How to Sleep with BIPAP Machine

[atgauthier]

Good Morning,

My husband has a history of sleep apnea. A few years ago he was prescribed a CPAP machine. It seemingly worked well. For whatever reason, he stopped wearing it. Fast forward a few years, extra pounds, two kids, busier than ever....I sent him back to the doctor for an updated study so we could figure out if settings had changed. This time, they prescribed a BIPAP machine. I don’t know much, but based on what I read, his CPAP pressures are so high that breathing against it would be near impossible, so a BIPAP machine would facilitate with that??

He got the machine at the beginning of April, wore it one night, had leaking issues with the mask, and just tried again last night. He adjusted the mask yesterday, so the leaking part is resolved. However, he cannot fall asleep. This says a lot because he can fall asleep anywhere (thanks to sleep apnea).

Here’s the technical info (just typing what I see on the nightstand):

Machine: ResMed AirCurve 10
Mask: ResMed AirTouch

Settings: neither of us can find it in the machine at this moment, but he believes the “high end” is 21 and the “bottom number” is 18. It has a 45 minute ramp up.

Any tips or suggestions would be appreciated!

[Pugsy]

First thing go here and request a copy of the clinical provider manual available for the machine.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
In the manual are the instructions for how to get to the clinical setup menu so you can know exactly what all the settings are.

Which AirCurve 10 machine is it...there are several models like
S
VAuto
ASV
S/T
complete model name should show up clearly on the bottom right hand corner of the face of the machine.

Ask him to try to isolate what it is that is causing him to not be able to relax enough to fall asleep.
And does he normally have trouble falling asleep even without trying to use the machine?

[atgauthier]

It is a VAUTO.

He has no trouble falling asleep. He has a much harder time staying awake. For instance, if I ask him to stay awake so I can fall asleep before the snoring starts, no matter how hard he tries, he normally falls asleep.

He says it’s the pressure that makes it difficult to fall asleep.

Will look up the other info shortly.

[Pugsy]

If he is using ramp then the starting pressures are quite low and a lot of people find that they feel air starved or like they are suffocating.
So ask him what it is that makes him uncomfortable with the pressures.
If he says the machine is rushing him..there are settings to maybe help with the timing.

The VAuto has 3 modes of operation
CPAP mode
Fixed bilevel mode
Auto Adjusting bilevel mode

So go into the clinical setup menu and figure out exactly which mode and what all the settings are.
Then try to get him to be specific with his problems or discomfort or whatever. The more information we have the better our chances of coming up with some ideas to help.

One thing that can be done just to help get used to the machine and breathing with it is watch TV or read while using it and not be under any pressure or stress to fall asleep.

[D.H.]

Try with the ramp and without, see which works better. Try with humidity and without, see which works better.

Also, what were his settings from years ago?

[yourbrokenoven]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

Overall, I also find it harder to fall asleep with my machine than without, but you get used to it. And it's not that big of a problem after a while.

Your husband sounds a lot like me being barely able to stay awake. That's me most nights, even now. Except tonight. This is another rare night I simply cannot fall asleep.

[Holden4th]

My initial problems with CPAP were because I was mouth breathing. Just as I was falling asleep my mouth dropped open and the air came rushing out which of course woke me up. So I'd close my mouth, start to fall asleep again and my mouth would open and I'd wake up again. I solved this of course with a soft cervical collar. I also learned how to breathe through my nose. It took a bit of time but I do it naturally during the day now.

[D.H.]

My initial problems with CPAP were because I was mouth breathing. Just as I was falling asleep my mouth dropped open and the air came rushing out which of course woke me up. So I'd close my mouth, start to fall asleep again and my mouth would open and I'd wake up again. I solved this of course with a soft cervical collar. I also learned how to breathe through my nose. It took a bit of time but I do it naturally during the day now.

Some who report mouth-breathing can learn to nose-breathe; once the nasal passages are kept open by enough pressure. Others probably do need a full-face mask.

[D.H.]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

. . .

I really found the opposite. My DreamStation came with C-Flex turned on. My old CPAP has no such feature. I felt that even this small pressure change was like the machine breathing for me (I know that's not the case, but it felt like it). Perhaps that was because I'd been using CPAP for sixteen years at that point and become used to it as it existed in 1999. It just seems hard to predict who would benefit from exhalation relief and to whom it would be detrimental.

BTW, my sleep doc said that there is no known therapeutic benefit or detriment to exhalation relief; it's whatever can make the patient comfortable and compliant.

[OkyDoky]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

BTW, my sleep doc said that there is no known therapeutic benefit or detriment to exhalation relief; it's whatever can make the patient comfortable and compliant.

I had the same experience as yourbrokenoven. Except for the toasting study.

DH's statement is not accurate. If you are talking about the 3cm EPR on regular machines maybe. BUT we are talking about bilevel machines where exhalation relief can go higher (called PS) and high PS can cause hyperventilation which triggers other reactions.

[D.H.]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

BTW, my sleep doc said that there is no known therapeutic benefit or detriment to exhalation relief; it's whatever can make the patient comfortable and compliant.

I had the same experience as yourbrokenoven. Except for the toasting study.

DH's statement is not accurate. If you are talking about the 3cm EPR on regular machines maybe. BUT we are talking about bilevel machines where exhalation relief can go higher (called PS) and high PS can cause hyperventilation which triggers other reactions.

He was speaking of the minor pressure relief on "regular" machines. That's the machine I have, so his answer is oriented towards that. If you have a Bi-Pap, you likely have more than "garden variety Obstructive Sleep Apnea."

[OkyDoky]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

BTW, my sleep doc said that there is no known therapeutic benefit or detriment to exhalation relief; it's whatever can make the patient comfortable and compliant.

I had the same experience as yourbrokenoven. Except for the toasting study.

DH's statement is not accurate. If you are talking about the 3cm EPR on regular machines maybe. BUT we are talking about bilevel machines where exhalation relief can go higher (called PS) and high PS can cause hyperventilation which triggers other reactions.

He was speaking of the minor pressure relief on "regular" machines. That's the machine I have, so his answer is oriented towards that. If you have a Bi-Pap, you likely have more than "garden variety Obstructive Sleep Apnea."

I'm not sure who HE is because what I see in this thread is related to BIPAP/Bilevel. Bilevel can be prescribed for regular Obstructive Sleep Apnea when someone has difficulty exhaling against pressure.

[D.H.]

During my sleeep study and subsequent toasting study I also found it very hard to breathe in or out with a CPAP. It was like breathing through a towel.

BiPAP was very natural, at least when going to sleep.

BTW, my sleep doc said that there is no known therapeutic benefit or detriment to exhalation relief; it's whatever can make the patient comfortable and compliant.

I had the same experience as yourbrokenoven. Except for the toasting study.

DH's statement is not accurate. If you are talking about the 3cm EPR on regular machines maybe. BUT we are talking about bilevel machines where exhalation relief can go higher (called PS) and high PS can cause hyperventilation which triggers other reactions.

He was speaking of the minor pressure relief on "regular" machines. That's the machine I have, so his answer is oriented towards that. If you have a Bi-Pap, you likely have more than "garden variety Obstructive Sleep Apnea."

I'm not sure who HE is because what I see in this thread is related to BIPAP/Bilevel. Bilevel can be prescribed for regular Obstructive Sleep Apnea when someone has difficulty exhaling against pressure.

This has no direct therapeutic benefit, at least not according to what I've been told. In that the patient can tolerate the therapy because of this, it's a benefit. I don't believe that there's a direct detriment either, at least not in most cases.

[LSAT]

My initial problems with CPAP were because I was mouth breathing. Just as I was falling asleep my mouth dropped open and the air came rushing out which of course woke me up. So I'd close my mouth, start to fall asleep again and my mouth would open and I'd wake up again. I solved this of course with a soft cervical collar. I also learned how to breathe through my nose. It took a bit of time but I do it naturally during the day now.

Some who report mouth-breathing can learn to nose-breathe; once the nasal passages are kept open by enough pressure. Others probably do need a full-face mask.

I have always been a nose breather, but I tend to exhale through my closed lips. I have used a nasal mask and pillows....but..I am not comfortable with them. I find the Full face much more comfortable and breathing more natural than having pressure blowing directly into my nose.