First night on Bipap

Ok, I got my new Resmed S9 VPAP S yesterday and it was set by secondwind for me. I know how to access the hidden settings. My first night was not what I expected. The pressure seemed very high, I feel like I was up all night, but I know I got some sleep as I don't feel all that tired today. I slept for a little over 9 hours and kept the mask on the whole time. In the morning and during the night I noticed my lungs burned a little. Kind of the same feeling where you go out in the cold and shovel snow. Now that I have been up a few hours I still feel it a little but it is a little better. My guess is that it is because I am not used to the pressure on my lungs, is this normal after starting cpap/bipap therapy? The worse part is that my AHI was 84.3! This is bad. During my sleep study before therapy my AHI was 106. After they initiated bipap it went down to 8. What is going on? I did notice something. On my sleep study the sleep doctor recommended settings of 17/14 with EPR of 3. I noticed that the inspiration pressure was set to 17, but the expiration pressure was only set to 4 on the machine. Shouldn't the expiration pressure be set to 14? I know how to change this. Oh, I also am using the Resmed software to look at the data.

I am thinking that Secondwind accidentally set the expiration pressure wrong. I would appreciate if someone more experienced than me on this forum could let me know and if they agree, I can change the setting and see what happens tonight. My only worry is that it will be even more difficult to sleep because of the increased pressure. Thanks ahead of time for taking the time to read my post.

BustaTC wrote: I am thinking that Secondwind accidentally set the expiration pressure wrong.

Yeah, I think that EPAP (exhale) is likely wrong...way to low at 4 cm and most likely caused the high AHI and maybe some of the chest wall (lung) discomfort.

Some lung discomfort just from using chest wall muscles that we haven't used in a long time can be expected..if it is horrible discomfort go see a doctor but if it is minor and seems to ease up...I imagine after you get used to the machine making you use muscles you haven't used in a long time...it will eventually go away.

Set EPAP (exhale pressure) to the 14 cm that the RX calls for.
It's still going to seem rather high and if you simply can't get used to it and can't sleep with it...you could tried something a little lower and work up to prescribed RX.
Something like maybe 15 IPAP and 10 or 11 EPAP might be settings to consider short term if you can't adjust to the 17/14.

You might also play with the PS...pressure support which is the difference between EPAP and IPAP...4 cm difference might be more comfortable than 3 cm..
So maybe try 17 IPAP and 13 EPAP....just a thought.

I really appreciate the response. I thought that the setting would need changed, just kinda wanted confirmation from someone else. I agree with the pressure settings. I mean I have had nothing to help with apnea in the past and something is better than nothing, and over time I can adjust. I will give the 17/14 a try and if it too much I think i might try the 14/10 that you suggested. I will have to see how it goes. As far as the lung discomfort it is nothing that is too terrible, it is just there. I am pretty sure it is how you described and only because I am not used to it. Thanks for the help. It is great knowing there are other going through this and they are so helpful! Perhaps someday I can pay the help forward to a newly diagnosed apnea sufferer.

I had the chest discomfort when I started using APAP and pressure was going up to 17-20... It only lasted for 2-3 days. If yours lasts longer or gets worse, consider lowering pressure as Pugsy suggests and working up to 17 over a few weeks.

Last night I changed my bipap setting to 14/10 as I tried with the 17/14 settings and the pressure was too much. I set it down lower in hopes over time, I can work up to what I need. First of all it seemed it took me around an hour to fall asleep, but I actually feel like I slept most of the night! I just downloaded the data and was pleased with the results. My AHI dropped to 16.7! I know that isn't perfect, but it is much better than what I have seen in the past. Here is the thing. It appears my AHI for obstructive was 1.2 and for central was 14.7. During my sleep study I had some central apnea's but they were pretty much written off as a non-issue. By the sounds of it I am not sure if even working up to my prescribed setting of 17/14 will even be beneficial. Could it be because I am still getting used to the therapy? Any thoughts? Thanks again for the help.

The centrals......were they in large clusters by any chance and any of them show up during the hour it took you to get to sleep?
Do you know how to post an image of a detailed report?
viewtopic.php?f=1&t=81072&p=737779#p737779

I haven't had a chance to take a look at the centrals to see if they were in groups yet, I will try to do that tonight. I just wanted to talk about the continuation of my therapy a little. On Sunday night I tried to fall asleep for 2 hours but my ResMed Mirage Quattro ffm kept leaking, very bad. I finally got fed up with it and just took it off and slept without my Bipap. Last night I was determined to get back to it, I did a lot of research on masks and leakage, and I made sure to shave before bed, and wash my face. My mask was washed as well. I then tried to create my own mask liner and completely re-fitted my mask. I tried with the mask liner and the leaks were pretty bad so I removed it and seemed to get an alright seal. I had the ramp set to 40 minutes, and my pressures are still 14/10 for the time being. After a little while I started to notice leaks. I couldn't turn over on my side, but I did finally fall asleep. During the night I woke up a few times to small leaks, but I just tightened my mask and went through it. I did get some sleep last night. When my alarm when off, I ended up with around 7 hours of sleep, my machine gave me a smiley face meaning the leaks must not have been too bad, and most importantly my AHI was 4.6! This is great. I still have not had a chance to look at the detailed data as I had to get ready for work, but I will tonight. I am pretty happy with my AHI and this is with the settings lower than my Rx. Thanks for the help everyone, I still need to figure out why these leaks are happening, they are annoying.