New BiPAP ST user having issues

[Satchfan]

Tried finding answers without much luck. So i got my Bipap ST yesterday. I realize I have only used it one night but have problems that will need to be addressed and may need to talk to Dr on Mon. Firstly my resp rate was set at 20 and pressure is 12/7. Immediately this thing is trying to breathe faster than my natural rate of around 12. So I set that lower but then think, was there a reason to set at 20? Second problem us its blowing my cheeks out and is a big distraction. I tried setting to spontaneous but that doesn't solve the cheek issue. What is usually the cause for the annoying blowing up of my face? Appreciate any feedback.

[Pugsy]

Your cheeks are inflating???
We call that chipmunk cheeks...search the forum for options.
It is NOT caused by the mode of operation you are using and switching to S mode means the machine can't make you breathe with the back up rate because there is no back up rate option in S mode.

Don't know why they set the back up rate to 20...that's high for anyone while asleep.
Maybe normal for awake but not for asleep...12 might even be a little fast for your sleep. Asleep with breathe a lot more slowly than awake.

What mask are you using?

When you get a chance fill out your equipment profile please.
Your machine won't be available as an option though...simply add it to the comments section so mainly you will only be showing the mask you are using. Use the text option for the mask...images are tiny and hard to see which mask you are using.

[Satchfan]

So first thanks for the reply. I tried searching the web with no luck for the cheek thing. I am using an f20 full face mask. I am copying in a post from my cpap facebook group that gives some background. I have updated my profile. Thanks




Been trying to get things worked out for a while.have been saying something is wrong for 2 years. I was told I wasn't giving it a chance and some just can tolerate CPAP. I would rip it off in a panic after lightly dozing off. Have been to 3 different sleep centers and third time was a charm. In the past ny machine report was saying I was having up to 60 episodes an hour with about a third of them central apnea. Well pulmonologist says that can't be, you didn't have central on the split study. I had it done in a sleep center not run by him. Third doc is a neurologist and does study in house. Did a two part study this time and I do have centrals when using CPAP. I would think that should have been seen on the second half of the split study. I need ST-BiPAP after all. So excited to have it work now. Should get the machine this week

[LSAT]

Pugsy said to "search the forum"...not the web.....
search.php?keywords=chipmunk

[Pugsy]

search.php?st=0&sk=t&sd=d&sr=posts&author_id=40932

I have explained the mechanics of why people get chipmunk cheeks in the past numerous time.
No time to type it again or find the post where I went into detail.
It's up somewhere in the link above. Just do a search for posts where I mentioned chipmunk cheeks.

[Miss Emerita]

I hope lowering your backup rate as Pugsy suggests will be more comfortable for you. I’m confused about the inflated cheeks, though. With a full-face mask, wouldn’t you just open your mouth to let the air out? Or is the problem that it wakes you up repeatedly? Since you apparently didn’t have the problem with your old machine, I do hope that fine tuning your settings will help.

[Pugsy]

With a full-face mask, wouldn’t you just open your mouth to let the air out? Or is the problem that it wakes you up repeatedly?

I think that when we see full face mask users complain of chipmunk cheeks is due to the fact that they don't just simply sleep through it and they get woke up by the ballooning cheeks and then have to open mouth to event things out.
If they slept through it they wouldn't even know it was happening.
For some reason they just don't sleep through it and of course anything that wakes us up is unwanted.

Unfortunately just having a full face mask so that no pressure is lost when the mouth is opened doesn't solve the problem of the wake up. Why people get chipmunk cheeks is the same for everyone no matter which mask they use and for the most part no matter what machine they use.
The exception might be simply the higher pressures some models will deliver for whatever needs need to be met.
Whatever the reason the fix is to shut that back door to the mouth and unfortunately that is much easier said than done for some people.

[raisedfist]

Tried finding answers without much luck. So i got my Bipap ST yesterday. I realize I have only used it one night but have problems that will need to be addressed and may need to talk to Dr on Mon. Firstly my resp rate was set at 20 and pressure is 12/7. Immediately this thing is trying to breathe faster than my natural rate of around 12. So I set that lower but then think, was there a reason to set at 20? Second problem us its blowing my cheeks out and is a big distraction. I tried setting to spontaneous but that doesn't solve the cheek issue. What is usually the cause for the annoying blowing up of my face? Appreciate any feedback.

If you need a backup rate, just set it to 8 or 10 bpm so it stays out of the way unless you stop breathing and need it. Setting the rate to 20 bpm is something you would do for an infant, or someone with severe respiratory problems where you wanted to guarantee a minimum minute ventilation.

For mask/cheek problems, try going into the settings and seeing what the "rise time" is set too. Anything lower than 3-6 is essentially a wack in the face; so if it's set to 1 or 2, try a higher number and see if the machine syncs up with you better.

[Miss Emerita]

Thanks, Pugsy, for explaining about the wake-up problem.

[palerider]

Tried finding answers without much luck. So i got my Bipap ST yesterday.

Is it a Resmed Aircurve ST, or is it a Philips Respironics BiPAP® ST?

They're made by different manufacturers.

If it's a Resmed, then it's *NOT* a "BiPAP®"

[Satchfan]

Yes I understand its not a trademark bipap but it is a bilevel machine which is bipap. Its a resmed aircurve st. And i sleep with a full face mask with mouth open and the cheek thing happens. It happens while I am awake trying to get to sleep. I will look around in here for ideas. Thank you all for the feedback. Btw. My last machine was cpap. So completely different. I couldn't tolerate that for diff reasons. Would wake in a panic after dozing off in a central apnea is what i am told. I am also a registered nurse for 20 years and have some knowledge but respiratory issues are mainly handled by the rt's and besides that we don't see bipap outside of the icu and that's not my area so I am learning. will get there. Just going to take time.

The AirCurve 10 ST is a

Bi level
Positive
Airway
Pressure
=BiPAP
device with backup rate that provides exceptional patient–ventilator synchrony.
Not trying to contradict but its the concept I was conveying. This description was copied from the Resmed site

[palerider]

Yes I understand its not a trademark bipap but it is a bilevel machine which is bipap.

A "BiPAP" is, by *definition* a Philips Respironics machine, especially with the lower case i you used in it.

A "bilevel" machine is a generic two pressure machine.

The AirCurve 10 ST is a

Bi level
Positive
Airway
Pressure
=BiPAP
device with backup rate that provides exceptional patient–ventilator synchrony.
Not trying to contradict but its the concept I was conveying. This description was copied from the Resmed site

Where is 'BiPAP' showing up on the Resmed site?

[Satchfan]

Not going there. You call it what you want and I will do the same as they have at every healthcare institution I have worked for over the past 20 years.

[Satchfan]

Not going there. You call it what you want and I will do the same as they have at every healthcare institution I have worked for over the past 20 years.
https://www.resmed.com/us/en/consumer/p ... ep-devices


They reference the acronym spelled out word for word. Are you going to argue because they dont write bipap. Its not?

[Pugsy]

BiPap is a Respironics trademark name.

ResMed has NEVER used a Respironics trademark name like " bipap" for any of their bilevel machines. What is found is the term bilevel.
They are very careful with their wording. They state bilevel positive airway pressure pressure device....but they are very careful not to use the term "bipap" because Respironics owns the trademark name "BiPap". These companies would sue their mother if they could find a reason to irk each other.

The medical industry seems to have adopted it as a generic term for all bilevel pressure machines. Doesn't make it accurate though.
I think it is confusing to not use correct terminology but that's what the medical industry does.
When people come here on the forum wanting help....it's really helpful if we know the correct model machines and not what it might be generically called.
What's available on a Respironics BiPap ST isn't exactly the same stuff that is available on the ResMed AirCurve 10 ST bilevel device.
Similar yes but exact no.

We have no control over what the medical industry wants to do as a whole and if they use generic terms....but when people come here on this forum and want our help....you deal with the people here and not the medical industry that wants to use generic names for all machines. We want to be able to offer the best help possible and we don't like playing guessing games with exactly which "bipap" someone is using.

Some people here are sticklers for correct terminology and details...perfectionists if you want to call them that but that's because to offer the best advice we have to know exactly which machine is being used because they aren't all the same even if that are the same type of machine.

Get over it and move on.

And yes...spoken by probably the worst perfectionist here.
I hate calling any bilevel a machine a bipap unless it is a Respironics machine because it isn't a bipap unless it is a Respironics machine...it's a bilevel machine... but I let it slide because it's not worth fighting over.

Move on folks...not worth fighting over.