Check my pressure support setting? (Bipap)

[Sibbs]

Longtime CPAP user who just switched to bipap. Just got a new Dreamstation autobipap. Want to make sure my DME set it up correctly.

According to my DME my doc's script reads: IMAX 18, EMIN 8, PS 4.

My DME is a stinker so I always check their work. Glad I did. They had both PSMIN and PSMAX set at 0. I just called and they said oops, both PSMIN and PSMAX should be set at 4. Does this intuitively make sense to have both min and max the same? As in PS set at a constant?

Forgive me if this is obvious. I'm still learning bipap and just want to make sure the DME isn't making mistake v2. Thanks. (Dreamstation manual with settings is here for those who are curious: http://www.apneaboard.com/dreamstation- ... structions)

Thanks!

[palerider]

According to my DME my doc's script reads: IMAX 18, EMIN 8, PS 4.

My DME is a stinker so I always check their work. Glad I did. They had both PSMIN and PSMAX set at 0. I just called and they said oops, both PSMIN and PSMAX should be set at 4. Does this intuitively make sense to have both min and max the same? As in PS set at a constant? !

*IF* you want to go by what they say the script is, then yes, psmin and psmax should be 4.

if they're that stinky, you might want to verify with the doc.

[Sibbs]

According to my DME my doc's script reads: IMAX 18, EMIN 8, PS 4.

My DME is a stinker so I always check their work. Glad I did. They had both PSMIN and PSMAX set at 0. I just called and they said oops, both PSMIN and PSMAX should be set at 4. Does this intuitively make sense to have both min and max the same? As in PS set at a constant? !

*IF* you want to go by what they say the script is, then yes, psmin and psmax should be 4.

if they're that stinky, you might want to verify with the doc.

I will. They're just out until the middle of next week.

Thought I'd check here to see if a constant value of 4 is generally reasonable or something only seen in odd circumstances.

[palerider]

Thought I'd check here to see if a constant value of 4 is generally reasonable or something only seen in odd circumstances.

varying pressure support capability is a respironics thing, resmed vpaps don't have a range of pressure supports (until you get to the adaptive servo ventilators.) so, yeah, it's generally reasonable

[Okie bipap]

They should both be set to 4. With your settings, you will have 12 - 18 cm H2O IPAP and 12 - 14 cm H2O EPAP.

[Sibbs]

Thanks folks – helpful as always.

[palerider]

ah, not quite. IMAX 18, EMIN 8, PS 4. gives an ipap of 12-18, and an epap of 8-14 (probably just a typo on your part.)

[Sibbs]

They should both be set to 4. With your settings, you will have 12 - 18 cm H2O IPAP and 12 - 14 cm H2O EPAP.

ah, not quite. IMAX 18, EMIN 8, PS 4. gives an ipap of 16-18, and an epap of 12-14 (probably just a typo on your part.)

Help me learn more?

My manual describes PS as the difference between IPAP and EPAP. If it's constant at 4 wouldn't that yield an minimum IPAP of 12? Calculated as EMAP min of 8 + 4 PS = 12 IPAP?

One other question. My old CPAP settings were 9 - 13 cm H20, with most of my time spent in the 10 - 11 range. Am I right in reading your note above that I'd now be in the 16-18 range for comparable inspiration pressure? If so, seems like I'm in for a big jump in minimum pressure (my brain doesn't usually like adding more than 1 or so cm H20 at a time). Or are the units not comparable?

Thanks, trying to learn as much as I can!

[palerider]

They should both be set to 4. With your settings, you will have 12 - 18 cm H2O IPAP and 12 - 14 cm H2O EPAP.

ah, not quite. IMAX 18, EMIN 8, PS 4. gives an ipap of 16-18, and an epap of 12-14 (probably just a typo on your part.)

Help me learn more?

My manual describes PS as the difference between IPAP and EPAP. If it's constant at 4 wouldn't that yield an minimum IPAP of 12? Calculated as EMAP min of 8 + 4 PS = 12 IPAP?

well, I got it backwards though. it should be epap of 8-14 and ipap of 12-18... sorry for the confusion.

One other question. My old CPAP settings were 9 - 13 cm H20, with most of my time spent in the 10 - 11 range. Am I right in reading your note above that I'd now be in the 16-18 range for comparable inspiration pressure? If so, seems like I'm in for a big jump in minimum pressure (my brain doesn't usually like adding more than 1 or so cm H20 at a time). Or are the units not comparable?

the whole bilevel thing is somewhat different feeling, since it's two different pressures on each breath. you'll just have to see how it feels.

it'll go from 8-12 on each breath, up to 14-18, if needed. where you'll spend your time, only time will tell.

[OkyDoky]

well, I got it backwards though. it should be epap of 8-14 and ipap of 12-18... sorry for the confusion.

my mind was bumfuzzled trying to figure this out.

it'll go from 8-12 on each breath, up to 14-18, if needed. where you'll spend your time, only time will tell.

Now this I can understand.

[OkyDoky]

This is how I understand it, like Palerider said, you will start off at Emin 8 + PS 4 = Ipap 12 while you sleep if the machine detects you need more Epap it will raise and the PS will push up the Ipap. Or if it determines you need more Ipap it will pull up the Epap so the PS always remains the same. The maximum you can go to is 18 Ipap and with PS of 4 your Epap would be 14.

[Sibbs]

Another expert who has been immensely helpful suggested trying the PS max at 8 to give the machine more flexibility. I'm going to try that as well. Fun to learn a new machine.

[palerider]

Another expert who has been immensely helpful suggested trying the PS max at 8 to give the machine more flexibility. I'm going to try that as well. Fun to learn a new machine.

a ps of 8 can hyperventilate someone who doesn't need it, and may then cause more centrals, watch your data carefully.