Howdy and welcome. A CPAP machine provides constant pressure to ensure your airway stays open (hope I didn't try to say this in some medical way). The BIPAP has two pressures that allow the airway to open then the machine relaxes the pressure a bit to make it easier to exhale. I am pretty sure these are prescribed when the pressure is relatively high. My pressure was set on my BIPAP at 21/25 meaning 21 exhale stage and 25 inhale. My pressure is a bit higher than most because that is what it takes for me. I also can't wear a nose pillow affair as they are not rated for pressures in this range. I have to use a full face mask.
For better answers by more educated embers, what exactly were you diagnosed with as far as AHI and what pressures is your BIPAP set? I am sure that would help folks provide more specific advice.
I had significant issues at first and didn't really know what questions to ask because I felt I was out on an island. My primary care doc was not helpful as she knows nada about sleep stuff and the associated equipment and I found this forum invaluable... still learning a lot and life with the BIPAP continues to improve and get easier! Good luck.
Hi Hopalong86. Wiredgeorge provided a pretty good explanation of BiPAP, and it is sometimes used for patients who need higher pressures than are generally comfortable on CPAP. There are also times when BiPAP is used for other reasons or health conditions. Adjusting to the machine can be difficult, and some patients find it helps to wear the treatment while doing some other activity (reading or watching TV) before actually trying to go to bed and go to sleep with the mask on. It helps to get used to the feeling of the mask and the air pressure. As for why you were prescribed your specific treatment and pressures, you sleep physician should be able to answer that question based on your sleep study results. Please keep us posted on how you are progressing!
Some patients have found it helpful during the early days of treatment to actually take the machine out of the bedroom in the evening and practice wearing treatment while they are distracted by another activity. I mentioned reading or watching TV, but some patients have told me they knit or do puzzles. When I started treatment, I used to take my machine into the living room a couple of hours before I went to bed and would wear it while I watched television. The distraction was helpful, and being outside the bedroom helped lessen the anxiety about needing to fall asleep. By the time I went to bed, I was ready to sleep and was used to the feeling of the mask and the air pressure. Remember to empty the water tank before moving the machine if you try this, and good luck!
Do you have a machine that shows you how many times you stopped breathing? or "events" you had? Some nights i have a very low number while others its quite high, i also suffer from chronic pain, fibromyalgia, myofacial pain syndrome, arthritis, 3 back surgeries ect. I am a mess and i thought this might be why some nights i just dont get good sleeps.
Hi Hopalong86. Pain of any kind can certainly interfere with sleep. I have worked with many patients who suffer from chronic pain issues related to some of the conditions you mention. Pain control can certainly help with improving sleep, but it would be interesting to try to find out why your AHI varies so much on some nights. For some patients, and depending on the treatment type, it can be body position. Some patients have sleep apnea symptoms that worsen when they are on their back, for example. While my particular machine does not give me numbers on a nightly basis, I can download the card and look at the data in Sleepyhead software. If you are interested, you might consider downloading the software and taking a look at your own data. I have known patients who have taken the reports to their physicians so they can talk about what looks good or not so good and what might help improve their sleep. Education is key, and you seem to be looking for answers! Congratulations, and I hope you find helpful information here on MyApnea.Org!
@hopalong86, I feel your pain (literally) I've also had serious back issues (5 lumbar surgeries, 2 of which have been fusions) I have degenerative disk disease, throughout my entire body and have figured my back issues have caused my sleep issues (tired, up multiple of times at night) can't sleep in any other position but lay on my back with pillows everywhere, for support and comfort. Once we purchased a sleep number bed, things did get better, however after my son gave me a Fitbit watch to track steps, etc., I noticed my sleep was very restless and it reported that I lost a lot of time during each night due to "waking up" which I wasn't aware of. Finally I talked to my PCP who set up an in home sleep study, said I had sleep apnea and left me with no extra information. Finally I tried an ear, nose and throat doctor, we wasn't much help either, and then finally a sleep doctor. The did do another "in house" overnight sleep study, set me up with a different company to get the cpap machine and mask, etc. my numbers have gotten worse, not better. I that the machine was supposed to improve my sleep, and the best I've had reported was one night with an AHI of 14, went back to the sleep doctor who said they would increase the pressure or see if that helps, it has not, maybe they will put me back in the sleep lab. I am so frustrated I want to scream. I have an app I downloaded called Dream Mapper which I check every morning after waking up. It not only tracks the mask fit, usage, the AHI number (last night 51) it also tracks clear apneas (143 last night) obstructed apneas (225) last night and hypopneas (99 last night). There have been nights that my obstructed Apneas and hypopneas have exceeded 300+ the other night they were 275 and 124 respectively which is close to 400 events. The machine pressure has been increased for just about a week now and I see no improvement. I do not fit the "normal sleep apnea" profile, not obese, not plagued with high blood pressure or diabetes, my neck size is not huge, etc. I've asked the doctor why it is that I'm having these problems and he is blaming it on the medication. I see my pain management doctor this week and will discuss with him. I've tried decreasing my dosage of Meds on good days to see if that helps with he sleep issues, have tried sleeping with and without my ambien prescription to see if there is any difference, and can't find any answers.
Do you have to sleep in a certain position with your pain issues? I was once diagnosed with fibromyalgia, but pain management guy dismissed that I had it and removed me from meds I was given to help that. My sister also has degenerative disk issues, has neck and lumbar fusions, fibromyalgia, etc...and was also diagnosed with sleep apnea, however she was at least 75 pounds overweight, had diabetes, high blood pressure, and neck size was huge, so I understand why they said she had sleep apnea. Are they blaming your sleep apnea on pain meds you take?
I feel compassion for what you are going through, I know what it's like to be in pain 24x7 with no relief. Finally after fifth back surgery and subsequent memory issues I couldn't return to work and filed for permanent disability. I never thought I would be in this position - ever. Figured I would work until normal retirement age, however that was not the plan....no way I have the stamina to do anything 8 hours a day for one day, much less five consecutive days. It finally took its tool. Hearing I had sleep apnea was enough to send me over the edge, with everything else I've been through, now can only sleep in one position and now I have to wear this device on my face, to help me sleep (worse)??? I hope they figure my stuff out, because I'm not going to keep putting up with all you have to do to keep up the machine, wake up face sweating, dry mouth, etc and find out number getting worse, not better. I hope and pray you get your machine and all figured out, you have enough challenges without this as well, take care, Jules
Hi Jules. It sounds like you are definitely going through some issues with your sleep apnea and the machine. I am glad to hear you are working with your physician to try and sort it all out. Please don't give up! Medications can definitely have an impact on your breathing and your sleep, and pain medications are known to cause some breathing changes. A good sleep physician will understand what is happening and work with you to treat the issues. I hope you persist to get your apnea treated while still being able to manage your pain! Please keep us posted on your progress, and best wishes!
Hopalong86, I have a Resmed machine... don't recall which model but it has a built in wireless modem and communicates with... well Resmed center I guess and tells them stats on my sleep. Hours of use, mask on/off, AHI, and mask seal are reported and they come back with a nightly score and a break down by reported number. Sleep 7 hours and you get max points, don't take off your mask during the night and you get so many points, mask seal is measured in some fashion and you get so many points if your mask stays sealed, and so many points for AHI (they call it events per hour). I just log into the Resmed/myair/index.com area of their site and bingo, it tells me how I did. I find the AHI particularly useful and if I have a question regarding my AHI going up, I monitor my O2 level the next evening with a pulse oximeter which looks like a large and cheap wrist watch. You put a doo-hickey (try to be as scientific as I can) on your finger and it records you blood oxygen level all night. You then connect to a computer and you can display the data in a variety of ways. It also records my pulse but since I woke up that AM, I assume that my pulse was working OK and pretty much don't look at that. Anyway, it made me feel better to be able to monitor O2 levels as I think, from what I have read, that very low O2 levels (mine were in the low 70s for fairly long periods) kill your brain cells and affect your heart and other organs. I have few spare brain cells left so this therapy has be most beneficial for me so far.
As far as back pain while the mask is on and you are in bed, my lower back kills me with pain unless I prop up some and I use a wedge shaped TV pillow plus a normal pillow on top of it. I think it is because when sleeping more soundly, perhaps I don't move AT ALL during the night. I sleep on my back and it is only when I am about to get up early in the AM that I will shift to my side which generally bumps my mask so it leaks some and that will wake me fully in a little while. I didn't sleep on my back, ever, prior to therapy. You just adjust.