IPAP set at "10" but Encore Pro says "11"

dllfo · Post by **dllfo** » Fri Sep 29, 2006 10:33 pm

The max IPAP is set at ten, how can a machine (In Auto BiFlex) go to a higher number?

My wife's numbers show that in MyEncore for three out of six days now. The last six days. I never saw this before, but we just switched to Auto BiFlex about a week ago.

What am I missing here?

Snoredog · Post by **Snoredog** » Sat Sep 30, 2006 1:00 am

it is a "auto" xpap machine, if it sees events not being treated with 10cm pressure it will increase to 10.5cm then 11.0cm if not prevented by Max. pressure settings.

The Remstar AutoBiFlex uses the same algorithms as the Remstar Auto w/cflex.

That machine should find both your ideal IPAP and EPAP pressures. BiFlex is a user adjustable setting like Cflex.

I would go by what EncorePro software is telling you. It should give you the 90% pressure if that was 10cm it will still go to 11cm if needed (if not prevented by Max. pressure settings).

SelfSeeker · Post by **SelfSeeker** » Sat Sep 30, 2006 5:36 am

I though the machine stops at the maximum pressure setting, at least for the APAP.

I thought it would stop so that it does not chase snores to to high a pressure which may cause more apnea episodes.

Am I wrong in this thinking or does it just go up by a small pressure.

How different is the BiPAP different from the APAP of Remstar M in this regard?

dllfo · Post by **dllfo** » Sat Sep 30, 2006 11:02 am

Self Seeker, I don't know much about the other machines...and still trying to figure out my own.

I also thought if we set a MAXIMUM IPAP, that was it. This is a surprise for me,
I may email Respironics to see how they are designed. One of my concerns is whether this is normal or is the machine malfunctioning????

Snoredog...two quotes from my initial post and your post....

"The max IPAP is set at ten, how can a machine (In Auto BiFlex) go to a higher number?"

Then you said - - "it is a "auto" xpap machine, if it sees events not being treated with 10cm pressure it will increase to 10.5cm then 11.0cm if not prevented by Max. pressure settings. "

I am confused by your comments. You may be right, being in the AUTO mode may allow it to go past the Max IPAP setting of ten. I really don't know the answers. Hoping someone does...

Thanks for the inputs...it is the weekend now, maybe some of our highly experienced members know. (I thought that was a pretty clever way of not saying they are smarter than I am javascript:emoticon(':)')
Smile

Snoredog · Post by **Snoredog** » Sat Sep 30, 2006 1:22 pm

[quote="dllfo"]Self Seeker, I don't know much about the other machines...and still trying to figure out my own.

I also thought if we set a MAXIMUM IPAP, that was it. This is a surprise for me,
I may email Respironics to see how they are designed. One of my concerns is whether this is normal or is the machine malfunctioning????

Snoredog...two quotes from my initial post and your post....

"The max IPAP is set at ten, how can a machine (In Auto BiFlex) go to a higher number?"

Then you said - - "it is a "auto" xpap machine, if it sees events not being treated with 10cm pressure it will increase to 10.5cm then 11.0cm if not prevented by Max. pressure settings. "

I am confused by your comments. You may be right, being in the AUTO mode may allow it to go past the Max IPAP setting of ten. I really don't know the answers. Hoping someone does...

Thanks for the inputs...it is the weekend now, maybe some of our highly experienced members know. (I thought that was a pretty clever way of not saying they are smarter than I am javascript:emoticon(':)')
Smile

rested gal · Post by **rested gal** » Sat Sep 30, 2006 1:37 pm

dllfo, do you have the Max IPAP set for 10.0 exactly, or did you set it for slightly over 10.0...like a Max IPAP setting of 10.5?

Snoredog · Post by **Snoredog** » Sat Sep 30, 2006 3:10 pm

According to Respironics Auto Alogrithm Training module:
the IPAP pressure cannot exceed the "Max. IPAP" setting. It also indicates the Delta is 3cm to 8cm, and the EPAP cannot go lower than "Min. EPAP" setting set.

I think he needs to go through programming again and set up the Min. & Max. settings correctly. Any range set should allow the machine to automatically find the correct pressure(s).

IPAP: Should have a Min. & Max. setting, the Min. setting would be just like a Autopap machine, can start lower and increase higher, so if you set a range such as 6.5cm to 11.0cm for IPAP, IPAP pressure should start at 6.5cm and increase as events dictate up to 11.0cm.

Note: you want your Max. pressure at least 1cm higher than the 90% IPAP found pressure on the report UNLESS you have CA's denoted on your PSG. EPAP maintains a 3cm to 8cm Delta below any IPAP pressures (I think you can optionally override that but why would you want to). You can also set a Min. EPAP pressure, meaning machine will not go lower than that Min. setting.

OwlCreekObserver · Post by **OwlCreekObserver** » Sat Sep 30, 2006 3:26 pm

dllfo wrote:The max IPAP is set at ten, how can a machine (In Auto BiFlex) go to a higher number?

My wife's numbers show that in MyEncore for three out of six days now. The last six days. I never saw this before, but we just switched to Auto BiFlex about a week ago.

What am I missing here?

My personal experience with straight CPAP is that MyEncore gets confused by fractional pressures. When I've changed it to, say 10 1/2, MyEncore reports it as 11. Or was it 10? I forget which direction it went.

I figured it was just something I was doing, but it may be a minor glitch in the software. Anyway, I think I'd be careful about reading too much into it as far as machine settings.

OCO

dllfo · Post by **dllfo** » Sat Sep 30, 2006 3:38 pm

RG - I just went in to look at it again. It is exactly on 9.5, not ten. The reason I lowered it was because (as you may recall from an earlier post) my wife said it felt like the machine was "inflating her" with too much pressure. I told her 9.5 was under her Max IPAPA scores, but she wanted to lower it a little to see if she would not have that "bloated" feeling.

Snoredog, I don't understand what you are saying. Max and min IPAP? I only have one IPAP that I know of. And one EPAP. On the 20th of Sept I set it at 4 for EPAP and 9.5 for IPAP. Per MyEncore, her MAX IPAPs were 9-9-9, then 10-10-10-10 with the machine set at 9.5.

I think the numbers I used initially were intended for easy math, like rounding them off.

Her minimum EPAP setting was set at 4 at that time. Since then, her 90% EPAP is 5-4-4-4-4.5-4.2-4.7.

MY CONCERN was how the machine could go thru its "Max" setting. that is all I wanted to know. Is this normal or is the machine malfunctioning.

Put another way, RG, you have this machine. Have you ever put the Max IPAP setting of ...make up any number...say ten and had YOUR machine go thru that number? Would you think your machine was malfunctioning or is there another explanation for the IPAP numbers.

dsm · Post by **dsm** » Sat Sep 30, 2006 4:10 pm

A question. Did Derek ever update MyEncore for the Bipap Auto ?
Just wondering ?

Dave,
What does Encore Pro printout say ?

Cheers
DSM

Guest · Post by **Guest** » Sat Sep 30, 2006 4:10 pm

I'd be curious to know what EncorePro says. Is it different than what MyEncore says? Possibly MyEncore massages the data?

Missy · Post by **Missy** » Sat Sep 30, 2006 4:37 pm

I, also, noticed that the MyEncore is confused with fractional pressures. I have been running at 9.5 and it is recorded as 10. Maybe a glitch. I don't know how I got along without the MyEncore and the card reader. It makes the world and all of difference in the treatment of apnea. If anyone reads this, and doesn't have the software and has been wondering, I would say do it. Find a way to get the tools to take charge of your treatment. You won't be sorry!!

NightHawkeye · Post by **NightHawkeye** » Sat Sep 30, 2006 6:31 pm

dllfo wrote:It is exactly on 9.5, not ten. The reason I lowered it was because (as you may recall from an earlier post) my wife said it felt like the machine was "inflating her" with too much pressure. I told her 9.5 was under her Max IPAPA scores, but she wanted to lower it a little to see if she would not have that "bloated" feeling.

That explains everything, Dave. Your machine is not really going to 10 cm pressure. What you are observing is another "feature" of the software, or depending upon perspective, some would also call it a "bug". Anyway, the thing is that Encore Pro only seems to report in whole numbers, hence if the machine goes to 9.5 cm, then Encore Pro rounds it up to the next whole number and the daily chart displays a line at 10.0 cm. Not all charts in Encore Pro do this by the way, but I do remember that the daily chart does.

I've looked at the raw data from the database before and it displays the exact number from the machine, so this is merely a software reporting issue, and not a therapeutic issue of any kind.

Hope this makes sense, Dave.

Regards,
Bill (expecting harsh protests that Respironics software couldn't possibly exhibit this "feature")

CollegeGirl · Post by **CollegeGirl** » Sat Sep 30, 2006 6:38 pm

Bill,
That would make sense if dllfo's wife's machine was set for Max IPAP 9.5 and was showing 10. The Max IPAP is set for 9.5, however, Encore Pro is reporting 11. So that glitch/feature doesn't account for dllfo's problem.

I don't know how auto bipap's work, dllfo, so I can't really help, except to say that if you ONLY had one IPAP pressure and only one EPAP pressure, that wouldn't be an AUTO Bipap, that would just be a regular bipap. Perhaps you're misunderstanding the machine's settings.

If it's an auto, I would assume it should have a *range* of pressures it can go to for IPAP or EPAP.

Again, I could be wrong, since I've never had a bipap auto, but it wouldn't make sense for there not to be a range in there somewhere.

dllfo · Post by **dllfo** » Sat Sep 30, 2006 6:38 pm

Encore pro says 9.5 for yesterday and MyEncore says 10.

When I look at MyEncore, it shows a 9.5 and a 10 in there. Why I don't know.
It may be that it rounds up or down.

Maximum Titrated IPAP Pressure is 9.5 (What I put in the unit)
Avg device IPAP pressure 90% of the time 9.4 (What she did during night)

So how did it get a ten from those numbers?

IPAP set at "10" but Encore Pro says "11"

IPAP set at "10" but Encore Pro says "11"

Re: IPAP set at "10" but Encore Pro says "11&