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Re: Bi-pap Inhalation rate--still screwed up

Posted by BostonBoy on July 04, 2001 at 08:19:42:

In Reply to: Bi-pap Inhalation rate--still screwed up posted by kev on July 03, 2001 at 19:49:40:

I think that the two BiPAPs are right. It's your expectation that is wrong. The result is that you are fighting the machine needlessly.

Given that more than one machine has been tried and that you do not say that they are BiPAP S/Ts, I suspect that both machines have been behaving exactly as intended by their designers. It seems very likely that there is nothing wrong with them. They just behave differently from how you think they ought to behave.

Pressure and flow are monitored by the BiPAP machines at all times. When the flow rate drops as you reach completion of the intake of a breath, the machine interprets the drop as signifying that you have completed inspiration and are starting expiration. It therefore switches to the expiration pressure. But if your breathing in is unsteady, or contains a mini-pause, the machine will have switched to the expiration mode by the time you resume inspiration, and you will find yourself breathing in with more effort because the airflow has flipped over to the expiration pressure setting. Your breathing won't synchronize with the machine until you take a second breath.

Try this experiment to show what I'm describing: During the day, while you are fully alert, put on the mask, run the machine, sit on the bed, and draw in about a half breath smoothly and steadily. Then smoothly stop breathing and stay sitting completely still without any chest movement and without allowing the pressure in your nose and throat to vary up or down.

I'll bet $$ that the machine will not change to the expiration pressure setting, or try to 'push' you in any way, until you release the inspiration pressure in your nose/throat/lung circuit.

I think you are misleading the machine because of unsteady breathing or because you are trying to 'tame' it to do your will. Unfortunately it doesn't read minds - it can respond only to pressure and flow changes! Once you fall asleep, and your mind disengages, the machine just gets on with doing its job - it responds tirelessly to your breathing pattern.

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