Accidentally reset bipap to default - Help me fix it please!

[nimboo]

Hello,



I need help fixing my dad's BiPAP Pressures - I accidentally reset the machine to defaults, and the pressure is suddenly too high for him to breathe.

My dad has been using this Respironics BiPAP Duet LX System for the past 12 years.

Over the past year, his mask has been breaking a lot, so I bought him a new mask, the Nasal Pillow mask.

While we were waiting for the mask to ship, I read a review that said the pressure is much higher with the nasal pillow mask than with the normal mask. However, this reviewer said, they were able to adjust the pressure of their machine, and once they did, the nasal pillow mask worked great.

I decided to research how to change the pressure settings while I waited for the mask to arrive. I found the website apneaboards.com and learned that certain combinations of the buttons while plugging the machine in could help you access the pressure settings. By holding the ramp button and the two light grey buttons, I reset the machine to defaults

Now, though, I have figured out how to get into the pressure settings (I think).

By holding the Power button and the right light grey button, I was able to get into a series of menus. The menus aren't as simple as "IPAP" and "EPAP." The values don't seem to be measured in cm of water either.

In the list of settings below, Mot DAC and Valve DAC are the only settings that seem to alter the pressure of the machine.

Here are all of the settings I found, and how they change with my inputs. Different screens are separated by spaces, you go from one screen to another by pressing the ramp button. You change values by pressing one of the two light grey buttons. The machine can be turned on while in these settings, and the pressure can be changed in real time:


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Pr Sensor = 202
Cm=0.0 0=-0.1
Turing the machine on increases the Pr Sensor and Cm values
Pr Sensor = ~510
Cm= ~15.7 0=-0.1

Mot DAC = 0
Period -1
Mot may be Not, and the DAC value can be altered by using the grey buttons, it seems to range from 0-200+
When you turn the machine on, Becomes
Mot DAC=225
Period 136
As you lower the DAC, the period increases. A DAC of 111 corresponds to a period of 279, and is a much lower pressure than a DAC of 225 and a period of 136. You can change these values while the machine is on, and hear and feel the difference.

Valve DAC=128
Turning the machine on does nothing. You can adjust the values of Valve DAC with the grey buttons
Lower values seem to reduce pressure, in a different kind of way.

Motor Current
ADC:1=2 mA

DC Level
ADC: 16=240 mV

Flow Input:
F1: 546 F2: 536
Turning the machine on changed the values to
F1: ~240 F2: ~840
The grey buttons do nothing

LPM: 0 (0)
0: -8 Raw: -8
Turning the machine on changes the values to
LPM: ~158 (~630)
0: -8 RAw: ~602

Pres SCI: SPI
0.0 00000:00000
The value in the bottom right is counting up
Turning the machine on changes the values to
Pres SCI: SPI
~15.7 00000.00000 (still counting up)
The left grey button restarts the timer

Clr time meters?
Yes

Deep Sleep?
Yes

FlowTable: -15883
Zero
Turning the machine on does nothing.
Pressing "Zero" Changed the value to 21845


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I'd really appreciate some help figuring out how to get my dad back to using his machine. He cannot afford another sleep study, and has no insurance, so figuring this out is our only option!

Thank you!

[palerider]

I'd really appreciate some help figuring out how to get my dad back to using his machine. He cannot afford another sleep study, and has no insurance, so figuring this out is our only option!

modern bilevel machines on the secondary market, such as from a couple of the members here, are MUCH less expensive than new, so, that might be an option, plus, he'd get back about 3/4ths of his night table.

in the meantime, hopefully someone will have the information you need.

[nimboo]

Hey Palerider, we were actually looking into just buying him a new machine (secondwindcpaps will accept our 12 year old polysomnographic, so we could even buy from him with a warranty).

We are just trying to figure out if he needs an AutoBipap or an AutoCpap with EPR. I'm honestly not even sure what the difference is.

All I know is my dad believes he needs an AutoBipap, because he remembers not being able to sleep with the Cpap.

I'm just not sure if modern Cpaps (or autocpaps) are good enough to mean that he no longer needs to go to a Bipap (or autobipap).

In general, we've concluded we need an auto machine, as they place less importance on sleep studies (which we can't afford).

We can probably only afford something around $500-$800.

Even that may be a stretch though so if we can get his old machine working again, that'd take some pressure off the situation. He has an AHI of 61, and has been sleeping without a machine for a week now as we try to figure all this out. He feels (excuse the language) like absolute shit.

Thanks

[Wulfman...]

I did some Google searching and found you had posted over on the apneaboard, too. However, you added some extra information there which you didn't post here.

Thank you! From his Polysomnographic 12 years ago:

"Impression:
1. Abnormal nocturnal polysomnographic examination revealing the following abnormalities:
a. Moderately severe/severe obstructive sleep apnea
b. prominent sleep fragmentation

2. Successful treatment of obstructive sleep apnea employing the following therapeutic parameters:
a. cpap pressure of 6cm of water
b. medium small respironics profile mask
c. chin strap
d. 12 feet of tubing
e. in-line humidification

Comment:
This patient has fairly prominent obstructive sleep apnea. There is considerable sleep fragmentation. Oximetry overall was relatively well preserved. Pressure requirements were fairly average.

The patient overall feels that he would like to continue to use the BiPAP, in that he feels his sleep would be more refreshing. Pressures under BiPAP would be difficult to calculate based on the present study, although an IPAP pressure of 8 or 9 and an EPAP pressure of 5 or 6 would probably be adequate."

It's interesting that he's using very low pressures and was actually prescribed a CPAP pressure of 6 cm.

But, since you've figured out how to get into the settings, maybe you can download this user manual for it and figure it out.

https://www.sleeprestfully.com/prodimag ... DuetLX.pdf

It turns out this machine is one of the few Respironics machines I DIDN'T have a clinical or service manual for.

I also can't figure out how to interpret all those numbers you have posted in your initial post. Maybe the user manual will help.

I also find it curious that in 12 years, the original settings were apparently never recorded from the clinical setup in this machine. That's one of the FIRST things we recommend to new users before they go fiddling around with their settings.

Good luck,

Den

.

[Wulfman...]

On second or third thought, since his pressures were supposed to be so low, he might just do pretty well with a (newer) CPAP machine. Get something that is fully data-capable to be able to monitor his therapy with software.
There are a number of machines that are for sale by forum users at any given time, or go to

http://www.secondwindcpap.com

and see what they've got for sale in the "lightly-used" category.

Or, go to https://www.cpap.com

and see what they've got (new). They are the sponsors/providers of this forum.


Den

.

[palerider]

Hey Palerider, we were actually looking into just buying him a new machine (secondwindcpaps will accept our 12 year old polysomnographic, so we could even buy from him with a warranty).

We are just trying to figure out if he needs an AutoBipap or an AutoCpap with EPR. I'm honestly not even sure what the difference is.

an auto bi-LEVEL machine (bipap is a trademark, like 'xerox') is best, because it can operate just like an autocpap, plus it has more capabilities. the difference, basically, between an auto bilevel and an autocpap with epr is that EPR gives you a max of 3cm pressure difference between inhale and exhale, bilevel machines can go much higher. (i settled on 5 with mine, through experimentation)

We can probably only afford something around $500-$800.

you can easily find one in that price range from some people here, possibly secondwind. every machine I've ever had was "used" even though one of 'em had zero hours on it when I got it

He feels (excuse the language) like absolute shit.

no doubt!

[grayghost4]

I can ship this one to the US $400 plus shipping

http://sfbay.craigslist.org/eby/hab/5468002384.html

I also have several bipap machine

PM if intrested

[Thatgirl]

If his pressures were indeed 8 and 5 or 6, there's no reason he needs a bipap. A straight CPAP set to 8 and EPR of 3 is bilevel at IPAP 8 and EPAP 5, at least for Resmed devices. Now, with that machine, there is of course no way you've been monitoring therapy effectiveness. So it's totally possible he's been having an AHI of 20 on those settings, still far improved from his baseline and untreated AHI, but far from optimal. If that's the case, he may need higher pressures when you start looking at things. So if you can afford a bilevel device, that gives you flexibility for that potential situation.

[nimboo]

Hey thanks for replying, Wulfman. That was indeed my post on apneaboards. To be honest I didn't include that information because I was afraid my post was already too long, and no one would bother helping me.

I really appreciate your advice. He has decided to go for an auto bilevel, as he really isn't sure what his pressure settings need to be any more, and doesn't want to buy a machine (like an autocpap) that ends up being incapable of meeting his needs.

Where do I find forum members to purchase from?

Grayghost, I will PM you, thank you for contactin me!

Thatgirl, that is exactly what we're thinking at this point. As we KNOW that we won't be able to afford a sleep study any time soon, we want to get an auto-bilevel that will take care of any eventuality (he has gained weight over the past 12 years, for example, not much, but we have no idea whether or not his pressures were even sufficient before the machine stopped being an option).

Thank you guys

[palerider]

Grayghost, I will PM you, thank you for contactin me!

grayghost is an honest, trustworthy person. I've bought machines from him before and wouldn't hesitate to do so in the future.

[nimboo]

Hey Guys!

We are now in posession of a Resmed Aircurve 10 Vauto! (thanks grayghost)

I would like some advice on how to set the machine up so my dad can use it tonight.

I've been reading the clinincians manual, and currently understand that I will need to set the ipap max, epap min, timax, and timin if I'm going to use the machine in vauto mode.

What would you set these to, given what we know about my dad's condition, for this first night? I know these settings can always be altered later (and more accurately, I believe, once we have some data we can analyze), but where would a good place to start be?

I'm guessing lower is better, because it is a vauto anyway, right? Like, maybe use an IPap min of 3 instead of 6 just in case he actually needs less pressure by now? The machine will use the proper pressure depending on his breathing no matter what as long as we don't set the minimum lower that what he needs, correct?

Would love some advice, thanks guys!

[palerider]

Hey Guys!

We are now in posession of a Resmed Aircurve 10 Vauto! (thanks grayghost)

see? I told you he was honest

I would like some advice on how to set the machine up so my dad can use it tonight.

I've been reading the clinincians manual, and currently understand that I will need to set the ipap max, epap min, timax, and timin if I'm going to use the machine in vauto mode.

What would you set these to, given what we know about my dad's condition, for this first night? I know these settings can always be altered later (and more accurately, I believe, once we have some data we can analyze), but where would a good place to start be?

I'm guessing lower is better, because it is a vauto anyway, right? Like, maybe use an IPap min of 3 instead of 6 just in case he actually needs less pressure by now? The machine will use the proper pressure depending on his breathing no matter what as long as we don't set the minimum lower that what he needs, correct?

Would love some advice, thanks guys!

noooo... don't go messing with the ti settings or trigger and cycle until you need to, leave them at defaults.


if you really think his old pressure was 6, then set minepap to 6.

if the epap never raises, you could consider lowering it after a few days, or if he's having good nights, just leave it, 6 is a very low pressure.

I personally would leave ipap max at the max, and set ps to 3 for a start.

I just noticed they took the default settings out of the air10 manual...

defaults: TiMax: 2.0 TiMin: 0.3 Trigger: medium Cycle: medium MaxIPAP 25 (pressure support is default 4, but I'd go for 3, and see how he likes it)