bipap settings

Trixie80

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Jun 21, 2014
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PALS
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03/2014
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CA
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does anyone else make noises when they sleep with a bipap. I make a humming noise right as I fall asleep and it wakes me up. I think the settings are too high, but curious if anyone else has this happen.
 

nightowl

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Aug 19, 2017
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Loved one DX
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11/2016
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Texas
Its possible the mask is not fitting right or theres a positional issue. The humming could be your closed mouth vibrating with the air coming in.
 

KarenNWendyn

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I notice I sometimes make a humming sound that occasionally awakens me. I think my issue is palate weakness. I didn’t have that issue prior to other bulbar dysfunction.
 

nona

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yes, I hum when I exhale on the bipap.
 

lgelb

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There are a number of possible causes, but the first thing to try aside from checking mask fit for over-tightening and (less likely) looseness, is to make sure your EPAP = 4 (some machines allow 3, even better) unless you have a pre-existing obstruction or other lung condition. Some PALS are needlessly in the AVAPS-AE mode or have an EPAP set too high.

If EPAP is appropriately low, the next thing to consider is Vt. If your lungs can't handle the volume they're getting, exhalation can be where that first shows up. It's sort of like loving cake while you're eating it, but then comes a sugar crash. This hypothesis can be tested by reducing Vt by 10%. Most PALS' are set too high at machine delivery.

If those are not the answer, you can try adjusting trigger sensitivity (if your machine is on AutoTrak, you will need to change trigger type to Flow Trigger first). If sensitivity is too high (expressed as a lower machine setting), you may not get enough time to exhale. If it's too low, air could be getting trapped. Cycle sensitivity (how soon the machine switches to exhalation pressure) can play in as well, along with rise time (how fast the machine ramps up pressure in inhalation, not to be confused with AVAPS rate, how fast the pressure adjusts to the amount of air you are moving vs. your target).

If not related to machine settings/mask fit, vocalizations can be considered a parasomnia and they may increase with fatigue in the experience of other PALS, so that would be another thing to try to manage.

Of course, I'm always happy to look at anyone's settings in the context of whatever you're experiencing, apart from vocalization.

Best,
Laurie
 

Trixie80

Active member
Joined
Jun 21, 2014
Messages
88
Reason
PALS
Diagnosis
03/2014
Country
CA
State
BC
There are a number of possible causes, but the first thing to try aside from checking mask fit for over-tightening and (less likely) looseness, is to make sure your EPAP = 4 (some machines allow 3, even better) unless you have a pre-existing obstruction or other lung condition. Some PALS are needlessly in the AVAPS-AE mode or have an EPAP set too high.

If EPAP is appropriately low, the next thing to consider is Vt. If your lungs can't handle the volume they're getting, exhalation can be where that first shows up. It's sort of like loving cake while you're eating it, but then comes a sugar crash. This hypothesis can be tested by reducing Vt by 10%. Most PALS' are set too high at machine delivery.

If those are not the answer, you can try adjusting trigger sensitivity (if your machine is on AutoTrak, you will need to change trigger type to Flow Trigger first). If sensitivity is too high (expressed as a lower machine setting), you may not get enough time to exhale. If it's too low, air could be getting trapped. Cycle sensitivity (how soon the machine switches to exhalation pressure) can play in as well, along with rise time (how fast the machine ramps up pressure in inhalation, not to be confused with AVAPS rate, how fast the pressure adjusts to the amount of air you are moving vs. your target).

If not related to machine settings/mask fit, vocalizations can be considered a parasomnia and they may increase with fatigue in the experience of other PALS, so that would be another thing to try to manage.

Of course, I'm always happy to look at anyone's settings in the context of whatever you're experiencing, apart from vocalization.

Best,
Laurie

thank you for the info.
I will try your suggestions and hopefully something works, but now that you mention parasomnia, that might be my problem because it only happens if I wake up during the night.
 

Trixie80

Active member
Joined
Jun 21, 2014
Messages
88
Reason
PALS
Diagnosis
03/2014
Country
CA
State
BC
i called the association that provided my bipap and it was the rise time that was too high. I turned it down to 350 and it has been working good. just wanted to let anyone else with this problem my solution.
 
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