Dreamstation Auto Bi-Pap

I am new to using Bi-Pap. I previously used C-Pap and had many issues with the pressure, especially the exhale. I couldn't tolerate C-Pap. My new machine, Dreamstation DSX700H11, the Clinician set it for 9/5. My first few nights, my AHI numbers were averaging 4.7. I sleep poorly with or without C-Pap/Bi-Pap but they say I need it to stay healthy. Being a Techie type, I went into the settings (Therapy) and changed it from Bi-Pap to Bi-Pap Auto. The machine was really easy to tolerate in this Auto mode. I checked my AHI number after using this mode and it was improved at 2.7.

I asked the Clinician why can't I use Bi-Pap Auto and she said I need fixed pressures to determine if the therapy is working. She tried to tell me that the download data won't show her accurate pressures because "Auto" is always adjusting to the Patient's needs. At least on the one night of Bi-Pap Auto, the numbers were improved. I'm not sure on how to set all the values in the Bi-Pap Auto mode (HELP) but as it is, it seems fine. Not sure why she had me buy the 700 series machine versus the 600 series machine if there was no need for this Auto Bi-Pap mode? Plus my insurance offers zero coverage towards the machine's cost so quite a hit for me.

I shouldn't be changing the operating mode but so far, it doesn't look like it's hurting the therapy any and it may be actually be helping with a lower AHI=2.7. Is anyone using this machine in the Auto Bi-Pap mode? I'm not a Doctor but am wondering what is so bad about the Auto mode beside she said not to....

If you haven't already done so download Sleepyhead and check your data to see where your pressures are cettling at. You haven't mentioned your pressures but you may need to just bump up your Exhale Pressure (EP) for both auto and/or BiPap. Since you bought the machine you don't have to worry about compliance.

I think you are better off with the auto. You can set it back to straight BiPap or not whatever you feel is working for you.

kitra wrote:I am new to using Bi-Pap. I previously used C-Pap and had many issues with the pressure, especially the exhale. I couldn't tolerate C-Pap. My new machine, Dreamstation DSX700H11, the Clinician set it for 9/5. My first few nights, my AHI numbers were averaging 4.7. I sleep poorly with or without C-Pap/Bi-Pap but they say I need it to stay healthy. Being a Techie type, I went into the settings (Therapy) and changed it from Bi-Pap to Bi-Pap Auto. The machine was really easy to tolerate in this Auto mode. I checked my AHI number after using this mode and it was improved at 2.7.

I asked the Clinician why can't I use Bi-Pap Auto and she said I need fixed pressures to determine if the therapy is working. She tried to tell me that the download data won't show her accurate pressures because "Auto" is always adjusting to the Patient's needs. At least on the one night of Bi-Pap Auto, the numbers were improved. I'm not sure on how to set all the values in the Bi-Pap Auto mode (HELP) but as it is, it seems fine. Not sure why she had me buy the 700 series machine versus the 600 series machine if there was no need for this Auto Bi-Pap mode? Plus my insurance offers zero coverage towards the machine's cost so quite a hit for me.

I shouldn't be changing the operating mode but so far, it doesn't look like it's hurting the therapy any and it may be actually be helping with a lower AHI=2.7. Is anyone using this machine in the Auto Bi-Pap mode? I'm not a Doctor but am wondering what is so bad about the Auto mode beside she said not to....

Your "clinician" doesn't know what she is talking about. YOu most likely could have saved big bucks buying at an on line DME. You can monitor your therapy on Sleepyhead and see the results daily. Check what you paid against what cpap.com lists.

LSAT wrote:Your "clinician" doesn't know what she is talking about. YOu most likely could have saved big bucks buying at an on line DME. You can monitor your therapy on Sleepyhead and see the results daily. Check what you paid against what cpap.com lists.

+1

kitra wrote: I asked the Clinician why can't I use Bi-Pap Auto and she said I need fixed pressures to determine if the therapy is working. She tried to tell me that the download data won't show her accurate pressures because "Auto" is always adjusting to the Patient's needs. At least on the one night of Bi-Pap Auto, the numbers were improved. I'm not sure on how to set all the values in the Bi-Pap Auto mode (HELP) but as it is, it seems fine. I shouldn't be changing the operating mode but so far, it doesn't look like it's hurting the therapy any and it may be actually be helping with a lower AHI=2.7. Is anyone using this machine in the Auto Bi-Pap mode? I'm not a Doctor but am wondering what is so bad about the Auto mode beside she said not to....

I am certainly no expert, but I agree with lsat & pale rider. Regarding your statement "I shouldn't be changing the operating mode" - I support your freedom to challenge authority that demonstrates their authority only by edict and not testable logic. Regarding her contention "that the download data won't show her accurate pressures because "Auto" is always adjusting to the Patient's needs." Perhaps a few nights of SleepyHead charts might dispel her of that notion - that is, if she is willing (and able) to follow the minute by minute traces of machine behavior and the correlated patterns of events.

kitra wrote:She tried to tell me that the download data won't show her accurate pressures because "Auto" is always adjusting to the Patient's needs. .

seems to me that 'adjusting to the patients needs' would be a good thing(tm).

My numbers are 9 Ipap and 5 Epap. I ran it in "Auto BiPap" again last night and the machine said an AHI of 2.2 this morning. I don't know what is considered good but the numbers are going down. In "Fixed" BiPap, I can definitely notice the pressure more. I'll have to try their "Fixed" BiPap settings to see if there is any benefit. I agree that I shouldn't be messing with this expensive device but at the same time, I've read that lots of Engineering went into the development of the Auto BiPap technology. My second biggest issue is the Mask. It works great laying on my back but I'm typically a side-sleeper. When on my side, my pillow seems to push on the mask and then a major leak. Plus the strap that goes over the back of the head doesn't stay in place as I must move around a lot. I'm appreciating this site and the feedback. Thanks a million.

LSAT wrote: Your "clinician" doesn't know what she is talking about.

Not necessarily true. We don't know what other issues this member has and it often makes sense, in other therapies, to establish a baseline for therapy before switching to something that is variable. In my case, that was easily established in my titration, but maybe it wasn't clear or the OP didn't have a titration on the bipap? On the other hand, I applaud the OP for taking matters into his own hands. After a few days of no improvement, I certainly would have and did.

I do agree with the rest however, that you could have saved a lot of money buying online.

As to leaks for side sleeping, others have suggested using a mask liner.

I too am real new (3 nights) to BiPAP
My titration study was a nightmare. The BiPAP was set to no special relief and the expiration dropped 4cm in a square wave and I had a TON of difficulty with that.
My machine is a ResMed AirCurve 10 VAUTO. I'm not (yet) using the VAUTO feature, instead starting with the Rx of 25/21, but, BUT the machine is set at an epr factor of 2. That seems to make all the difference in the world. It smooths out the transition that I was having so much trouble with. You have to set this with the "Clinician Settings" but it does not impact your Rx Settings.

SewTired wrote:

LSAT wrote: Your "clinician" doesn't know what she is talking about.

Not necessarily true. We don't know what other issues this member has and it often makes sense, in other therapies, to establish a baseline for therapy before switching to something that is variable

you wanna back that up? because I see no validity in your statement.

palerider wrote:

SewTired wrote:

LSAT wrote: Your "clinician" doesn't know what she is talking about.

Not necessarily true. We don't know what other issues this member has and it often makes sense, in other therapies, to establish a baseline for therapy before switching to something that is variable

you wanna back that up? because I see no validity in your statement.

Of course! Insulin is one of the most common and widespread examples. Almost everybody starts off with sliding scale. Only after the effects of the insulin and the patient's reaction is established do they switch to other options (carb/insulin ratio for instance). Physical therapy often starts with baseline exercises for several weeks before expanding to see what the damaged parts can do without further injury or instability. My late SIL's home ventilator - they started off with specific settings and altered only after a baseline was established. Eventually, she only used the ventilator when sleeping, but some of the resistance on the part of the doctors was unfamiliarity with her illness.

edited to add: Now where would this fit in with xpap usage? Say you have brittle blood pressure? It makes sense to find out FIRST what pressures result in even blood pressure. That way, when you do try the alternating pressures, you know it's the cpap usage and not some other thing, causing the wonky blood pressures. If you move it back to the straight pressure and the blood pressure is still wonky, then you know it's something else and not the cpap usage.

SewTired wrote:

palerider wrote:

SewTired wrote:

LSAT wrote:Your "clinician" doesn't know what she is talking about.

Not necessarily true. We don't know what other issues this member has and it often makes sense, in other therapies, to establish a baseline for therapy before switching to something that is variable

you wanna back that up? because I see no validity in your statement.

Of course! Insulin is one of the most common and widespread examples. Almost everybody starts off with sliding scale. Only after the effects of the insulin and the patient's reaction is established do they switch to other options (carb/insulin ratio for instance). Physical therapy often starts with baseline exercises for several weeks before expanding to see what the damaged parts can do without further injury or instability. My late SIL's home ventilator - they started off with specific settings and altered only after a baseline was established. Eventually, she only used the ventilator when sleeping, but some of the resistance on the part of the doctors was unfamiliarity with her illness.

edited to add: Now where would this fit in with xpap usage? Say you have brittle blood pressure? It makes sense to find out FIRST what pressures result in even blood pressure. That way, when you do try the alternating pressures, you know it's the cpap usage and not some other thing, causing the wonky blood pressures. If you move it back to the straight pressure and the blood pressure is still wonky, then you know it's something else and not the cpap usage.

your statement is ridiculous. comparing pap therapy to insulin is ridiculous, unless you're going to compare an apap to a built in insulin dispenser that both monitors your blood sugar and adjusts the insuln dosage on a minute by minute basis.

there's no sense, or validity in the OPs 'clinician' statement, and even less in your ridiculous comparisons.