BiPap Epap/Ipap Delay

[dozeoff]

I have two Bi-Pap machines. One is an older M series Respironics, and one is a relatively new PR System One. About six months ago, I noticed a "lag" (for lack of better words) fro EPAP to IPAP when taking a breath. Sometimes, IPAP doesn't kick in at all. This happens on both machines. This causes me to panic because for a couple of seconds, i feel like i can't breathe. (The 2 seconds in epap when ipap should be engaged). Now, I'm panicking over it and can't get to sleep. When I do fall asleep, I immediately wake up. I go through several iterations of this before I finally get to sleep. I wake up in the middle of the night when IPAP doesn't kick in right away.....and I start all over again. It's really causing me some serious problems. Anybody else have this issue? If so, how did you get around it? (BTW, I have been on Bi-pap therapy since 2009. Everything was going great until recently )

[jilliansue]

Hi. So you started noticing this 6 months ago, wtih both machines?

I am afraid I do not have detailed information to give you, but I used to feel that the IPAP cut off too soon for me, before I drew as long a breath as I would like. If I kept inhaling, the machine would, once again, switch to IPAP till I was done inhaling, but not the most comfortable thing. Someone on this list sent me a great explanation of how to change some settings on my machine that had to do with the maximum amount of time the machine was "allowed" to blow the IPAP rate. And also changing the breaths per minute. If you think this could help you, I still have her response to me and can send it to you.

Good luck,
Jill

[dozeoff]

Yes I have two machines and both exhibit the same behavior. The M series I've had for about 3 years. I purchased the PR System One in October because of this issue, and it too does the same thing.
I know what you are talking about with the IPAP not lasting long enough for a bigger breath. Some machines you can change this, some you can't. Mine you can't.
That is not my problem, and the length of time IPAP lasts is fine with me. My problem is when I take a breath in, IPAP doesn't kick in right away.
My pressure settings are 11/5. When I breathe in, I'm expecting the 11 to immediately start. It does not, and I'm inhaling at a pressure setting of 5. Well, I don't get any air at 5. Then after about 1.5 seconds of inhaling, THEN the 11 kicks in. It used to be instant. As soon as I was done with exhaling, the machine somehow registered that I was done with the exhale and instantly begin blowing the 11 on the inhale. So, I don't know if maybe a pressure sensor is out of whack or what. If so, what are the odds that I would be having the same problem with the new machine. Maybe it's me? I replaced the hose and nasal pillow in case there may be some kind of small leak. I'm at a loss.
I was reading some blog from a lady that had the same problem, only with her, her breaths were so shallow that the machine couldn't detect the pressure difference. That is not the case here....at least I hope not. I'm wondering if some machines are more sensitive than others.

[robysue]

Are you using A-Flex?

If "yes", maybe that's triggering the sensation you're talking about? A-Flex is supposed to "round" the transitions from EPAP to IPAP and from IPAP to EPAP as well as provide a bit of extra exhale relief.

If "no", do you know what your Rise Time setting is? Given the description of your problem, it sounds to me like you'd be happiest with Rise Time = 1 (the shortest). But even Rise Time = 3 only delays reaching the full IPAP by a bit less than 1/2 second.

[dozeoff]

The device is FLEX capable (Bi-Flex) and it is turned off. If I turn it on, it's much worse, as expected. I have RISE off. So, no flex, and no rise....on both units. Maybe sensors are off or the machines are dirty inside? It's really dusty here (Kansas), and I change my filters regularly; however, they get really dirty awfully quick. I dust and dust and even have a HEPA filter in my room.
This is so frustrating. I'm sending the new unit in for warranty repair. Maybe they can tell me what's wrong. If they ship it back saying nothing is wrong, I don't know where to go from there.

[skinman]

Hey, my first post! You're not alone. I believe I have the same machine. Got it last Tuesday after 60 days with the PR Auto CPAP that didn't like me much. On Saturday as I was falling asleep (trying to), the blower was making a humming noise that changed in pitch with the flow. It was loud enough to be annoying.

During the next 20 minutes, the blower shut off for 15 to 20 seconds and then turned back on. It did that three times, the last time the unit lost power and then came back on. On Sunday I looked at my data for the first time and the "Pressure" graph showing EPAP/IPAP had blank gaps showing no pressure. The "Leak" line normally around 24, dropped to zero, and came back up when the blower started again.

I told my DME about it on Monday and although puzzled, told me to bring it back in for a new machine (haven't done that yet). I'm going to try it tonight without the "Auto On" turned on to see what happens. Perhaps a batch of machines with faulty pressure transducers?

Since many others use this machine without reporting the same issue, they either made a change to the firmware, or there is something faulty on the component side. I don't know.

OK. I got my first post under my belt, thanks to all who contribute because I've learned a lot lurking for a while.

Mike

[MZH]

I feel like my exhale isn't long enough; the machine is forcing an inhale too soon. I have a RESMED S9 VPAP and my pressure is currently 4/12. I don't do well at a default of 2.0 for TiMax or the default M for trigger and cycle. I seem to need a very high. Last night it was at H and I had an AHI of 9.9 - 41 OSAs, 41 Cs, and 5 H. Unbelievable. My AHIs had been around 2.0 until this month. I'm on Entocort, a gut steroid, and have been lowering my dose. Every time I do that, the AHI gets bad. Sometimes the AHI and breathing changes can be from a change in medication and/or dose change. Of course, I had to figure this out; the docs don't take the time to help us figure it out. What a sad state of affairs.