got y new machine....now what???`

Well, I am now the official owner of not 1, not 2, but 3 CPAP machines. I went from an old fashioned CPAP, to a spiffy APAP. Apparently that wasn't working, so I just got an auto BiPAP...woohoo. The pressure came set at 14/8 on the BiPAP, the supposed proper pressure for me (however, was previously titrated at 16 and 10). The first 2 nights woke up in the morning feeling like crap. Pressure definitely is too low. I hacked the machine and changed it to auto. Problem, is I can't figure out how to prevent the exhalation pressure from rising too high to negate the BiPap feature. Does anyone happen to use the M series Auto Bi-Pap and know how to limit the max EPAP pressure?

Thanks,
Sarah

I haven't the foggiest as I am a ResMed-er. Howemsoever, it wouldn't surprise me at all if access to the Clinician's menu for that M Series Bi-Pap wasn't the same as access to the Clinician's menu for any of the other M Series xPAPs.

lawdognellie wrote:Problem, is I can't figure out how to prevent the exhalation pressure from rising too high to negate the BiPap feature. Does anyone happen to use the M series Auto Bi-Pap and know how to limit the max EPAP pressure?

I'm not sure what you mean you are trying to do by "limiting" the EPAP, Nellie, while using auto bilevel mode. In autotitrating bilevel mode, the only way you can "limit" how high the EPAP might go, would be by how high you set your max IPAP pressure.

If you use the bipap auto in auto-titrating bi-level mode, it is always going to start out using exactly 2cms more IPAP pressure than whatever you have your EPAP set at. EPAP will never get up closer than 2 cms under whatever IPAP pressure is being used at any given moment.

If you really want to "limit" how high the EPAP goes, it sounds like what you might need to do is use the machine in just bipap mode for awhile, at various EPAP/IPAP settings until you find an effective IPAP/EPAP pressure.

Or, if I were going to use it in auto-titrating bilevel mode, given the different bipap pressures you mentioned having been prescribed on two different occasions ( 16/10 and 14/8 ) I'd probably give these settings a try:

Max IPAP 16

Min EPAP 10 (the highest that EPAP might go is 14, if IPAP ever did go to 16...remember the machine will start out using IPAP 12 / EPAP 10 and vary those throughout the night, as needed. )

Max Press Sup 6 (which is the most it can be set for, given an IPAP of 16 and EPAP of 10. 16 minus 10 = 6 )

Bi-flex 3 (gives some additional drop in pressure at the very beginning of each exhalation... set Bi-flex however it feels smooth to you.)

AutoRamp Time - I'd turn this OFF, but whatever you like.

AutoRamp - I'd have it off...but if you do set an AutoRamp Time, set it however you like.

Mask Alert - I'd set this "off"

Auto Off - off

Split Night Time - definitely OFF

Show AHI/Leak - ON

Patient Reminder - OFF

When you speak of wanting to limit the EPAP, do remember that the EPAP pressure is probably the more important of the two pressures to "get right." EPAP is what is supposed to be set high enough to eliminate obstructive apneas when using a bi-level machine. And that goes for even when using the machine in autobilevel mode, imho.

Good luck, Nellie. Hope your treatment goes well.

Do you have the Provider (clinical) manual for your machine?

I left my machine on auto left night, maximum EPAP at 20 and minimum IPAP at 8. This morning machine was at 20/18. Majorly different from 14/8. The problem is I can't exhale when the pressure is at 18 (the whole reason I got a Bipap in the 1st place). I wish I could cap the IPAP pressure around 12, but allow the EPAP pressure to go up to 20 as needed. Otherwise my lungs just keep filling up like a balloon.

Thanks,
Saraj

Also, what is "Max Press Sup"?

Thanks,

Sarah (gee I can spell my name really

Simply... the max difference between the IPAP and the EPAP

That setting is called "PS" on the older pre-M BiPAP Auto with Bi-Flex, so when you see "PS" mentioned in some of the posts in these threads, it's the same thing... PS and Max Press Sup are the same thing.

Dec 08, 2006 subject: Question for BiPap users - UPDATED 12/14/2006
viewtopic.php?t=15666


Mar 04, 2007 subject: Need a little help to set my Respironics BiPap on auto !
viewtopic.php?t=17887