Trouble using BiPap

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SanDiegoSue

Active member
Joined
Mar 14, 2017
Messages
40
Reason
PALS
Diagnosis
03/2017
Country
US
State
Ca
City
San Diego
I’m short of breath, so I was given a BiPap. It terrifies me. I often breath out of my mouth, so they gave me a full face mask. I’m claustrophobic, so I panic. I’vebeentrying To force myself to use it, but I can’t seem to last more than 5 minutes. Have any of you had this problem? How did you learn to use the BiPap?
 
I am so sorry you are experiencing claustrophobia. Others here will likely have a variety of solutions, but I will tell you of my experience and what was recommended to me that worked, in the hopes some of it might help you.

I went through 5 different masks before I found the one that fit. I tried two different nose only ones, one that was kind of like a cannula and two full nose/mouth ones. I tried a chin strap to keep my jaw shut while using the nasal masks, but it just didn't work.

It also took a while to get the right air pressure- when the air wasn't going into my nose and rushing out of my mouth or being swallowed by me in my sleep, it was creating painful pressure in my nasal passages and giving me earaches. It helps to have someone who knows what to set it at work with you to make it as comfortable as possible. Laurie (Igelb) is a master at this and provided me invaluable advice.

The one I currently use sits over my mouth and nose- it's "comfortable", but intrusive. It took a while to get used to it. I was cinching it too tight, afraid it would leak air- it was painful and left bruising on my cheeks and nose. Once I loosened it a bit, it felt less intrusive and didn't leak as I'd feared.

I started by using it only while I was awake, and only for 10 or 15 minutes at a time when relaxing in my lounger. Once I got over the crawling "get this thing off of me" feeling, I started using it at night. I'll be honest, I take some really excellent drugs to reduce spasticity in order to get me to sleep, and to remain asleep the night through- so once I'm out, I won't wake up for 7 to 8 hours. At which point the mask gets removed immediately. While it is intrusive still, I don't wake up feeling totally wretched, foggy and with a headache the way I did before getting the breather.

It's definitely better to get used to it before you absolutely have to use it. Another completely unexpected bonus to the thing was my skin is in better condition than it has been in years. I guess ample breathing and appropriate levels of oxygen really is good for your skin!

Best of luck. You may never like the feel of it, but with time you can learn to tolerate it. The benefits of using one really do outweigh the discomforts.
 
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SD Sue, I'd be happy to help. Do you know what kind of machine you have and/or what the settings are? What is hardest about using it?

Ideas to think about: reduce the pressure to start with (I don't mean a ramp-up; I mean literally start with an IPAP of 4, i.e. a constant pressure like you might have with a CPAP); try a nasal mask -- many PALS who are "mouth breathers" tolerate a nasal mask well; use it while you are doing something else, even listening to music and sync your breathing to the beat; use it when you are dead tired, etc. Everything ShiftKicker says is true.

And make sure you have enough humidification, but not too much. It's winter even in SD!

Best,
Laurie
 
I use Nasal Pillows instead of covering both my mouth and my nose with a face mask and it works great. I automatically keep my mouth closed but open it as I choose. I'm not drowning or suffocating this way. I have been using it for twenty years. Also I use C-PAP and not Bi-Pap - I hate Bi-Pap. I am in control with C-Pap..
 
Detroit your CPAP is likely for sleep apnea? I am glad it works well for you at this point

CPAP is not a safe option for PALS with respiratory weakness because the constant pressure does not allow PALS to exhale against it. Exhalation will be even harder than if they use no respiratory assistance leading to CO2 buildup

I recently heard a respiratory therapist suggest one way to ease into things was to try the mask without being connected to the machine to get used to it. This was in addition to the wearing in the daytime while distracted by tv or other activity
 
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Ditto everything Nikki said, DL, and the BiPAP actually affords you more control over, well, everything. If you don't like the BiPAP after using CPAP, it wasn't set right for you. In fact, it can be set as a CPAP as I suggested to SD Sue (4 across the board to start, no variability for achieving a target volume) and then moved to therapeutic settings from there.

You can set a low pressure on CPAP to have a low pressure to breathe against, but the IPAP will not be giving you a deep enough breath because it cannot be set independently of the EPAP.

Best,
Laurie
 
I had problems at first because of too insensitive triggering.
 
Yup, trigger/cycle settings that match your breating are critical to comfort (and respiratory support!)
 
Those nasal pillows only vs face-mask can make a big difference too..
 
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