Can these settings be right?

Got my software and got it installed. (Yippee!) Now I need help understanding what I see.

The readout says these are my settings:

Max IPAP=20.0
Min EPAP=10.0

What confuses me is this. My DME therapist said she was setting it for 4-20 cm, since my titration study is not back yet. This does not appear to be a 4-20 setting to me.

For the two nights I have used the machine, I have had
90% IPAP=17-19
90% EPAP= 15-16.
I was hoping for lower pressures.....

Anyone know what it means? First, do you think she made an error in the settings, and second, does it even matter, given the pressures I have been running so far?

Soon I should get my titration results, and then perhaps we can set it more closely. However, the DME rep indicated that there would be no need to reset, since it is an Auto BiPAP.

Comments welcome.

Moogy

Moogy wrote:Anyone know what it means? First, do you think she made an error in the settings, and second, does it even matter, given the pressures I have been running so far?

It means that the machine is set up properly and is working properly. Lucky you! You're doing great Moogy if you can handle that pressure right off the bat.

Now, as for what it means . . . Your BiPAP operates at two different pressures every time you breathe; IPAP is your inhalation pressure and EPAP is exhalation pressure. Your machine automatically chooses each of these pressures with the following limitations. 1) IPAP cannot be more than the maximum specified (20 cm), 2) EPAP cannot be lower than the minimum specified (10 cm), and 3) there cannot be less than 3 cm difference between IPAP and EPAP, for example if IPAP goes to 17 cm, then EPAP cannot be more than 14 cm.

Hope that helps.

Regards,
Bill

Thanks for the help interpreting, Bill. I understand it better now.

The MyEncore software is great. It is SO easy to use and has such good charts. I really understand a lot more about how my machine is working now. Too bad the Encore and MyEncore software doesn't routinely come with the machine so that everyone could use it to monitor his/her activity.

On the other hand, the installation instructions that came with the Encore software from Respironics made NO sense.... I bumbled through only because I am pretty familiar with computers.

Moogy

Moogy,

Since I don't use an auto I can not be sure about your readings. I know that you have a very high AHI (over 100) if I remember correctly. Since I also have a high AHI (98), I gave quite a bit of thought about its implications in regard to an auto BiPap. I have a straight Respironics BiPap Pro 2 with BiFlex, which works for me quite well at settings of 17/13. As I indicated in an earlier post in response to your inquiry about autos, I thought that since a high AHI would indicate the apneas and hyponeas come so closely together that an Auto BiPap's presssures would essentially not vary too much. It seems that might be so, given your readings of 90% at the high pressures, whereas a non-auto BiPap would be at the high pressures 100% of the time. So, my guess is that your auto BiPap is working correctly for your needs.

It should also be noted that one's AHI does not necessarily correlate well with your required pressure settings-- i.e., just because one has a high AHI does not necessarily mean that the pressure settings will be high, and vice versa for a low AHI. It will be interesting to find out what your titrated pressure turns out to be.

So, it appears that you got the first part of the challenge right. The next part is the interface. How is that working for you?

Ann

Ann,

With this Auto BiPAP machine, I think that 90% at 17-19 means that at that level, 90% of my apneas are controlled. It doesn't mean that I spend 90% of my time at that level. The MyEncore software has another chart showing how much TIME was spent at each level, and while I am still learning to read it, it looks like there was a lot of time at the lower pressures.

I am keeping in mind your warning that my apneas might be too frequent for an auto to control. I will follow my numbers for a while and see how it works.

Moogy

Moogy wrote:I think that 90% at 17-19 means that at that level, 90% of my apneas are controlled. It doesn't mean that I spend 90% of my time at that level.

You're close, Moogy. It actually means that you spent 90% of your time at or below that pressure level, so if your 90% pressure is 19 then all times at pressures less than 19 are included in the 90%. What's your AHI? That's the best measure of how well the machine is controlling your apnea.

Regards,
Bill

My AHI was 5.2 last night, down from 102.5 at my sleep study! Apparently this machine is really working! I am managing 6-7 hours a night on the machine, with average inhale pressures of about 14 and maximum inhale pressures of about 18. Exhale pressures are a bit lower, since I have an Auto BIPAP. So far, so good.

Still waiting on my titration study. I am really glad I didn't wait for the results, but instead insisted on getting an auto machine right away.

I am still a bit tired and sleepy, still taking one Provigil tablet daily, but MUCH improved.

If the percent of time in variable breathing is a loose indicator of how much REM sleep I am getting, can someone tell me what a normal number might look like? Mine was in the 20s the first couple of nights of therapy, but has dropped to about 15. I do hope to feel better rested with more time in therapy.

Moogy

Moogy-

Thanks for the explanation. Since I have not seen a print out I was not sure of your data. I am interested in an auto Bipap but have to see how it works with such a high AHI first before I make any changes. Actually, though, I am pretty happy with what I have.

(Still, I like to keep my options open just as I think others on xpap do about their equipment including interfaces-- always looking for something better!)

Ann

Moogy wrote:If the percent of time in variable breathing is a loose indicator of how much REM sleep I am getting, can someone tell me what a normal number might look like? Mine was in the 20s the first couple of nights of therapy, but has dropped to about 15.

Depends on who you're asking, Moogy. There has been some discussion about that here, but no one seems to know quite what "normal" is. On nights with more apneas my variable breathing is higher. On nights when I sleep longer my variable breathing is also higher.

When I first started xPAP my variable breathing was between 10% and 20%, but I had been accustomed to disturbed sleep at that time. Then for a few weeks my variable breathing consistently ran between 30% and 40%. I think I was catching up on REM sleep. Now it is usually between 20% and 30% and I wonder if I'm getting enough REM sleep. .

Still don't know what "normal" is.

Regards,
Bill