odd experience during first BiPAP night

momexp5 · Post by **momexp5** » Sat Oct 01, 2005 6:17 pm

Has anyone had a machine seem to have trouble synching up to your breathing, exhale vs. inhale?

I have a BiPAP now a Respironics BiPAP Pro 2 with BiFLEX. Last night was my first night with it. Pressures are 8 and 4. I went to BiFLEX because of air in my stomach - and I just seemed to need more pressure relief on exhale.

The machine didn't seem to work right at all, when I first laid down. I was on my back, hose was fine, same as while I'd been on regular CPAP, head slightly elevated on pillows - the pressure was doing weird things.

I'd inhale, and it would support the inhale, but then the pressure would cut out, as if it'd gone to the exhale pressure, and it would do this before I was finished inhaling. Significantly before I was finished inhaling, it was like it was cutting off the inhale and forcing an exhale. And I think that it was also going from exhale to inhale too quickly, too. It was like the machine couldn't get in synch with my breathing. It did this repeatedly, even after I shook and moved the hose to check it for kinks. I was about ready to get up and retrieve my CPAP (my DME forget it, she left it here by mistake, she's picking it up Monday). However, when I turned to lay on my side, the problem resolved itself. And I believe I went back to lying on my back, but the problem didn't return.

Once the machine decided to work, it was great! I think I slept much better than I have with the CPAP. It was *much* easier to breathe well, or so it seemed by the end of the night. I will certainly come back tomorrow and report on my second night. But I'd like to hear if anyone has had a similar experience!

Guest · Post by **Guest** » Sat Oct 01, 2005 8:11 pm

I know how to fix it but I am too lazy to type it out

MartiniLover · Post by **MartiniLover** » Sat Oct 01, 2005 8:25 pm

When I first made the switch to BiPAP from CPAP I experienced the same thing. I think the machine and you need a couple of nights to sinc up together. I have noticed it lately, but ever so often I will suddenly feel like I'm not getting enough air (pressure) but shortly that goes away and I can't even tell it is on.

Good luck with your second night.

Sleepless on LI · Post by **Sleepless on LI** » Sat Oct 01, 2005 8:57 pm

That can happen when my CFlex is on with my Remstar Auto with Cflex. I don't know anything about BiFlex, but I can only assume it's bipap's "Cflex" which is designed to make it easier to exhale.

What you seem to be experiencing is stacked breaths. Sometimes that occurs as the machine to start the inhale pressure again before you have finished your entire exhale. I had that happen to me when I had my Cflex turned on and that was the last night I used it. It honestly freaked me out. And people love Cflex as it makes it easier for them to exhale against the higher pressures. I don't have any trouble exhaling, and got a bit panicky from the stacked breaths, so I have never used it again.

I don't know what exhalation you have your machine set for, but if it's low enough where you don't have a problem exhaling, you probably don't need any type of Bi-flex. But that's what it sounds like to me.

jdacal · Post by **jdacal** » Sat Oct 01, 2005 10:45 pm

Mine does it when I first turn the unit on. Takes about 15 seconds to get in sync with my breathing. I find it helps to let out one really hard exhale. Helps kick-start it. After that initial 15 seconds or so, I don't have problems the rest of the night.

WillSucceed · Post by **WillSucceed** » Sun Oct 02, 2005 6:10 am

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, C-FLEX, CPAP, auto, APAP

WillSucceed · Post by **WillSucceed** » Sun Oct 02, 2005 6:12 am

Sleepless on LI · Post by **Sleepless on LI** » Sun Oct 02, 2005 6:55 am

WillSucceed wrote:Guest wrote:
I know how to fix it but I am too lazy to type it out
Sheesh! What was the point of that post? 'I know how to help you but can't be bothered.' Very nice! I'm sure that many posters on this forum don't always have the time or energy to type out a big long answer but, if we can help one-another, why not do it?

Or maybe not posting anything at all would have been a bit more courteous? Maybe turn it around and think how you would feel if you had a real concern, took the time to post it for help and someone had the answer you needed but flat out told you they didn't have time to give it to you? I guess the reason you didn't identify yourself. That wasn't nice or at all in the spirit of this forum

.

thewebbie · Post by **thewebbie** » Sun Oct 02, 2005 7:37 am

I started with the same machine during the week and have been having the same problem. I increased the Rise Time and it seemed to help a little bit.

momexp5 wrote:Has anyone had a machine seem to have trouble synching up to your breathing, exhale vs. inhale?

I have a BiPAP now a Respironics BiPAP Pro 2 with BiFLEX. Last night was my first night with it. Pressures are 8 and 4. I went to BiFLEX because of air in my stomach - and I just seemed to need more pressure relief on exhale.

Sleepless on LI · Post by **Sleepless on LI** » Sun Oct 02, 2005 8:42 am

After speaking with my son, who is an RRT, he had this to say, in part (very much abridged as it took some time for him to explain this to me).

He said PEEP is not at all a bump in pressure. PEEP is CPAP, PEEP standing for positive end expiratory pressure and CPAP standing for continuous positive airway pressure. It is the end expiratory pressure used when you speak of ventilators, not CPAP machines, however synonymous. As he put it, PEEP is used for positive pressure on expiration along with ventilators. CPAP is mode of breathing not on a ventilator, but a PEEP is given. You can also use CPAP on a ventilator, but no ventilation will be provided, just an added pressure. When you are titrated at your sleep study, they are only setting an ePAP for your CPAP machine. Your iPAP is irrelevant. They set the end expiratory pressure that you should never go below. PEEP is the same thing only on a ventilator, your positive end expiratory pressure.

Stacked breaths do not come from PEEP at all. Stacked breaths are Auto PEEP. Auto PEEP is the problem, which comes from an inappropriate PEEP level being set. And it can also come from, as I had mentioned, CFlex or BiFlex. PEEP is just the end pressure at exhalation setting. You CANNOT turn off PEEP or you render your machine useless as there will be no pressure set for exhalation, thereby not keeping your airways open.

It is a very long and involved explanation, but the bottom line is that you can eliminate the stacked breaths by turning off the BiFlexCFlex option on your machine. If you want the detailed info, feel free to PM me.

For more information, http://www.ccmtutorials.com/rs/mv/page14.htm.

momexp5 · Post by **momexp5** » Sun Oct 02, 2005 9:53 am

MartiniLover wrote:When I first made the switch to BiPAP from CPAP I experienced the same thing. I think the machine and you need a couple of nights to sinc up together. I have noticed it lately, but ever so often I will suddenly feel like I'm not getting enough air (pressure) but shortly that goes away and I can't even tell it is on.

Good luck with your second night.

Thanks, ML - I'm wondering if what you say isn't exactly what has to happen - is there software or something in this machine that measures breathing rates, inhale durations, etc., and chunks through some algorithm over the course of a particular number of hours usage, to determine the machine's behavior? Like a self-modifying something or other?

The machine's behavior did repeat, but not as bad - it cut off the end of the inhale, but not by as much. And same thing, on my back, it misbehaved, on my side, it was fine.

There is a known difference from last night, in that I discovered that the BiFlex hadn't been on the first night. So, BiFlex was off the first night, and on the second night.

momexp5 · Post by **momexp5** » Sun Oct 02, 2005 10:02 am

jdacal wrote:Mine does it when I first turn the unit on. Takes about 15 seconds to get in sync with my breathing. I find it helps to let out one really hard exhale. Helps kick-start it. After that initial 15 seconds or so, I don't have problems the rest of the night.

Okay, I'll try that jd, I believe it might be helpful - will report back

momexp5 · Post by **momexp5** » Sun Oct 02, 2005 10:07 am

WillSucceed wrote:Guest wrote:
I know how to fix it but I am too lazy to type it out
Sheesh! What was the point of that post? 'I know how to help you but can't be bothered.' Very nice! I'm sure that many posters on this forum don't always have the time or energy to type out a big long answer but, if we can help one-another, why not do it?

lol, thanks, Will - but perhaps guest has a cold or is depressed or something and saying he/she was lazy was a wry self-deprecating device.

Lori, and Will - I don't think this is breath-stacking - the problem is not on the exhale, it's on the inhale. I do feel the "bump" at the end of the exhale, I think, but it's not bothering me - the problem I'm having is with the *inhale* getting cut short.

momexp5 · Post by **momexp5** » Sun Oct 02, 2005 10:08 am

Sleepless on LI wrote:.

lol - Lori, I *do* like your smilies!

momexp5 · Post by **momexp5** » Sun Oct 02, 2005 10:15 am

thewebbie wrote:I started with the same machine during the week and have been having the same problem. I increased the Rise Time and it seemed to help a little bit.

::checking Respironics' manual:: Definition of Rise Time: "The time it takes for the device to change from EPAP to IPAP." Options are from 0 (fastest rise time) to 3 (slowest rise time).

Webbie, did you increase the setting number, say, from 1 to 2? Or did you really increase the rise time, which would mean dropping the setting number, say, from 2 to 1?

It *seems* like my issue is going from IPAP to EPAP, not EPAP to IPAP, but I suppose all these things are interrelated and feed off each other, so I'll put "adjust rise time" on my list of fixes-to-try.

odd experience during first BiPAP night

odd experience during first BiPAP night

Re: odd experience during first BiPAP night

Re: odd experience during first BiPAP night

Mask

Additional Comments: Newbe