Don't understand this machine, Respironics Bi Pap Auto SV

HI folks, I just got a Respironics Bi Pap Auto SV w/humidifier. Things seem to settle down when I get to sleep, but getting to sleep is a problem. The machine seem to cut off my air at times on inhale. I think it has something to do with the no. of breaths per minute settings but I'm not sure. You would think that the machine would be happy for you to take a breath any time you want, but that doesn't appear to be the case. It seems to want you to take a breath only when it wants. It makes it hard to fall asleep when it shuts off the air if I take too long to initiate another breath.

Also I don't see any way to access my performance data. I can't find a way to look at how many apnea's I had at night of even my compliance time. Do I have to get a card reader and software to do this. I have a copy of the provider book but it doesn't seem to mention this except for the card reader and software .

Thanks for any help

Bob

you might want to put the name of your machine in your subject for the thread to attract those few who do understand them - just go back and click on edit and change the subject

Thanks Jules, I think I got it this time.

Bob

it isn't a very common machine - hope you get some takers now

Can you list your settings?

I have BPM set on "Auto" and don't have any of those struggles. I did have those types of issues when trying to find the right BPM on the BiPap S/T that didn't have an "auto" setting.

I think you really need the card, reader, and software. There are 4 parameters, like tidal volume, that are displayed on the LCD, but not much.

Once you get the settings right you should have no problems with the machine. That machine gives me the least intrusive, easiest to get along with breathing pattern of any I have used. There are many times when I have to check to be sure it is on!tOt just fades into the pattern of my regular breathing.

Adjusting the "rise time" can help with the transition feel from exhale to inhale. I have mine set at "2."

Good luck!
Michael

vulcan wrote: It makes it hard to fall asleep when it shuts off the air if I take too long to initiate another breath.

Bob

Hi Bob,
For the past 2 1/2 weeks, I've been using a borrowed PR auto Bi-pap but I don't think it has the SV. Prior to that I used PR System One apap. Whenever I stopped breathing with the apap, the machine would seem to force air on me which often awakened me. I felt like the machine was doing its job. With the Bi-pap, several times in the last couple of days, I've ripped the mask off (complete with the neatly tied stocking) while gasping for air. Last night, it happened several times when I sat bolt upright but calmed myself down and didn't yank off the mask. It DID seem like the machine shut off the air. I wondered if I'd forgotten to turn it on. That just doesn't make sense. Both machines are on the same settings. I'm using the same mask but struggling with it. I had no major leaks. My nose was stuffy, though. Maybe I rolled over on my back but the machine should still take up the slack, shouldn't it? I was too tired to try to figure it out last night, so after the second or third time I ripped the mask off, I just left the dang thing off and slept without it. I'm going bass-ackwards. It's much easier for me to breathe using the bi-pap if it would consistently give me some air. I hope someone here can help.

(Elena, after 4 months, I'm still feeling like a newbie...)

Jane

Hi Michael, thanks for the reply.

The setting from the machine are:

6cm H2O EPAP
10cm H20 IPAP Min
25cm H2o I PAP Max
10 BPM
1.2 Sec Ti
Rise time 4
Ramp 40
Ramp start 5 cm H2O
Apnea 0 seconds.
Patient 0 Seconds
Min vent 0 lpm
Hours 19.8

I haven't been using the ramp. Just two nights on this thing. The DME just called (on Sunday afternoon believe it or not) Wanted to know how I was doing. Told them all this. They said some adjustments might have to be made but to give it a try for a few more days because I was not having any trouble while I'm sleeping. Of course I told her I wasn't feeling any benefit either. She said give it a while.
Maybe I'm too impatient.

Thanks for the help.
Bob

vulcan wrote:Hi Michael, thanks for the reply.

The setting from the machine are:

6cm H2O EPAP
10cm H20 IPAP Min
25cm H2o I PAP Max
10 BPM
1.2 Sec Ti
Rise time 4
Ramp 40
Ramp start 5 cm H2O
Apnea 0 seconds.
Patient 0 Seconds
Min vent 0 lpm
Hours 19.8

I haven't been using the ramp. Just two nights on this thing. The DME just called (on Sunday afternoon believe it or not) Wanted to know how I was doing. Told them all this. They said some adjustments might have to be made but to give it a try for a few more days because I was not having any trouble while I'm sleeping. Of course I told her I wasn't feeling any benefit either. She said give it a while.
Maybe I'm too impatient.

Thanks for the help.
Bob

My uneducated guess is that the problem may be the "1.2 Sec Ti" setting. If that is a maximum, then any time it takes you longer than 1.2 seconds to breathe in, the machine will cycle to breathe-out pressure before you are through breathing in.

Yeah, just turn the BPM to "Auto." Then you should be fine!

The Ti is "inspiration time." That is how long the inspiraton breath will last, but it only applies when the BPM is set to numbers different than "Auto."

Rise time is a bit long. That counts how long it takes to fully switch to full inspiration pressure from the exhalation pressure. But that isn't quite as criticism as Ti and BPM.

Your EPAP is a bit low. You probably can't tell how many apneas you have. When you get data tracking, if you have apneas, that pressure might be low. But I'll let you figure that out with the DME.

The IPAP max is high. If you need it, or are just plain doing OK, that is probably fine. If you get massive leaks from pressure, or ever feel like pressure is just out of control or running away, you might need to pull that in a bit.

I also don't use the ramp. If you let your breath settle a bit after you lie in bed, before you put tge mark on, you should be fine. Sometimes the machine will start with higger pressures if you are breathing harder or faster from exertion.

Have you been on CPAP before? If so, that machine should feel great very soon. It should be easy to use, and easy to get used to.

Good luck!
Michael

jnk wrote: My uneducated guess is that the problem may be the "1.2 Sec Ti" setting. If that is a maximum, then any time it takes you longer than 1.2 seconds to breathe in, the machine will cycle to breathe-out pressure before you are through breathing in.

That is correct. JNK and I "cross posted" at the same time.

That Ti is fairly short. It will "cut off" your inspiration at that time and switch to exhalation, even if you aren't quite ready. Combined with a longer rise time, you might feel like you don't have enough time to inhale.

If you have annything more than Obstructive Sleep Apnea or Complex Sleep Apnea, you need to be careful changing settings. Then you might want to try a Ti above 2.0 to start, and move up from there.

Otherwise, an Auto setting for BPM should work for most apnea sufferer. It makes setup much easier too.

M

When I do Auto SV titrations on people, I have the rise time at 2 or 3. That is what Respironics recommends. All of your other settings look good. Setting the BPM to Auto may help too. I found pateints respond better to the Auto setting rather than using an exact number for the BPM. Good Luck unto you...

Hope1952 wrote:My nose was stuffy, though.

It sounds like it may be the cold. Were you doing OK for the first week or so?

What are your setting? What were they on APAP? Are you on BiPap Auto, or straight (fixed) Bipap?

Your machine is a bit different than the SV. But you should be able to get it set up for therapy that is more comfortable than the APAP (at least for most people.)

M

unadog wrote:

Hope1952 wrote:My nose was stuffy, though.

It sounds like it may be the cold. Were you doing OK for the first week or so?

What are your setting? What were they on APAP? Are you on BiPap Auto, or straight (fixed) Bipap?

Your machine is a bit different than the SV. But you should be able to get it set up for therapy that is more comfortable than the APAP (at least for most people.)

M

Thank you, unadog. Yes, I was doing ok at first but stopped taking Zyrtec because of side effects. (so I started taking it again today, along with flonase, vicks nasal spray, and neti pot) So maybe that's the problem. And my mask worked fine at first, too, but the nasal pillows had started leaking. (so last night I tied the stocking around my head to hold the pillows in place and it seemed to help for the short time I wore it)

My settings are on auto 9-11.5 and the exhale is on 7. The DME who loaned me the machine said the exhale could only be 2 numbers lower than the lowest number on the auto part. (sorry I don't know the correct terms) I don't know if that's correct. My apap was also set on 9-11.5.

Now that I'm using a bi-pap, my lungs don't feel strained when I wake up in the morning like they did on the apap. So that's an improvement. And it's far less effort to breathe while using the bi-pap machine. But my numbers are not as good as they were on apap. Maybe it takes time to adjust to bi-pap?
Thank you for the response.
Jane

Thanks all for the help and infusion of knowledge. Looks as though Jane is getting some help too. That's great. I really appreciate you folks being around and taking the time to answer.

to answer the question, I have never been on any PAP machine before. Got this one Friday afternoon.

I'll try tonight with the BPM on Auto and see how it goes.
just one change at a time I think....

Thanks again

Bob

Well I slept with the BPM set to Auto and it worked fine. Still took a while to get to sleep. Guess , I'll get used to it eventually.

Thanks for all the on target help. Some very knowledgeable folks here I appreciate you folks sharing with me.

Rest Well

Bob