disturbing episode with auto BIPAP

I've been having a very difficult time on BIPAP for my first 14 days, even though my AHIs in the sleep study averaged 53 per hour and my averages with the machine are 5.4

I pretty much feel like crap after using the BIPAP

last night I had a very disturbing episode...
I woke up at 3am from a sound sleep essentially feeling like I was not getting any air whatsoever
I ripped the full face mask off and took several deep breaths
I was covered in sweat
for full disclosure, I had a cortizone shot in my shoulder at 7pm last night (don't know if that has anything to do with anything?)

though in a dazed state after waking at 3am, after a few deep breaths, I seem to remember that the machine was still blowing air and I turned it off

a few moments later I turned the machine back on to look at what pressure it was starting off at.
it was registering a pressure of 8 which is what my starting pressure is without the ramp, so that looked good.
however, I noticed that the humidifier had gone from a setting of 3 down to 0.
also, I checked the ramp and it had gone from 5 minutes up to 45 minutes...to go from pressures of 4 to 8
it's as if the machine turned off for a spell and rebooted itself to several different settings.

I have yet to purchase the software to check out the numbers in detail.

I will call the respironics dealer and RT this morning and tell them of the problem

any other insights to add?

thanks

evan


I have a respironics BiPAP Auto Bi-Flex with humidifier
my ramp pressure is set to go from 4 to 8
my pressure range is set from 8 to 25

Is it possible that your humidifier just ran out of water - have you checked it? You can't run the machine that way because the humidifier will burn out so your machine may have turned itself off (which would explain lack of air!). Have you tried turning off the ramp feature altogether? 8 is not a very high pressure to get used to and most of us don't bother with the ramp at all.

hello julie

thanks for getting back to me

the humidifier was still over 25% full

evan

You might see if your RT can read your data and give you a print-out. That might give you some clues about what happened.

Best wishes,
Tony

Good thinking, Tony.
I once had a machine (PB420E) suddenly misbehave -- and it sure showed on the report!

O.

Hi Evan,

Yes, have your machine thoroughly checked. An injection of cortisone would not cause the symptoms you described. Please let us know what you find out about this sudden "misbehavior" of your machine. I am so sorry that you had this episode. It sounds very frightening. L

thanks for the replies

just talked to my RT and I will drive to his office in salinas to get a printout from my machine

also...he is going to lend me an overnight oximeter (oxygen finger thing) to use over the weekend

thanks again

evan

My guess is either you shut the machine OFF or there was a power interruption. The machine will auto start if it senses breathing.

IF auto shut-off is on and you had a large enuff leak it will also shut OFF but will start once breathing is sensed again. You can change the setting for auto off but not for auto-start.

The Ramp button needs to be pressed for it to work - so just don't press it.

Let us know what you find out from the report.

well..

I just got back from seeing the RT who sold me the machine and all he did was reset the ramp minutes. (still don't know why the machine changed them from 5 to 45...or why the humidifier went down to 0, or why I woke up without any air pressure)

we downloaded the info from the chip, but the only relevant info was the time in which I took the mask off...whIch I already knew from looking at my clock.
There was, however, a leak prior to the episode when I ripped off my mask, but the chip readout does not give the time of the leak

also...even though the led readout on the machine says 0% large leak, the chip data says that during the night I had an average leak of 27.1 (I don't know what that means)

I called the respironics company and they said that they do occasionally have power shutdowns, and if it is not the cord, then the machine needs to be sent back to the manufactures (I left a message with the RT whole sold it to me and told him what the person at respironics said)

I feel even more clueless about all of this

evan

Do you actually have the printout?

There was, however, a leak prior to the episode when I ripped off my mask, but the chip readout does not give the time of the leak

The time of the leak should show on the graph because the bottom axis of the graph is time.

A large leak that either 1) increased the pressure uncomfortably or 2) caused you to lose enough pressure to keep your airway open could cause the reaction you had--more than likely #2, since discomfort from pressure alone won't cause the sweating and gasping for air.

even though the led readout on the machine says 0% large leak

Large leak data on your screen is almost useless because it records only 7 and 30 day averages so the leak has to be HUGE and LONG (minimum of around 34 minutes to show 1% on the 7 day average). You need to look at the detailed leak data on the printout for anything useful.

Respironics machines report the total leaks per minute, so you have to subtract the vent flow rate of your mask at that pressure to determine if the 27 LPM was too high or not. At your pressures, I'm guessing it's well within the mask's vent rate, so that indicates NO leakage on average for that night. But that doesn't preclude a sudden leak spike that will not show up in the average data. The detailed chart can show you a leak like that and how long it lasted.