Bipap auto w/biflex questions

Hi All-
I've had this machine for 2 months now. Has anyone else noticed that at times the machine begins to exhale a flash before you want to exhale?
When this happens, it wakes me up and drives me crazy. I have to turn off the machine and turn it back on to reset it. I haven't gotten any good answers from either the DME staff or the sleep doc staff.

I also would like to start tracking my own progress using the Encore Pro software. I'm not computer saavy and sometimes read threads where users have difficulty with the program. Any words of wisdom out there?

Thanks,
Barb

I call it "running up against it" or my timing is off from the computers...but it will happen to me once in awhile. NOT often. My wife has the same rig, she says it has never happened to her.

I don't turn my machine off to reset it, I just continue breathing. It adjusts to me. If it is a timing issue that happens every day, and several times per hour or something like that you probably need to determine a couple of things.

Does your insurance company rent or buy? Tricare rents. I got my unit replaced a month or so back. No questions. I described mine "running away" with me every morning. Not some mornings, but every morning. It woke the wife up, so we tried having her look (I was asleep) to see if the strap was off or in the mask was "off" and so on. It looked normal. We even tried changing pressures to a lower level, etc. I got another machine asap when I asked for it.

There are some really good articles on how to install it. I think it was Asleep in Alabama's article that did it for me, and I still had a couple of problems.
But I am on heavy pain meds. You should do fine, if not....ask away.
Good luck with it......
The downside is that this machine is loud enough I can hear it.

bsil wrote:Hi All-
I've had this machine for 2 months now. Has anyone else noticed that at times the machine begins to exhale a flash before you want to exhale?
When this happens, it wakes me up and drives me crazy.

When the Auto BiPAP starts an exhalation, it just drops the pressure. Is the problem that you are still inhaling, and you cannot inhale with such low pressure?

Is it possible that your exhale pressure is too low for your comfort? On the Respironics Auto Bipap, you can change the "pressure support" setting, so that you will not have such a big drop between inhale and exhale pressures. The settings can go from 2-8 cm (I think). This measurement is the MAXIMUM difference in pressures between your inhale and exhale, but the unit can give you a smaller pressure difference (with a minimum of 2 cm) if it detects such a need.

Post your current settings, and I will give this some more thought.

Once in a while my machine seems to start the inhale or exhale before I am fully ready, but if I continue to breathe as normally as possible, it realligns with my pace within a few breaths. I have never had it wake me up.

Moogy

bsil wrote: Has anyone else noticed that at times the machine begins to exhale a flash before you want to exhale?

Yep, it happens. (I've been flamed here for pointing this problem out before.)

In my case, I found a few solutions which reduce this problem to something more manageable.
1) For practical purposes, mask leaks have to be eliminated. With BiPAP, the inhale and exhale pressures are different which cause leaks to show up at the higher inhale pressures which may not be present during exhale. This difference apparently throws off the machine's synchronization timing, hence the effect you observed.
2) Switching to standard fixed pressure BiPAP mode rather than auto-BIPAP mode prevents this problem from getting out-of-control. With me, the machine at times would occasionally increase pressure up to its upper limit and just stay there. I'd eventually wake up, realize that the machine was at its maximum pressure, and at that point I'd have to reach over and turn the machine OFF to get it back to normal operation at a lower pressure. Although I tried repeatedly, I was never once successful in resynchronizing with the machine so that it would back down from its highest pressure.
3) Find the perfect mask for you which doesn't leak at all. For me the Comfort Curve mask is almost the perfect mask. With it I can use the BiPAP-auto most nights without the synchronization getting out of control, but some nights . . .
4) Make sure you are not congested when you use the BiPAP-auto. Congestion just makes this synchronization problem that much worse. (Sorry, I know there's sometimes not much to be done when congestion takes over, but being aware that it triggers this problem, may help you in dealing with it.)

Hope this helps a little.

Regards,
Bill (who still thinks the BiPAP-auto is a great machine, just not the perfect machine)

Hi All-
Thanks for all your help!

Dllfo, Moogy and Nighthawk-It actually happens only 1-2 times per week. Last night was one of them. Instead of turning off the machine, I tried to breathe through it, as you suggested. It must have resolved itself, because I fell back asleep!
My machine is 3 months of rental, 4th month is purchase. This is my 2nd machine, the first was Resmed auto. Because of all the insurance payments between the 2 machines, this Bipap auto is almost mine. I'm beginning to think that my problem might be mask leaks. I'm using the Swift nasal pillows. Most nights, I use poligrip strips.
Unfortunately, I have never asked for a copy of my prescription, so I don't know what my prescribed settings are. However, here are some stats from the Encore Pro as run by the doc's office:
SLEEP THERAPY LONG TERM TREND:

Avg. 90% IPAP Pressure: 10.7
Avg. 90% EPAP Pressure: 6.7
Avg. Obstructive Apnea Index: 1.3
Avg. Hypopnea Index: 2.8
Avg. AHI: 4.1
Avg. Flow Limitation Index: 1.1
Ave. Vibratory Snore Index: 1.8
Avg. Mask leak: 84
Avg. 90% Leak: 37.8
Avg. Leak 30.8
Avg. Large Leak 2 min.

I would like to get my own program at home so that I can keep better watch on a daily basis. Thanks for all of your input. Oh and btw, I think from reading the graphs, my machine is set from 5-15.
What are acceptable leak rates?
Thanks again, any other thoughts?
Barb

Barb, check your private messages...the button at upper right of this page.

It looks like your only problem is leaks, if that were under control your AHI should go down even more. There should be no large leaks at all, put mask on and remove it with the machine off. Jim

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