Taming a new Respironics BiPap S/T

UPDATE:

Last night I had the opportunity to switch over to my BiPap S/T and will do so for at least 3 nights non-stop trials. If all goes ok I may switch full time to the Bipap S/T. IPAP 15, EPAP 8, BPM 6, MAX Insp 3.0secs.

The 1st fear was confirmed when I just could not get the BiPap S/T to stop switching from IPAP to EPAP too early while I was using my F/F mask (Resmed Ultra Mirage).

So I opted for my Adams Circuit nasal pillows mask & as far as I was concerned had a good night & had no real issues.

My ongoing conclusion from this 1st full night and from feedback provided by Bill (NightHawkeye), is that at the higher CMS ranges (say 14 CMS+) the Respironics BiPaps appear to have problems with masks that have high fixed leak rates.

I will run the machine in the same config again tonight, then I may try another type of mask.

Using the Adams Circuit mask, the data on Encore Pro did list the night as having an average leak rate of 45 liters/min which IIRC is also the fixed leak rate of my F?F mask at 15 CMS.

The above results bear out a test I did months back with my 1st BiPap Pro 2 machine - back then I concluded the machine was faulty but now I am of the opinion that Respironics BiPaps (Bipap Pro 2 & BiPap S/T) do not like F/F masks with high fixed leak rates.

Both a PB330 BiLevel and a Healthdyne BiLevel I use, do not have this problem with the Ult Mir F/F mask.

I have a 2nd Bipap Pro 2 plus a PB320 on their way & will compare these with the same conditions.

DSM



[/b]

dsm,

Thank you for your continued research into this matter. Your findings are both very informative and interesting.

My problems were *much* worse with my Ultra Mirage FF mask. I seemed to do better, or at least feel more comfortable, while using my ComfortLite 2 direct seal interface.

Even with my Bipap Pro's "comfort" setting (I believe this might actually be the rise time) set as high as it will go (3), the problem remains. Ultimately I think that I will be switching to another machine.

Thanks very much for continuing to look into this matter!

BNLfan

[quote="dsm"]UPDATE:

Last night I had the opportunity to switch over to my BiPap S/T and will do so for at least 3 nights non-stop trials. If all goes ok I may switch full time to the Bipap S/T. IPAP 15, EPAP 8, BPM 6, MAX Insp 3.0secs."

"My ongoing conclusion from this 1st full night and from feedback provided by Bill (NightHawkeye), is that at the higher CMS ranges (say 14 CMS+) the Respironics BiPaps appear to have problems with masks that have high fixed leak rates.

I will run the machine in the same config again tonight, then I may try another type of mask.

Using the Adams Circuit mask, the data on Encore Pro did list the night as having an average leak rate of 45 liters/min which IIRC is also the fixed leak rate of my F?F mask at 15 CMS.

The above results bear out a test I did months back with my 1st BiPap Pro 2 machine - back then I concluded the machine was faulty but now I am of the opinion that Respironics BiPaps (Bipap Pro 2 & BiPap S/T) do not like F/F masks with high fixed leak rates."
DSM



[/b]

Bella,

Most of the new masks I have come with either a CD or a paper booklet.

These lists a graph showing the fixed-leak rate at any given CMS.

If you don't have access to the literature, try their web site or try phoning their nearest agent.

Naturally with a Bilevel, there are two curves that apply, the IPAP & EPAP. Obviously, it is the IPAP curve that matters as being the higher pressure, it will have the higher leak rate.

Also re the Synchrony, I am not confident the results I am describing, will automatically carry over to a Synchrony. I am guessing that the machines is essentially the same as the Bipap S/T but can't say for certain.

Can you confirm if you have an issue with IPAP switching too soon to EPAP when using a F/F mask ?

*******************

Re leaks/squeaks, I sometimes get leaks-squeaks from my Ultra Mirage F/F & while using my PB330. I use a Respironics Premier chinstrap with my mask (chin strap on 1st mask 2nd). I recently tightened the mask a little & of late have had no more leaks/squeaks.

This does vary a lot, if my weight is creeping up a little, I seem to have less leak-squeaks, if going down or I feel dehydrated, they seem more common. I put this down to the 'puffiness' factor of my face.

I think that the more fluid we retain, the more pliable our face is at night & perhaps adjusts better to whatever mask we use. ( Just a theory )

Cheers

DSM

Pliable face!! Got to love that one.

In regard to the leak rate, i'll do a bit more surfing to see if I can find info on the F&P 431. Their site didn't seem to list the information. I can just see it - you have to buy it to find out the info. I doubt my DME would know, or else he'd snipe at me for wanting to know. (Just like he did when I said that I wanted a nasal mask/pillow that I could wear my glasses with. Apparently, I shouldn't need my glasses in bed because I'm supposed to be sleeping only. No reading etc.). I am going to make an appointment with him.

I've read a couple of times about using the chin strap with the ff. I haven't tried it yet, I think mostly because I love my Swift so much. I just want a reliable full face mask for when I'm congested.

In regard to the IPAP - EPAP flipping, that very seldom happens to me. It's almost always ok. Now and again it seems that I'm not getting a full inhale, but it seems to be at times when I'm breathing quickly and shallowly. I have chronic pain issues, and sometimes just turning in bed causes me to be short of breath.

See if this works:

http://www.fphcare.com/osa/pdf/HC431/185043239.pdf

Guest thanks for taking the time to do that. It certainly did help. It looks to me like the F&P 431 has a leak rate of 46 lpm at 14 cms, and the Comfortfull which I have and dislike has a leak rate of about 35 (I have a tough time figuring that one from their chart ) So, if I'm looking at DSM's testing correctly - at a pressure setting of 14 cms (which is the same as mine), his leak rate with the Adams Circuit mask was 45 lpm, is acceptable according to the mask specs.

Or did I get this wrong and 45 lpm is too much for the Bipap S/T to "quietly" handle? And if so, I'm running out of ideas for the ff mask.

I always disliked math.