Inferior BiPAP machine or just a normal problem?

I just got a BiPAP machine a couple weeks ago, but I've been on a CPAP machine for about 8 years now. The reason for the change was that on the CPAP we had to turn the pressure down because I was getting a lot of air in my stomach and it was causing severe pain at the level they came up with - 10cm. It's bearable at 8cm. My doctor's theory was that a BiPAP would help eliminate the air in the stomach problem.

This theory seemed to work as we now have the machine set to 5cm ePAP and 11cm iPAP and I haven't had any problems with air going down the wrong way ...

BUT, it's not even working as well as my old CPAP machine set to 8cm .. I'm waking it more tired and I've been more tired throughout the day. I've been on it now for a week and a half and I've noticed the the machine cuts off the pressure sometimes in the middle of breathing in, and when I'm more relaxed and breathing more softly it never kicks into the higher pressure at all. I do also have the heated humidifier.

I have a call into the company that supplied the machine to ask about it, but I have the distinct feeling that I just have in inferior machine. The machine they gave me is the Respironics ST (Gray with SmartCartd).. and when I picked it up even the respiratory therapist said it's the main machine they give out because the other models and brands are a lot more expensive. And after getting home and looking for the clinician's manual (to no avail) I found out that this model isn't even available anymore..?

So my question -- is this a "common" problem with BiPAP machines, or should I bug them to give me a different one?

Mask: ResMed Mirage Quattro (recently converted from a Fisher Paykel FlexFit 431, can't decide which one I like better)

Any thoughts would be appreciated!

- Jason

Is your machine set on auto? If so, it will not rise to the highest pressure unless you need it. Also, since your bipap is an ST, it has a timed inhalation and exhalation. If you inhale for a longer period than the machine is set for, it will stop applying the inhalation pressure at the time it IS set for, so you will not be getting the pressure for your entire inhalation. Sometimes, if you really get out of rhythm with it, it may REALLY annoy you by starting it's inhalation pressure while you are trying to exhale

Call the DME and ask them to explain more about the machine, and see if any of the settings need adjusting.

your I time on your machine is wrong. That's why it is cutting off mid breath.

St's do not have an auto mode, as it is not an auto titrator. Technically, you are on a bipap ST.

The RT who said the other brands are "a lot more expensive" was either lying, or an idiot. ST's are significantly more expensive then a regular machine... SIGNIFICANTLY.

I can call up my warehouse and say "I want 10 450's, 10 s9 elites, 20 m series, 10 shoeboxes, 20 activa lt's in all sizes, 40 swift fx's, plus my standard weekly order, and one ST"

The reply I get is "Why do you need an st? Who ordered it for which patient? are you sure they don't want a standard s?"

ST's are EXPENSIVE!

And the reason you don't hvae a clinicians manual, is because you are not a clinician, and you are not supposed to be changing your machines settings.

I just came across an interesting talk on YouTube that among other things talked about BiPAP and mentioned that to be effective, the lower level of pressure may have to be set to the same level as your CPAP pressure: https://www.youtube.com/watch?v=zXbxVTW ... re=related
Start watching at about 6:00. The interesting quote is around 6:44.

This might explain the undertreatment when you're on the lower pressure.

The video came from this thread on apneasupport.org: http://www.apneasupport.org/viewtopic.p ... 186#172186

My machine is not set on ST mode, simple S .. There's a setting for how long the delay is for it to increase pressure, that's turned off so it just goes right up to the inhalation pressure.

As xerort said, there is no auto mode ..

I've been through the clinician menu (just wanted the book to make sure I made the correct assumptions on the settings) since the company I got it from had it all screwed up and the alarm started beeping every time it detected apnea.

I do think the RT was BSing me on that, b/c I went looking into the models and saw plenty of other machines around the same price.