No change in AHI

[ehreesejr]

I am now on day 9 with the Resperonics M series Bipap Auto. My aveage AHI is 12.6 ( I can only read out AHI not AI seperately) . I was on the Resmed S8 Vantage auto for about 5 months and my AHI was typically 12 +/_ 2 with AI of 2+/_1. My pressure range on both machines was set at 5 to 20.
My Resmed pressure was about 12 (95 th percentile). My Bipap pressure is 12.2/9.7 aveage
Resmed leakage was near zero l/s (liberty mask). My Bipap is 32.5 l/m Average (F&P 432 FF mask).
According to the Doctor, my sleep study result was an AHI 12. My titration pressure on the second night was not accurately deterministic; which is the reason for the 5 to 20 pressure range.
I notice on this site that most folks get to very low AHI's. My AHI seems to be a constant.
Any thoughts on the reason for this would be appreciated.

[Hawthorne]

I know little about Bipaps but I think your pressure range (5-20) is too wide. A minimum pressure of 5 is generally too low for most people to breathe easily and deal with the CO2. The maximum of 20 would still be uncertain, since your titration was problem (maximum may need to change later) but the minimum should change now.

Someone who knows about Bipap would be better able to advise you on settings but, with a 90% at 12.2 and 9.7, the minimums should be higher than 5 cm. That AHI is too high at 12. I think you could get that down with higher minimum pressures.

[ehreesejr]

Hawthorne,
Thanks for the input. I have a ramp start for 15 minutes that runs at 5e/7i which seems comfortable , Since it climbs to 9.7/12 why would you think I should have the clinician change the setting ( I am not authorized to change pressure settings).What do you think is happening?
Thanks again
Ed

[Hawthorne]

I really have to let someone who knows more about Bipaps answer you clearly but it takes a long time (15 mins) to get up to the point where you are getting therapy with those settings. A lot of events can happen with that range and time.

Someone who knows more about Bipaps may say otherwise. Take their advice over mine since, as I said, I don't know much about Bipaps.

"Experienced Bipap users" - HELP!

[Snoredog]

I would set it to:

Auto Biflex
EPAP Min=9.0
IPAP Max=20
PS=6

Biflex no higher than 2

[ehreesejr]

Snoredog ,
Thanks for the response. I can control the ramp and the Biflex which I have at 3. I'll zero out the ramp and set biflex at2 and try that.

Thanks again,
Ed

[cflame1]

You can control any of it if you really want to. It's not against any law for you to change it. Just make your changes cautiously and it'll be ok.

You won't get a better AHI until you control your own treatment.

There are directions all over the board for changing pressures on both Respironics and Resmed machines... why not use them?

[ehreesejr]

cflame1,
Where is the information on the Resperonic? Do you have a reference?

[CpapMasks]

Sounds like you had an inadequate titration: hence the guesstimate numbers of 20/5....

What was your last CPAP pressure for 5 months? Let's say it was 15cm. You need to set the baseline (EPAP) at 3-5cm less than your old CPAP setting, and then you can max out the IPAP to 20. SO in this example you would set it to 20/12 or 20/10.

There's a good chance we can get your AHI down below 5......

Unplug your machine
open the cover on the top
depress both arrow buttons at the same time, hold them down while plugging the machine back in....KEEP HOLDING
You'll see the Open Lock, then you can let up on the buttons and scroll through the settings.........


Cheers, Jack! MBA,RRT, R.Psgt, AE-C.
frostrrt@gmail.com

[Snoredog]

Snoredog ,
Thanks for the response. I can control the ramp and the Biflex which I have at 3. I'll zero out the ramp and set biflex at2 and try that.

Thanks again,
Ed

Nothing wrong with using Ramp, might as well make it comfortable falling asleep, if you want Ramp,
set it at about 6.5 for 30 minutes, it will bump up EPAP from 6.5 by .5 cm every 5 minutes. If you are still not asleep, press the Ramp button again.

IPAP pressure will start off 2 cm higher than EPAP even with ramp.

[ehreesejr]

Thanks to everyone for all the help. This is agreat site for dealing with a tough problem.
Ed