Can't sleep with pressure - suffocation feeling

[robysue]

The Respironics Bipap M Auto for $45 would give you an idea if bilevel settings would help or not.
If you need help with it...I am familiar with the M series machines and can help.
Only problem with the M series is the default PS of 2 in auto mode...and for that reason I would suggest that you not try auto bilevel mode and instead try a fixed bilevel mode to see if increasing PS would help or not.

I agree with Pugsy. An M-Series BiPAP Auto for $45 would give you an idea of if bilevel settings would help or not.

Oddly enough when I first got my System One BiPAP Auto, the settings were IPAP 8, EPAP = 6 in straight BiPAP mode. And even though the PS = 2, it felt a whole lot easier to exhale and breath comfortably with the BiPAP Auto than it ever felt with the S9 AutoSet running in Auto mode with the pressure range set at 4-8cm and EPR = 3. Later when I started using the BiPAP Auto in Auto mode with min EPAP = 4, max IPAP = 8, that default min PS = 2 still felt much better than the S9 with EPR = 3 ever did. In my case it had a lot to do with when EPR raises the pressure vs. when the BiPAP does if BiFlex is turned off.

So it's just possible that the min PS = 2 might not be as big of a problem for phopap as we might expect.

While the M series Bipap doesn't offer the data details of the newer machines...there's enough to get us an idea what is going on.
You will want to erase any old data on it though so as to not mix with your data. I can help you do that too if you decide to get it.
We can get an AHI average and leak average on the machine LCD screen...we can get you close in terms of some data without having to spend more money on the card reader or smart card.

Again, I agree with Pugsy here. The M-series BiPAP Auto for $45 is a good way to test the concept of whether bilevel would be more comfortable. And there's enough data to get a bit of an idea on what the settings to try. If the experiment is positive in terms of comfort and allowing phopap to get to sleep, then figuring out how to get a better quality permanent machine can be tackled later.

[robysue]

Thanks robysue for the in-depth response. Terms: “ASV” means what?

An ASV machine is a high end machine that is used to treat central sleep apnea or complex sleep apnea. It's not what you've got and avi's comments about it can and should be ignored since they are not relevant to fixing your problem.

[Pugsy]

So it's just possible that the min PS = 2 might not be as big of a problem for phopap as we might expect.

Might not be as big of a problem...maybe due to the timing of the inhale/exhale response more than the actual drop. I never got a chance to try EPR until some time after I made the switch to bilevel and RestedGal loaned me her ResMed S9 VPAP Auto and I tried it in cpap mode to see what EPR felt like.
I do know that I used my first bilevel in fixed mode for a long time because PS of 4 was just so much more comfy to me than the default of 2 PS (first Respironics BiPap Auto was a 750 which didn't have min and max PS). I could use the 2 PS default but I didn't "like" it.
Once they came out with the 760 where we had min and max PS in auto I sold the 750.

Bilevel response time might suit OP much better since it tends to stay more with the person's actual breathing than it does what it thinks the person should be doing...plus there's the additional timing adjustments available.

For $45...sure worth trying and it's not like the M series BiPap is a crap machine.
Heck...would make a great back up or travel machine if nothing else.

[phopap]

The Respironics Bipap M Auto for $45 would give you an idea if bilevel settings would help or not.
If you need help with it...I am familiar with the M series machines and can help.
Only problem with the M series is the default PS of 2 in auto mode...and for that reason I would suggest that you not try auto bilevel mode and instead try a fixed bilevel mode to see if increasing PS would help or not.

Thanks for the offer of assistance pugsy - my diagnosed treatment pressure is 6cm, and minimum pressure is 4cm, so it seems to me that the higher possible PS with a bi-level won’t be of any use to me, because that minimum 4cm will still cause the suffocation at the end of my exhales. If, in the future, my target gets above 7cm, at that point I can see the bi-level’s greater PS range as potentially useful. I hope I'm beginning to understand the bi-level correctly.

BUT,

if robysue had a better experience with the Respironics bi-level, then it sounds like it's worth a try. I just hope the Respironics M series bi-level model has the special something that the System One had for robysue. Is there a particular feature/setting that I can look for in the M series Auto manual that would indicate that it might do what the System One did?

I agree with Pugsy. An M-Series BiPAP Auto for $45 would give you an idea of if bilevel settings would help or not.

Oddly enough when I first got my System One BiPAP Auto, the settings were IPAP 8, EPAP = 6 in straight BiPAP mode. And even though the PS = 2, it felt a whole lot easier to exhale and breath comfortably with the BiPAP Auto than it ever felt with the S9 AutoSet running in Auto mode with the pressure range set at 4-8cm and EPR = 3. Later when I started using the BiPAP Auto in Auto mode with min EPAP = 4, max IPAP = 8, that default min PS = 2 still felt much better than the S9 with EPR = 3 ever did. In my case it had a lot to do with when EPR raises the pressure vs. when the BiPAP does if BiFlex is turned off.

So it's just possible that the min PS = 2 might not be as big of a problem for phopap as we might expect.

[Pugsy]

Is there a particular feature/setting that I can look for in the M series Auto manual that would indicate that it might do what the System One did?

Not really...the main difference between the M Series and the System One 60 series is with the PS setting in auto adjusting mode.

In fixed mode you can set the PS to whatever happens to feel like you can exhale comfortable...that feature is the same in all the Respironics bilevel machines when in fixed mode.
Fixed meaning the pressure doesn't vary beyond the 2 settings.
Example...if you choose the lowest setting of 4 cm as your exhale setting and want to try a PS of 2, 3 or 4 then your inhale would be the 4 cm plus 2, 3 or 4 and it stays that way all night.
Auto adjusting means that the pressure can roam around during the night depending on what settings you choose.
The default minimum PS of 2 is hidden and you can't see that option..instead what is shown is the max PS..so let's say 4 PS...then the machine could maybe use 2 cm or up to the 4 cm as it needs to.

The 60 series bipaps don't hide that minimum and actually let you select separate minimum and max PS if you want to.
Otherwise the M series and the 60 series pretty much function the same except the 60 series or newer bipaps gather more data but as far as how they go about their jobs...that's unchanged.

With the bipaps the timing of that reduction is different than the timing on the EPR drop. Now will it be enough to make your breathing experience more comfortable.....that's unknown.

Alternately you might get with your doctor and whomever supplied you this machine and ask them if you could just try a bilevel machine and see if you can do it or not. Your DME (whomever supplied you with your current machine) might have a bilevel machine they would let you try in their office just to see if you can handle it.

You might be surprised but exhale at 4 cm with inhale of 7 or 8 on a bilevel might be more comfortable for you than using EPR. The timing is different and the machine won't try to make you inhale before you are ready because there are some timing adjustments available on bilevel that aren't available with EPR.