they said it worked finme. When I got it back it did work as before but only lasted one week, then reverting to the bipap configuration. I presently have a Resmed Aircurve 10S, but Resmed support just refers me back to the equipment supplier, who has no clue of what I am saying. Am I the only one with this problem? I researched on emphysema.net and there was an article saying that bipap machines can be set to either the patient's expiration or manually. Nobody seems to know how to set it manually. It need to be set like a low volume respirator, and that article on emphysema.net states that it can be done. Who must I contact to achieve this, please?

[palerider]

Perhaps someone can assist me. I was diagnosed ten years ago. I was prescribed a Vpap 2, an old dinosaur machine they tell me, and it was set to 24/20, as I was 98th percentile severity. It would give me my upper limit on inspiration, but halfway through my expiration, it would kick in again and my lungs stayed open with more air than my present bipap, which only gives me the inspiritatory pressure when I exhale fully. That said, it is difficult for me to fall asleep, as I have to continuously monitor my breathing as I feel I'm smothering. Doing so allows my brain to churn on other things, and therefore harder to sleep. The humidifier runs out of water before morning, and I wake up through the night with my tongue stuck to the roof of my mouth. Yes, I have the heated hose. My old machine had two external reservoirs with two heaters to accommodate me. When the machine crapped out, it went from whatever it was to a regular cpap or perhaps a bipap, but without the features I needed. I sent it in for repair, but they said it worked finme. When I got it back it did work as before but only lasted one week, then reverting to the bipap configuration. I presently have a Resmed Aircurve 10S, but Resmed support just refers me back to the equipment supplier, who has no clue of what I am saying. Am I the only one with this problem? I researched on emphysema.net and there was an article saying that bipap machines can be set to either the patient's expiration or manually. Nobody seems to know how to set it manually. It need to be set like a low volume respirator, and that article on emphysema.net states that it can be done. Who must I contact to achieve this, please?

the aircurve 10s is a very customizable machine, but what customizations are needed depend on what kind of lung problems you have. do you have an obstructive lung disease, or restrictive lung disease?

Patients with obstructive lung disease have chronic airflow limitation. These patients have particular difficulty exhaling air, which leads to air trapping and hyperinflation. These patients require a longer exhalation, which often leads to asynchrony with standard bilevel settings.
The recommended settings use a faster rise time to ensure that the lungs are filled quickly, and a high cycle sensitivity to provide an earlier cycle to exhalation. The rapid inhalation and prolonged exhalation will help to prevent auto-PEEP and preserve synchrony.

Patients with restrictive lung disease have a difficult time maintaining the inhalation phase long enough to ensure adequate tidal volume and gas exchange. This can be caused by a physical restriction of the lungs or by neuromuscular weakness.
The recommended settings use a low cycle sensitivity and a longer Ti Min time to provide a longer inhalation time to help increase tidal volume and gas exchange.

you mention emphysema.net, emphysema is an obstructive disease, but your description sounds more like a restrictive issue.

what are the settings on your 10s?