Home Titration with Bi-Pap

[izzyb]

I have read a lot about doing a home titration on this board. Is that using your own machine? Is my machine capable of that and how do I do it?

Thanks.

[Hawthorne]

Your machine is capable of doing a home titration but I will leave it to someone who knows more about Bipaps to suggests how you should start setting it up for that.

[jdm2857]

You may want to change the title of the thread (edit the first post and change the subject) adding the words "with BiPap".

It will get the attention of the right people.

[izzyb]

jdm2857, thanks for the suggestion.

[rested gal]

I have read a lot about doing a home titration on this board. Is that using your own machine? Is my machine capable of that and how do I do it?

Thanks.

izzy, according to a topic you started a couple of months ago ("Which is better?" Jun 04, 2009)

viewtopic/t44051/viewtopic.php?f=1&t=42 ... 98#p373798

I believe you were already doing a "home titration" then, whether you realized it or not.

In that thread you wrote:
My prescription for bi-pap is a fixed 16/11. Over the last probably year I have been experimenting with it on auto. When I have it set at auto 20/15 (I have tried different numbers, but this seems best) and I check my numbers daily, they are usually 19-20/16-17. Of course my leak rate is higher, but my AHI index is below 0.5. My AHI on the fixed 16/11 is usually 1.x. When it is on auto at the high numbers, I am awakened more often by leaks. So my questions is, is it better to have a little higher AHI index and have less leaks which means more sleep (I have a big problem sleeping anyway), or is the lower AHI better? I know that as long as it is below 5 that is good, so should I be happy with a 1.x and less leaks?

It helps to use the Encore Viewer software, however, instead of trying to go by LCD data with a Respironics machine. But it can be done the way you were going about it.

[izzyb]

rested gal, I didn't realize that was it. So do you just experiment with the numbers until you get the lowest AHI you can with the best leak rate and leave it at that? At my last doctor's visit, I told him I had been trying the auto and that my index was better using it, but he said that it couldn't tell what was a sigh, etc. and that the machine was smart but not that smart (paraphrasing). But he wasn't upset that I had been messing with the settings. What I don't understand is if the machine is picking up sighs, wouldn't that make my index higher?

If I use the auto again and reach numbers I like, then should I leave it on auto or use those numbers to set it at a fixed rate? I am confused about which is best. And I am just not going to get the software and reader at this point. Even though I know people here will help, I'm afraid I won't be able to understand it. My brain has taken a downward spiral in the last few years. My memory and comprehension is terrible, and I used to be a fairly intelligent person.

Thanks, izzyb

[ozij]

But he wasn't upset that I had been messing with the settings. What I don't understand is if the machine is picking up sighs, wouldn't that make my index higher?

Your brain is funtioning much better than your docotor's, Izzy. If the machine were misintrepreting you sighs, you index would indeed be higher -- and it would zoom away to pressures that would bother you.

If I use the auto again and reach numbers I like, then should I leave it on auto or use those numbers to set it at a fixed rate? I am confused about which is best.

If you get better numbers on auto mode, and feel better, leave the pressures there for two weeks or more. Maybe you'll find you feel so great that you'll just leave it like that.

When you've seen how you're doing on auto mode, you can start thinking about changing to fixed.

I'm afraid I won't be able to understand it. My brain has taken a downward spiral in the last few years. My memory and comprehension is terrible, and I used to be a fairly intelligent person.

I'm sorry you feel like that, Izzy. I hope you can find therapy pressures that will help you get over that downward spiral.

O.

[Guest]

ozij, thanks for your help. I have more questions as usual. When I was experimenting with the auto, one time I had it set on 20/15 which gave me my best index. My daily pressure numbers were usually 19-20/16-17. This worried me because my original fixed setting was 14/10 and then they bumped it to 16/11 when I said I wasn't really feeling better. What bothers me is my original setting of 14/10 and even 16/11 is what I consider a lot lower than what the auto is giving me. I mean, what if I set the auto on 16/11? My exhale wouldn't be able to get past 14 would it since there is that difference of 2 between inhale and exhale pressures? And if I need a 19 or 20 on inhale, then it would be on 16 all the time which wouldn't be high enough. Am I making any sense on what I am asking? The bottom line is whether or not I would be doing the right thing by using pressures that high. Why would the pressure titrated at the lab be so much lower than what I am getting at home? I'm afraid I will use too much pressure and screw myself up somehow because I don't know what I am doing.

And since (I was told) that the pressure for bi-pap is not equal to pressures for cpap - the equivalent to cpap is lower - these higher pressures seem off the charts. I mean when they switched me from cpap to bipap that night, it was because I was at 17 on cpap. And since they set me up at 14/10 on bi-pap at that point, there must be a difference between cpap and bi-pap of about 3. That's my logic anyway. So, if I am using an inhale of 20 on bi-pap that would be equal to about 23 on cpap. I guess relating it to cpap doesn't really matter since I am on bi-pap, but it just makes me wonder.

I just don't know if I can rely on a good index alone. I know there must be other factors to be taken into consideration. And I know you will say get the software.

Thanks, izzyb