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How to set a BiPAP

Posted: Mon Dec 14, 2009 8:36 pm
by BrandyMB
I have a kinda dim question. I would like to know the optimum way to set a bipap. What pressure, like the EPAP setting. My titration study showed AHI at the following pressures:

5 - 84.4
6 - 17.1
7 - 2.4
8 - 9.8
9- 0.0
10 - 0.3

I should add, sleep was on my back and right sides. back was 112.3 min with a total AHI of 18.16, RAI 18.69. On my side was 211,6 min with AHI of 0 and RAI of .28. It seems obvious I should not sleep on my back and do better on my rt side. I'm sleeping on the couch right now, kinda elevated on my side. The wife dont mind as the noise interferes with her sleep. I have set my machine to 10 IPAP but wonder what is correct to try on the EPAP end. As I stated in another thread, I've been having sleep onset apneas, my O2 desats to 88% (I got a finger meter). Past couple days I have been taking half an Ambien to fall asleep and the other half mid-night.

I do know that when I get a hand;e on this I should star feeling better (prayer). I feel like hell right now.

Thanks in advance for the advice, past and future. You all really rock!
-Mark

Re: How to set a BiPAP

Posted: Mon Dec 14, 2009 9:02 pm
by rested gal
The EPAP is the important pressure to set "right", imho. If it were me, I'd want the EPAP set high enough to prevent most apneas right from the get-go. Then I'd set the IPAP about 4 cms higher than EPAP.

EPAP's job is supposed to be to prevent apneas. Not just to be a "lesser pressure for easy exhaling" (although it does serve that purpose too.)

I'd probably set the EPAP at, or close under, the single prescribed pressure, whether I was using the bipap auto in just bilevel mode or in auto bilevel mode. But that's just me, and I'm not a doctor.

My thoughts about EPAP setting on a bilevel machine (and min EPAP on the BiPAP Auto.)

November 2007 - EPAP is for more than just comfort exhaling.
viewtopic.php?p=227068#p227068

December 2007 - my understanding of how a bipap titration is done.
viewtopic.php?p=231786#p231786

May 2008 - discussion with RonS about importance of EPAP setting.
viewtopic.php?p=265020#p265020