Bilevel IPAP Quits Before Done Inhaling

[Joyful Sleeper]

Hi All,

Last night was my second night trying the PR System One REMStar 60 Series BiPAP Auto with Bi-flex (DS760 Bilevel Machine). Last night I used it in straight bi-level mode with pressure support (difference between EPAP & IPAP) of 4. I found that it bothered me (when going to sleep, when I woke during the night & was going back to sleep & upon waking) because if I took a long slow inhalation (which is "natural" for me), the IPAP pressure quit (went down to EPAP pressure) before I was done inhaling.

I did a search and there are multiple reports of this with bi-level machines (the common explanation is that the IPAP pressure is machine set to cut off at about 3 seconds even if the person breathes in for longer than 3 seconds), but the threads on this that I found are at least 5 years old and referring to much older machines. I tried playing with the bi-flex & rise settings but it didn't seem to change much (which is logical since rise is dealing with the change between exhale & inhale & my issue is the change between inhale & exhale). Ramp isn't available because I was using EPAP=4 which is already the minimum. Are there other ways of getting around this sensation? It didn't bother me once asleep & with time I might just get used to it but it was curious if I'm missing something or any of you had other ideas.

Thanks!
Joyful Sleeper

[palerider]

Hi All,

Last night was my second night trying the PR System One REMStar 60 Series BiPAP Auto with Bi-flex (DS760 Bilevel Machine). Last night I used it in straight bi-level mode with pressure support (difference between EPAP & IPAP) of 4. I found that it bothered me (when going to sleep, when I woke during the night & was going back to sleep & upon waking) because if I took a long slow inhalation (which is "natural" for me), the IPAP pressure quit (went down to EPAP pressure) before I was done inhaling.

I don't see any settings in the prs1 for a setting to address what's bothering you.

the s9 vpap machines, in s, st and auto mode allow you to change the TIMin and TiMax times, which is the minimum and maximum time the machine stays at ipap, TiMax can be set up to 4 seconds.

you'll likely either have to get used to it, or swap machines.

[Guest]

Knowing only 1 pressure setting (4) I will point out that many people can't breath at 4cm. So what are the rest of your machine settings?

[chunkyfrog]

I don't use bilevel, but I have noticed my EPR switching on before I think I'm finished exhaling,
On careful observation, I realized that the switch apparently occurs when my breath volume has reduced
to a very low level. It seems to be preparing for my next inhale, as I have no difficulty breathing when awake.
--not sure how different the sensing/switching mechanism is from mine;
A question: If you couldn't hear it, could you tell it is happening?

[Jack_Russel_Fan]

I use the 760P and got used to the way it works. I also noticed on very long slow inhales it did what you described. I just give in and exhale when it does. Does not bother me anymore.

You may just need to adjust to it. Maybe give it some time!

[Joyful Sleeper]

Hi All,

Thanks for your responses--I appreciate it!

Glad to know that the ResMed machine has an option of changing the settings and yes, I could probably also learn to ignore it/get used to it if needed.

I don't hear an audible noise (my hearing isn't fabulous), I just feel it in my body (it feels like the air gets cut off before I'm finished breathing in). It's interesting because SleepyHead showed RE's while I was awake (& not while asleep)-- probably because every once in a while due to this sensation I took a big fast breath just to feel like I got enough air & SleepyHead saw it as a Respiratory Effort Related Arousal:).

For the guest who asked for the other settings, that night I used IPAP=8 & EPAP=4 (last night IPAP=8.5 & EPAP=4). The reason for the low EPAP is to hopefully avoid aerophagia pain. I've used a minimum pressure of 4 before (on my S9 Autoset the low end of my pressure range was set at 4 for a while) without any difficulty or feeling like I couldn't breathe, but it's of course different to have the experience of an alternating higher pressure for inhale and lower pressure for exhale.

I appreciate your sharing your experiences & knowledge:)!

Joyful Sleeper