New to Bipap

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Urchin08
Posts: 5
Joined: Sun Nov 21, 2021 12:03 pm

New to Bipap

Post by Urchin08 » Sun Nov 21, 2021 12:24 pm

Hi all,

I am relatively newly diagnosed with mild sleep apnea and have been trying to get used to the machines for around 4 months now. About a month ago I was moved onto Bipap because of aerophagia on the cpap machine.

For the past 3 weeks I have been on the lumis 100 vpap st and have been finding it very hard to adjust. Harder in fact than the cpap.

At the start I was having alot of masks leaks and I have since changed to the n20 which has helped (though not perfect).

I have also changed the ti max time from 2 to 3.5secs and the rise time from 200ms to 500ms. Both these feel closer to my natural breathing rythme.

At the moment I am only managing around 4hrs sleep per night with the mask on. After about 5-6 hrs I tend to give up and get a couple hours sleep without it on. I am feeling quiet exhausted during the day in a way I haven't felt since starting on the cpap.

I have included my oscar report below from a recent night where the leaks were less than normal. I would love to hear what people with more experience can see in the charts if anything at all.

At this stage I am wondering if it is time to try a dental device or a full face mask. Or maybe it is a case of waiting a little bit longer.

Thanks for the help
Barry
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Miss Emerita
Posts: 2052
Joined: Sun Nov 04, 2018 8:07 pm

Re: New to Bipap

Post by Miss Emerita » Sun Nov 21, 2021 1:18 pm

Welcome!

I'm not able to advise you about settings for your machine, but I have a question whose answer might help the people who are.

I'm curious why you've been prescribed an S/T (spontaneous/timed) machine, rather than a less specialized bi-level machine like the ResMed Aircurve 10 VAuto. Do you have a condition like COPD, asthma, obesity, or muscular/skeletal disease that limits your ability to breathe normally?
ResMed Aircurve VAuto
Bleep mask

Oscar software is available at https://www.sleepfiles.com/OSCAR/

Urchin08
Posts: 5
Joined: Sun Nov 21, 2021 12:03 pm

Re: New to Bipap

Post by Urchin08 » Sun Nov 21, 2021 1:29 pm

Hey, thanks for having me!

I'm pretty healthy overall except for the mild sleep apnea.

I don't know why they decided on the S/T.

I'm also not sure if it was my doctor or resmed who decided to send me the ST model. It sure is expensive though.

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Pugsy
Posts: 59520
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: New to Bipap

Post by Pugsy » Sun Nov 21, 2021 1:44 pm

DMEs (equipment suppliers) aren't supposed to dispense any type of machine other than what the doctor prescribes.
Your machine is a VERY specialized machine normally dispensed for specific and unusual problems.

I strongly suggest that you contact your doctor about this machine and the issues you are having with it.

S/T mode isn't for sissies because it forces a breath whether a person wants to or is ready to breathe or not.
Usually used when people aren't breathing well enough on their own for some reason.
Extremely disconcerting to people who don't have a problem breathe to have the machine try to force a predetermined breathing pattern.

Now this type of machine can be used to treat plain vanilla OSA but the settings needed have to be spot on.
Assuming your hyponeas are obstructive in nature and not central in nature the usual advice is a little more EPAP minimum baseline needs to be used to better hold open the airway and prevent the collapsing of the tissues.
Awfully expensive way to treat plain old OSA though...and not so easy on the patient either. Adapting to the machine isn't easy and most people who come here on S/T machines are having problems one way or another.

Get in touch with your doctor and figure out why this machine at this settings and what to do to reduce the hyponeas ...as well as help you sleep with this machine (or any machine).
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

Urchin08
Posts: 5
Joined: Sun Nov 21, 2021 12:03 pm

Re: New to Bipap

Post by Urchin08 » Sun Nov 21, 2021 1:58 pm

The forcing a breath is what I am having most trouble with as it feels SO unnatural.

I will get onto my doctor with that question. Though she can be a little hard to get in contact with, usually setting apts 3 months apart minimum.

I was wondering why other Bipap users weren't complaining about the issues I am having.

I didn't realize this was such a specialized device.

Thanks for pointing it out.

As for central v obstructive, the the airsense 10 I was using previously showed mostly central apneas but my doctor said you cant trust the accuracy of this reading.

When I originally had the home sleep test I was mostly obstructive and so that is what we are trying to treat right now.

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Pugsy
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Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: New to Bipap

Post by Pugsy » Sun Nov 21, 2021 2:21 pm

Can you get into the clinical setup menu area and tell us what the various options for "mode" might be for the machine?
I am fairly sure there are multiple options but I don't remember what they are.
While you are in there can you look to see if you see BPM setting? Breaths per minute or how fast the machine wants you to take a breath. If it is very high that can sure be disconcerting but if you reduce it and it doesn't kick in to force a breath so often you might have an easier time.

I use a bilevel machine myself but it only breathes with me and doesn't/can't try to force me to breathe.

Maybe there is a similar mode available on this machine and if we can cut out the forced breathing rate you will find the machine more comfortable.
If you didn't have a truck load of centrals on the other machine you don't need a machine to force a breath on you.
A few centrals here and there is no big deal. We only worry about centrals when present in large numbers, causing desats or causing a lot of wake ups.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

Urchin08
Posts: 5
Joined: Sun Nov 21, 2021 12:03 pm

Re: New to Bipap

Post by Urchin08 » Sun Nov 21, 2021 3:09 pm

The modes I can use are:
S (Spontaneous) mode
ST (Spontaneous/Timed) mode
T (Timed) mode
PAC (Pressure Assist Control) mode
iVAPS (intelligent Volume Assured Pressure Support) mode
CPAP mode

Maybe S mode would be closer to the Bipap?

There isnt a bpm setting but they do make suggestions for ti min and max based on bpm

I was waking up a few times on the last machine maybe that's why she chose the S/T. Though as it stands I am waking up just as often.

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Pugsy
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Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: New to Bipap

Post by Pugsy » Sun Nov 21, 2021 3:23 pm

S mode is more like a fixed bilevel mode. It won't try to force you to breathe if you don't breathe fast enough to keep the machine happy.
you might give it a try and see how you do with it.
As far as ti min and max I would start with the factory defaults as usually they work well for most people.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

Urchin08
Posts: 5
Joined: Sun Nov 21, 2021 12:03 pm

Re: New to Bipap

Post by Urchin08 » Sun Nov 21, 2021 3:36 pm

I'll try that out and see how it goes.

Thanks for all your help!