Am I not understanding sleepyhead or a bipap machine settings?

[palerider]

95% value for IPAP but not EPAP,

The 90/95% number is just a miscellaneous statistic that is given significance by people that don't understand how to read a pressure curve, I really has no meaning, any more than minimum, maximum, average or median numbers do.

One of our members, a mathematics professor, explains what the numbers really mean in this excellent post: http://adventures-in-hosehead-land.blog ... de-to.html

What do they mean about what you should set your machine to?... nothing.

Pugsy's 95% number is, or has been, somewhere around 18, but she does great with her minimum at around 7, because she only needs that high pressure when she's in REM.

[Sleepygal1]

What do they mean about what you should set your machine to?... nothing.

Pugsy's 95% number is, or has been, somewhere around 18, but she does great with her minimum at around 7, because she only needs that high pressure when she's in REM.

That is very interesting. I will read it right now. Still though, there needs to be some actionable statistics, I'd imagine. I could just set it back to AutoBIPAP mode but I read that some people do better on fixed pressures rather than it moving around all night and disturbing my sleep with pressure changes. I wanted to see if it would help me feel better in the morning or if this is the best it's going to get.

I don't have any issues with higher pressures, so what difference does it make if I am hit with 11cmH2O all night vs 7 and 11 only during REM? Will it cause any lung issues or what?

[palerider]

What do they mean about what you should set your machine to?... nothing.

Pugsy's 95% number is, or has been, somewhere around 18, but she does great with her minimum at around 7, because she only needs that high pressure when she's in REM.

That is very interesting. I will read it right now. Still though, there needs to be some actionable statistics, I'd imagine.

Why? Your sleep isn't a constant, it goes up and down in stages, all night long, add into that what position you're in, and many other variables, and you really should realize that trying to summarize anything in a night's sleep with some statistical number isn't even a fuzzy approximation of what actually happened.

I could just set it back to AutoBIPAP mode but I read that some people do better on fixed pressures rather than it moving around all night and disturbing my sleep with pressure changes.

In all fairness, you can find just about anything out on the internet.

I've never seen anything *credible* to affirm that pressure changes disturb sleep. However, what I have seen is that *breathing events* disturb sleep, then the auto machine raises pressure, and sometimes people wake up after the *breathing event*, and then they blame the pressure increase... not catching on to what it was that disturbed their sleep in the first place.

Of course, having a minimum set too low in auto mode just causes more events, and worse sleep, but getting the min pressure high enough to handle most things, and only relying on the auto for exceptions, like REM sleep, works quite well.

Will it cause any lung issues or what?

Nope, crank it up! (my min pressure is higher than that).

[Pugsy]

How about a compromise between fixed and auto adjusting? I need to see what the machine is actually wanting to do to get a feel.
Those overview long term statistics are confusing as hell and they aren't always correctly reflecting what the reports show.
I have seen this personally with my statistics.

Did you know that in fixed mode the Flow Limitation flagging is turned off and Flow Limitations are kinda important that we know if they are happening or not. After all Flow Limitations are important enough that in auto mode the machine will go trying to kill them with more pressure. Snores, OAs, Hyponeas and Flow Limitations are the driving force for the auto adjusting pressures.

So how about you try auto mode but with a small range to see if you sleep better without the machine roaming around so much and you still get FL flagging in case some happen.

My suggestion for tonight..
Auto Mode.

Minimum EPAP 10 and PS 4 to 6 (small range) with IPAP max of 16.
Then lets see tomorrow what shows up on the report.

You can use Encore Pro on Windows 10. You can request it over at the apneaboard....you have to register and be logged in to find the special members only section where it talks about how to get Encore Pro. They push SleepyHead but will send you a link for Encore Pro if you request it.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
Be sure and get the extra supporting texts which are hints on how to use Pro. It's a bitch.
You can't use Encore Basic with the DreamStation....not compatible...you have to use Pro.

[Sleepygal1]

Pugsy and Palerider, I really appreciate your input, thank you so much.

Pugsy, I will try those settings tonight and report back. I love a good experiment. Thank you again!

[ajack]

Hi All,

I'm trying to understand my settings on the Dreamstation AutoBipap on basic Fixed BIPAP mode. Sorry for not setting up all the graphs the right way but I just want you to notice the "Fixed Bi-Level" and EPAP 11, IPAP 18, then notice the pressure graph. I am not getting it. The IPAP line is static at 18 as I expect, but the EPAP is ramping up from 11 -> 13 (when 11 is selected as EPAP!). I checked all the settings and see nothing related to PS, Ramp, Flex is turned off, nothing obvious. Can anyone tell me what is going on???

odd_bipap.png

I was hoping your 2nd chart would have more data. My concern is that the chart is showing a median tidal volume of 840, this is very high. If you look at other charts few would be above 600.
Can you post all your settings. I'm wondering if the min breath length is set too high. The fixed PS 7 may also be too high. Is there a reason you switched from auto?
You have the setup manual from apneaboard for your model?

[palerider]

Hi All,

I'm trying to understand my settings on the Dreamstation AutoBipap on basic Fixed BIPAP mode. Sorry for not setting up all the graphs the right way but I just want you to notice the "Fixed Bi-Level" and EPAP 11, IPAP 18, then notice the pressure graph. I am not getting it. The IPAP line is static at 18 as I expect, but the EPAP is ramping up from 11 -> 13 (when 11 is selected as EPAP!). I checked all the settings and see nothing related to PS, Ramp, Flex is turned off, nothing obvious. Can anyone tell me what is going on???

odd_bipap.png

I was hoping your 2nd chart would have more data. My concern is that the chart is showing a median tidal volume of 840, this is very high. If you look at other charts few would be above 600.
Can you post all your settings. I'm wondering if the min breath length is set too high. The fixed PS 7 may also be too high. Is there a reason you switched from auto?
You have the setup manual from apneaboard for your model?

Just ignore ajack... he reads a lot, but understands little.

[Sleepygal1]

I was hoping your 2nd chart would have more data. My concern is that the chart is showing a median tidal volume of 840, this is very high. If you look at other charts few would be above 600.
Can you post all your settings. I'm wondering if the min breath length is set too high. The fixed PS 7 may also be too high. Is there a reason you switched from auto?
You have the setup manual from apneaboard for your model?

Thanks Jack, you got me concerned, but this was just a quick test of 10 minutes to see what pressure the machine would report. Nothing to be alarmed about. Once I dialed in the settings more, I am now at 520 median 700 95%. One more thing I'll try to keep in mind when I look at my reports. thanks again!

[palerider]

I was hoping your 2nd chart would have more data. My concern is that the chart is showing a median tidal volume of 840, this is very high. If you look at other charts few would be above 600.
Can you post all your settings. I'm wondering if the min breath length is set too high. The fixed PS 7 may also be too high. Is there a reason you switched from auto?
You have the setup manual from apneaboard for your model?

Thanks Jack, you got me concerned,

That's why you should put ajack on the foe list.

He's read a huge amount of stuff, but he doesn't understand the practical applications of it.

That old joke about "knowledge tells you that a tomato is a fruit... Wisdom tells you not to put it in your fruit salad".... he's got tomatoes in his fruit salad.

[ajack]

I was hoping your 2nd chart would have more data. My concern is that the chart is showing a median tidal volume of 840, this is very high. If you look at other charts few would be above 600.
Can you post all your settings. I'm wondering if the min breath length is set too high. The fixed PS 7 may also be too high. Is there a reason you switched from auto?
You have the setup manual from apneaboard for your model?

Thanks Jack, you got me concerned, but this was just a quick test of 10 minutes to see what pressure the machine would report. Nothing to be alarmed about. Once I dialed in the settings more, I am now at 520 median 700 95%. One more thing I'll try to keep in mind when I look at my reports. thanks again!

As I said, I was hoping the second chart would have more data. 520 is a better number. Put up another chart is a few days after seeing how it settles. I may be able to offer an opinion.

[palerider]

I may be able to offer an opinion.

Please don't.