Starting BiPAP treatment

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Air Jordan
Posts: 29
Joined: Mon Nov 30, 2015 3:19 pm

Re: Starting BiPAP treatment

Post by Air Jordan » Sun Apr 04, 2021 11:21 am

Coatimundi wrote:
Sun Apr 04, 2021 11:09 am
The rest of us are going to have to pick up the pieces after all of this is over.
Coatimundi wrote:
Sat Apr 03, 2021 1:37 pm
I have a BMI of 43. But aging and bad health has caught up with me, and the OSA got so bad.
I don't think you will be picking up any pieces. Here's hopes your disability checks, food stamps and Medicaid sustain you.
Jordan

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Coatimundi
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Re: Starting BiPAP treatment

Post by Coatimundi » Sun Apr 04, 2021 11:29 am

Air Jordan wrote:
Sun Apr 04, 2021 11:21 am
Coatimundi wrote:
Sun Apr 04, 2021 11:09 am
The rest of us are going to have to pick up the pieces after all of this is over.
Coatimundi wrote:
Sat Apr 03, 2021 1:37 pm
I have a BMI of 43. But aging and bad health has caught up with me, and the OSA got so bad.
I don't think you will be picking up any pieces. Here's hopes your disability checks, food stamps and Medicaid sustain you.
I get none of those things. Pretty nasty comment to make about someone, either way.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Thu May 13, 2021 7:38 am

Now using Swift FX nasal pillow mask with large size nasal pillow insert.

It looks like my SleepCube doesn't have the data card function. So communicating with a computer would require a cable of some kind but I haven't looked through the manual to see what kind is needed.

It has the SmartCode function. I used this to look at my 1-day and 30-day average. My Pressure Plateau Time appeared to be at the maximum the system would register (>=31%) and per the IntelliPAP website that means the pressure should be slightly adjusted upward. I took the top pressure from 15 to 16 since the PPT was SO high. Let's see how it goes tonight.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Fri May 14, 2021 1:05 am

Did another SmartCode reading. AHI is now 2.5 (down from around 3.0-3.5 most of the time before). Only 8% of my time was at plateau pressure, compared to somewhere north of 31% (apparently that number is the highest reading so who knows how bad it was). So the machine is now not having to shovel as much air as it can into me.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Sun May 16, 2021 1:15 am

I tried adjusting my lower pressure to 12. Did another SmartCode reading - AHI is down to 2, non-obstructive events also almost zero, but the Peak Pressure Time shot back up to the maximum reading. I'll try the same settings again for a while because I don't want to get stuck in a loop adjusting pressures all over the place, but the PPT needs to improve.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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jimbud
Posts: 1381
Joined: Sat Dec 01, 2018 8:19 pm

Re: Starting BiPAP treatment

Post by jimbud » Sun May 16, 2021 9:59 am

These are the DeVilbiss machines supported by Oscar:

DeVilbiss
Partly Supported by Oscar

DV54 Auto
DV64 CPAP
DV64 Auto

So I guess you will have to find your optimum pressure the old fashioned way. :wink:

https://www.apneaboard.com/adjust-cpap- ... re-on-cpap

It is just a general guide, (not a great option) but might help. :)

We are here to help. This about all I can suggest with my limited knowledge.

Hopefully someone else with more experience/knowledge can/will help out. :D

JPB

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Sleep on a Buckwheat Hull Pillow.

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Coatimundi
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Mon May 17, 2021 1:24 am

jimbud wrote:
Sun May 16, 2021 9:59 am
These are the DeVilbiss machines supported by Oscar:

DeVilbiss
Partly Supported by Oscar

DV54 Auto
DV64 CPAP
DV64 Auto

So I guess you will have to find your optimum pressure the old fashioned way. :wink:

https://www.apneaboard.com/adjust-cpap- ... re-on-cpap

It is just a general guide, (not a great option) but might help. :)

We are here to help. This about all I can suggest with my limited knowledge.

Hopefully someone else with more experience/knowledge can/will help out. :D

JPB
Yeah. It looks like with my machine, Oscar is not an option. I was specifically prescribed BiPAP based on my sleep study results so I need to go with this.

I was reading Apneaboard yesterday and there were some good tips. I'm not doing so good with the gradual changes suggested for pressure. (Meaning, I'm not doing the gradual change and am being abrupt.)

I did another SmartCode reading. My Peak Pressure Time was zero and my AHI declined to 1.5. Also there are measures for 95th and 90th percentile IPAP and these were a little bit below the maximum pressure (for me right now, 16). I also reduced the exhale pressure to 10.5. So it looks like my body really likes this.

I think it will be good to keep this for now as I am feeling all right this morning. BUT... only about three hours of sleep because my nose felt a bit stuffy. So I'm just throwing way too many factors at this right now. Ugh.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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jimbud
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Joined: Sat Dec 01, 2018 8:19 pm

Re: Starting BiPAP treatment

Post by jimbud » Mon May 17, 2021 8:49 am

Coatimundi wrote:
Mon May 17, 2021 1:24 am
So it looks like my body really likes this.

I think it will be good to keep this for now as I am feeling all right this morning.
Good to hear. AHI of 1.5 is very good. Looks like you are getting a handle on things.

My therapy is up and down depending on ? :?:
I just keep plugging on.
Quality of life is what it is all about. :D

Good Luck.

JPB

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Sleep on a Buckwheat Hull Pillow.

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Coatimundi
Posts: 36
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Mon May 17, 2021 10:53 pm

jimbud wrote:
Mon May 17, 2021 8:49 am
Coatimundi wrote:
Mon May 17, 2021 1:24 am
So it looks like my body really likes this.

I think it will be good to keep this for now as I am feeling all right this morning.
Good to hear. AHI of 1.5 is very good. Looks like you are getting a handle on things.

My therapy is up and down depending on ? :?:
I just keep plugging on.
Quality of life is what it is all about. :D

Good Luck.

JPB
Thanks. I got more sleep last night. AHI is 1.5 with this morning's reading and the Peak Pressure Time is zero. The 95th/90th percentile readings are also below not only the current maximum pressure (16) but just a hair under the old maximum (15) so apparently the new max is a good pressure for me. A couple (as in just one or two) of hypopneas during the night as well.

I'm guessing here that the original minimum pressure (it was 11 and I reduced it to 10.5) was a bit too high and it was making me retain too much CO2 because I couldn't exhale enough.

I hope you are able to find the right settings for yourself somehow.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Pugsy
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Location: Missouri, USA

Re: Starting BiPAP treatment

Post by Pugsy » Tue May 18, 2021 7:30 am

90/95 % numbers just mean that's where a person was AT OR BELOW for 90/95% of the night.
They are NOT where a person spent 90/95% of the night. They are just numbers that are easily skewed to the high side with relatively short periods of time at the higher numbers.

Your minimum number is your most critical setting...not the max.

If the machine could go to 100 that doesn't mean it would or that the max setting did much.

The only real reason to limit the max might be if going higher causes a bigger problem than the going higher might be trying to fix.
Like if going higher caused central apneas or aerophagia issues that were really uncomfortable.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

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Coatimundi
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Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Tue May 18, 2021 9:07 pm

Pugsy wrote:
Tue May 18, 2021 7:30 am
90/95 % numbers just mean that's where a person was AT OR BELOW for 90/95% of the night.
They are NOT where a person spent 90/95% of the night. They are just numbers that are easily skewed to the high side with relatively short periods of time at the higher numbers.

Your minimum number is your most critical setting...not the max.

If the machine could go to 100 that doesn't mean it would or that the max setting did much.

The only real reason to limit the max might be if going higher causes a bigger problem than the going higher might be trying to fix.
Like if going higher caused central apneas or aerophagia issues that were really uncomfortable.
Right - my point had been that I spent zero time at my highest setting that night. So for whatever reason I was naturally taking in a lower pressure.

Today's readings were back at about my max (for the percentiles), 3% for peak pressure time, 2.5 for AHI, and an Exhale Puff Index of 12. Also I felt during the day yesterday that my brain was still trying to go to sleep so I made an effort to be on the machine for at least five hours last night. I was wondering if the noise from the machine wasn't letting me rest as well so I put in earplugs. I wonder if something in my inner ear was making me exhale more through my mouth.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
Posts: 36
Joined: Sat Apr 03, 2021 1:01 pm
Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Thu May 20, 2021 12:37 am

Pugsy wrote:
Tue May 18, 2021 7:30 am
90/95 % numbers just mean that's where a person was AT OR BELOW for 90/95% of the night.
They are NOT where a person spent 90/95% of the night. They are just numbers that are easily skewed to the high side with relatively short periods of time at the higher numbers.

Your minimum number is your most critical setting...not the max.

If the machine could go to 100 that doesn't mean it would or that the max setting did much.

The only real reason to limit the max might be if going higher causes a bigger problem than the going higher might be trying to fix.
Like if going higher caused central apneas or aerophagia issues that were really uncomfortable.
I did my SmartCode reading again. AHI is back at 3.0. I will put the minimum pressure back up to 12 tonight and give that a try. Virtually no exhale puffs, though, and peak pressure time is at 7% (and the percentile scores are back near 16).

I also think I need to ditch the earplugs. I don't like what it feels like they're doing to my inner ear.

I had a lot of inertia this morning. I wake up and my behavior is like "Okay get this mask off of me" and then I feel as if I could lay there all day and all night without a care in the world. Just apathy and a bit of grogginess. I probably need to make myself sleep more.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
Posts: 36
Joined: Sat Apr 03, 2021 1:01 pm
Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Thu May 20, 2021 5:37 am

Getting sick of this unsteadiness/lightheaded feeling. I am going back to my previous mask (Mirage Activa)and pressure settings. I put my current nasal pillow mask on and ran it for a minute or so during the day today with the current settings and now I feel weird all of a sudden.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
Posts: 36
Joined: Sat Apr 03, 2021 1:01 pm
Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Thu May 20, 2021 11:43 pm

I laid down with the old mask and settings (Mirage Micro nasal, 15 max/11 min) for about an hour as I was in bed reading things on my phone for a while, so the results are to be considered in that context. But my AHI is now 1.5, no leaking, but a lot of exhale puffs (29). Not sure if that was during sleeping or when I was clearing out my ears several times.

There is a bit less sleep inertia and an overall better feeling today, but I'll give it time to see how the day progresses. There's just about zero lightheadedness and unsteadiness. It's guesswork, but my inner/middle ear seemed to have really not liked what the nasal pillows were doing. Or was it the pressures. Or the earplugs. I don't really know because I kept changing everything. Ugh.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.

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Coatimundi
Posts: 36
Joined: Sat Apr 03, 2021 1:01 pm
Location: USA

Re: Starting BiPAP treatment

Post by Coatimundi » Thu Nov 25, 2021 11:57 pm

I watched LankyLefty's videos about mouth leak and mouth taping. I use the medical tape brand he recommended, Smith and Nephew/BSN Cover-Roll Stretch - 2" x 10 Yards, and it has been working much better in terms of avoiding mouth leaks and helping me sleep better. AHI still varies between 0.5 to maybe 3.0 but the exhale puff reading is just 0 or maybe 1. Essentially zero mask leak.

_________________
Machine: IntelliPAP AutoBiLevel Machine with SmartCode
Humidifier: IntelliPAP Integrated Heated Humidifier
Additional Comments: Severe OSA, prescribed BiPAP at 15/11 pressure.
* DeVilbiss SleepCube - IntelliPAP AutoBiLevel Machine with SmartCode
* ResMed Mirage Micro nasal mask
* Integrated Heated Humidifier
* Severe OSA. BiPAP prescribed at 15/11.