Question for BiPAP Auto M Experts

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lazyace
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Question for BiPAP Auto M Experts

Post by lazyace » Sat Sep 12, 2009 3:25 pm

I am now trialing a BiPAP Auto M and can't figure out why it switches from IPAP to EPAP before I'm ready. I inhale and before I am done it switches to exhale. Is it a matter of changing a bi-flex setting or turning bi-flex off and playing with the Rise Comfort setting?

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Re: Question for BiPAP Auto M Experts

Post by GumbyCT » Sat Sep 12, 2009 3:54 pm

lazyace wrote:I am now trialing a BiPAP Auto M and can't figure out why it switches from IPAP to EPAP before I'm ready. I inhale and before I am done it switches to exhale. Is it a matter of changing a bi-flex setting or turning bi-flex off and playing with the Rise Comfort setting?
I'm wondering if you have any medical issues not mentioned? Have you tried calling your DME?

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builta
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Re: Question for BiPAP Auto M Experts

Post by builta » Sat Sep 12, 2009 5:28 pm

Hi,

Is is possible that you are taking very deep breaths. If so, it could be that you are changing the rate of your inhalation/exhalation and triggering the change. I have noticed that this can happen to me if I take unusually large breaths (for me).

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lazyace
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Re: Question for BiPAP Auto M Experts

Post by lazyace » Sat Sep 12, 2009 5:37 pm

GumbyCT wrote:
lazyace wrote:I am now trialing a BiPAP Auto M and can't figure out why it switches from IPAP to EPAP before I'm ready. I inhale and before I am done it switches to exhale. Is it a matter of changing a bi-flex setting or turning bi-flex off and playing with the Rise Comfort setting?
I'm wondering if you have any medical issues not mentioned? Have you tried calling your DME?
No medical issues that would impact the settings.
builta wrote:Hi,

Is is possible that you are taking very deep breaths. If so, it could be that you are changing the rate of your inhalation/exhalation and triggering the change. I have noticed that this can happen to me if I take unusually large breaths (for me).
Could be somewhat deep breaths, but I don't think it is abnormal.

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Re: Question for BiPAP Auto M Experts

Post by jweeks » Sat Sep 12, 2009 9:22 pm

lazyace wrote:I am now trialing a BiPAP Auto M and can't figure out why it switches from IPAP to EPAP before I'm ready. I inhale and before I am done it switches to exhale. Is it a matter of changing a bi-flex setting or turning bi-flex off and playing with the Rise Comfort setting?
Hi,

I also have the M series BiPAP Auto. I notice that it sometimes cuts me off when I inhale. I have a bit of a tendency to breathe shallow and show, then try to catch up with a deep breath. The machine has made me more aware of my breathing, and I have been learning to breathe at a little more regular rate.

I also notice that I hold my breath from time to time, especially when falling asleep. The machine will detect this and try to force me to breathe. For example, if I hold my breath a bit, then take a deep breath to catch up, the machine will automatically go to high pressure by itself 5 times in a row to try to get me to breathe.

-john-

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momof2inmn
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Re: Question for BiPAP Auto M Experts

Post by momof2inmn » Sat Sep 12, 2009 9:33 pm

Yep, deep breaths is what does it for me, too!

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rested gal
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Re: Question for BiPAP Auto M Experts

Post by rested gal » Sat Sep 12, 2009 10:08 pm

lazyace, the BiPAP (including the BiPAP Auto) will blow the higher IPAP pressure for about 3 seconds. If you've not started to breathe out within that 3 second time period the machine will automatically switch down to the lower EPAP. That can feel like the machine is cutting off your inhalation.

The BiPAP is supposed to stay down at the lower exhale pressure until you start to inhale again. But the BiPAP is not supposed to stay up at the IPAP pressure for longer than about 3 seconds, even if you are still inhaling.

I wish they'd make 4 seconds instead of 3 seconds be the limit for the higher IPAP to last, but... it's 3 seconds. Apparently most people normally inhale for about 1 to 2 seconds.

The BiPAP (including the BiPAP Auto) will stay at the lower EPAP pressure until you start to breathe in again. Inhaling triggers the machine to switch up to the higher IPAP pressure.

Holding your breath, or the normal pause before inhaling again, makes the machine stay at the lower EPAP pressure until you actually start to inhale again.

The slightest indication of breathing in or breathing out triggers the machine one way or another. That "slight indication" might even be from aerophagia (air getting accidentally pushed down past the esophageal sphincter) which could make the machine think there's been a change in airflow from you. A sudden little leak could also make the machine think there's been a change in your airflow.

In the following thread I wrote about "4 seconds" being the limit for IPAP to blow, but it's 3 seconds, I believe:
viewtopic.php?p=233928#p233928
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ctmerchant

Re: Question for BiPAP Auto M Experts

Post by ctmerchant » Sat Sep 12, 2009 10:33 pm

Same thing happened to me. Change the rise setting on your machine. Mine was set at 2, I upped it to 6 and I sync much better with the machine now

ctmerchant

Re: Question for BiPAP Auto M Experts

Post by ctmerchant » Sat Sep 12, 2009 10:39 pm

Oops, forgot. I also extended my "ramp" time from 15 to 30 minutes. It allowed me to fall asleep and stay asleep longer so when the machine reached full pressure, I didn't wake up.

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Re: Question for BiPAP Auto M Experts

Post by rested gal » Sat Sep 12, 2009 11:14 pm

ctmerchant wrote:Same thing happened to me. Change the rise setting on your machine. Mine was set at 2, I upped it to 6 and I sync much better with the machine now
Are you using a ResMed machine, ctmerchant?

I think lazyace is using the Respironics BiPAP Auto M series machine, which does not have a "rise" setting of "6", as far as I know.

From the Provider manual of the BiPAP Auto M series:
Image


I don't think the rise setting -- called "comfort rise" in the Respironics BiPAP Auto M series -- has the adjustments in milliseconds (200 ms - 900 ms) that ResMed VPAP (and VPAP Auto) machines have.

From page 8 of the VPAP Auto provider manual:

Rise Time Adjustment
(S mode) Rise Time is the time taken for the pressure to increase from EPAP up
to IPAP. Rise Time can be set to MIN (the fastest Rise Time) and then in 50-unit
increments from 200 to 900. This will control the rate of pressure increase when
the VPAP Auto switches from EPAP to IPAP.


At any rate, "rise" settings (the rate of speed the machine takes to reach the full IPAP pressure once an inhalation has started) are not the same as length of time the IPAP pressure can last during an inhalation. Length of time the IPAP pressure can last is what lazyace was asking about, I think.

But perhaps prolonging the amount of time the machine takes to reach full IPAP pressure might get added onto the built-in 3 seconds (or whatever amount of time) duration IPAP lasts? If so (and I don't know that it would be so) that could give a leeeetle more time for inhalations that last longer than usual. Like when taking an unusually slow, deep breath.
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Re: Question for BiPAP Auto M Experts

Post by Patrick A » Sun Sep 13, 2009 12:29 am

rested gal wrote:
ctmerchant wrote:Same thing happened to me. Change the rise setting on your machine. Mine was set at 2, I upped it to 6 and I sync much better with the machine now
Are you using a ResMed machine, ctmerchant?

I think lazyace is using the Respironics BiPAP Auto M series machine, which does not have a "rise" setting of "6", as far as I know.

From the Provider manual of the BiPAP Auto M series:
Image


I don't think the rise setting -- called "comfort rise" in the Respironics BiPAP Auto M series -- has the adjustments in milliseconds (200 ms - 900 ms) that ResMed VPAP (and VPAP Auto) machines have.

From page 8 of the VPAP Auto provider manual:

Rise Time Adjustment
(S mode) Rise Time is the time taken for the pressure to increase from EPAP up
to IPAP. Rise Time can be set to MIN (the fastest Rise Time) and then in 50-unit
increments from 200 to 900. This will control the rate of pressure increase when
the VPAP Auto switches from EPAP to IPAP.


At any rate, "rise" settings (the rate of speed the machine takes to reach the full IPAP pressure once an inhalation has started) are not the same as length of time the IPAP pressure can last during an inhalation. Length of time the IPAP pressure can last is what lazyace was asking about, I think.

But perhaps prolonging the amount of time the machine takes to reach full IPAP pressure might get added onto the built-in 3 seconds (or whatever amount of time) duration IPAP lasts? If so (and I don't know that it would be so) that could give a leeeetle more time for inhalations that last longer than usual. Like when taking an unusually slow, deep breath.
Thank you for the information I forgot how to change settings on my M-series. (I know read the owners manual) that's too easy.
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Re: Question for BiPAP Auto M Experts

Post by lazyace » Sun Sep 13, 2009 6:41 pm

rested gal wrote:lazyace, the BiPAP (including the BiPAP Auto) will blow the higher IPAP pressure for about 3 seconds. If you've not started to breathe out within that 3 second time period the machine will automatically switch down to the lower EPAP. That can feel like the machine is cutting off your inhalation.

The BiPAP is supposed to stay down at the lower exhale pressure until you start to inhale again. But the BiPAP is not supposed to stay up at the IPAP pressure for longer than about 3 seconds, even if you are still inhaling.

I wish they'd make 4 seconds instead of 3 seconds be the limit for the higher IPAP to last, but... it's 3 seconds. Apparently most people normally inhale for about 1 to 2 seconds.

The BiPAP (including the BiPAP Auto) will stay at the lower EPAP pressure until you start to breathe in again. Inhaling triggers the machine to switch up to the higher IPAP pressure.

Holding your breath, or the normal pause before inhaling again, makes the machine stay at the lower EPAP pressure until you actually start to inhale again.

The slightest indication of breathing in or breathing out triggers the machine one way or another. That "slight indication" might even be from aerophagia (air getting accidentally pushed down past the esophageal sphincter) which could make the machine think there's been a change in airflow from you. A sudden little leak could also make the machine think there's been a change in your airflow.

In the following thread I wrote about "4 seconds" being the limit for IPAP to blow, but it's 3 seconds, I believe:
viewtopic.php?p=233928#p233928
RG,

I have come to the conclusion in just two nights that unless there is a way to lengthen the time between inhale and exhale, I simply cannot tolerate this machine. I feel like I am almost hyperventilating because I can't keep pace with the cycles. Do you know whether there is another machine that offers the user the ability to lengthen that span? I like the BiPAP better than the APAP for the aerophagia. But now, the breathing is more of a nuisance than the aerophagia was. What is the difference between the Respironics BiPAP and a VPAP? Does ResMed make a comparable product? If so, what do you know about it?

Thanks!

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Re: Question for BiPAP Auto M Experts

Post by GumbyCT » Sun Sep 13, 2009 7:35 pm

Do you know what the settings currently are?

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Re: Question for BiPAP Auto M Experts

Post by lazyace » Sun Sep 13, 2009 8:23 pm

GumbyCT wrote:Do you know what the settings currently are?
I've got biflex turned off because when I played with those settings it didn't seem to have much impact on the spread. I have the rise set on 3. IPAP is set to 7 and EPAP is 5.