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Permalink Reply by Charley K on November 8, 2009 at 1:36am

Thank you SAZ for your explaination of the IPAP pressure settings. You made it more understandable for me :-})
Thank all of you responders for your advice and suppoprt.
CharleyK

Saz RPSGT said:

Nothing like chiming in late!!

That kind of pressure isn't common, but it's not completely out of line either. Typically two reasons a spread like that would be seen:

1. You have been diagnosed with COPD (chronic obstructive pulmonary disease) and need a greater spread to help "blow off" CO2.

2. You were intolerant to straight CPAP of 25cmH20 which was the effective pressure during testing. BiPAP titrations are set based on EPAP (lower of the two pressures for when you exhale) being the first pressure where Obstructive Sleep Apnea events (this includes Mixed Apnea as well) are no longer seen. With OSA gone, this means that your airway is always kept open so that you can initiate a breath and trigger the IPAP pressure (when you inhale) The IPAP pressure is set for when all other Sleep disordered breathing events are gone. This includes Hypopneas, RERAS, and even snoring.

Sorry that last one was wordy, but it's a common question and even confusing for many technicians.

Let me know if that helps out.

Saz

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Permalink Reply by RockRpsgt on November 20, 2009 at 5:21pm

Could you please repeat that last part for me Saz.

I am also a clock watcher. I can't have a clock in my room or i will stare at it all night. To solve this problem I bought a phone with a really annoying alarm. I set the phone on a dresser on the opposite side of the room way out of reach. When it goes off I am forced to get out of bed to turn it. getting out of bed is typically the toughest part for me as i like to sleep. This process eliminates 2 of my sleep problems.

Saz RPSGT said:

Nothing like chiming in late!!

That kind of pressure isn't common, but it's not completely out of line either. Typically two reasons a spread like that would be seen:

1. You have been diagnosed with COPD (chronic obstructive pulmonary disease) and need a greater spread to help "blow off" CO2.

2. You were intolerant to straight CPAP of 25cmH20 which was the effective pressure during testing. BiPAP titrations are set based on EPAP (lower of the two pressures for when you exhale) being the first pressure where Obstructive Sleep Apnea events (this includes Mixed Apnea as well) are no longer seen. With OSA gone, this means that your airway is always kept open so that you can initiate a breath and trigger the IPAP pressure (when you inhale) The IPAP pressure is set for when all other Sleep disordered breathing events are gone. This includes Hypopneas, RERAS, and even snoring.

Sorry that last one was wordy, but it's a common question and even confusing for many technicians.

Let me know if that helps out.

Saz

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