Getting used to the bipap

Last night, we tried the bipap for the first time. It was not good. I am hoping that what we need is to use it during the day so he can get used to it. I am hoping our PALS can give me some advice.

What does the bipap feel like? I realize the mask must feel suffocating at times, but what does the air pressure feel like? I am hoping that if I understand it more, I can help my PALS to use it and understand it more.

He gets so tired, so fast. I believe that part of it is he can't get enough good air in, and the bad air out.

I appreciate any words of wisdom here. Just feeling so damn helpless.....
Love and light
Meg

Other than the discomfort of the mask, it should feel restful and easy to breathe when he's lying down. There are a lot of settings - cycles per minute, pressure when inhaling, pressure when exhaling. It took a little trial and error with the respiratory therapist to get it right. The key for me was having the exhalation pressure low enough so I felt like I could get the air out easily.

Trying it for short periods should help him.

Things to find out:

Is his mask comfortable? If its not, where does it bother him?

Is the air warm enough? Is he getting dried out for feels cold when he tries it? If so, the humidity settings need to be cranked up. & if the humidity gets too high, to where it drips on him inside the mask (not fun) a hose insulator helps a lot, as well as tucking the hose under the covers, or a throw if he's not in bed. Its the contrast between cold room air, and warm bipap air that causes this.

Is the problem more when he breathes out? If he feels like he's fighting the wind, then maybe it needs adjusted down.

Or, if he feels like he's not getting enough air when breathing in, then maybe that setting needs bopped up.

There is not reason why you can't try wearing it for a while. Its good for you to know how it feels. I've had everyone in my family try the bipap as well as the cough assist. The more everyone understands, the easier it is to make things go smoothly.

good luck!

When I first started using a bipap, it took a few days to get used to it. I think it is important to get used to at shorter increments rather then boom you have a bipap now you must use it all night. The first night I think I had it on for about 45 minutes or so, the next a little over an hour and so on, then before I knew it I was sleeping through the night with it on.

He will ultimately sleep better and feel better. It is normal to take some time to adjust to it. Good luck!

Have him try wearing it in the daytime while watching TV until he gets over the claustrophobic feelings from having the mask on his face.

I have been using a bipap at night since August, I am not sure why but I was able to be compliant with it very easily. I think because it is needed for me so much as my respiratory system seems to be affected the most. I like trfogey's idea of using it during the day to try and get used to it.

Since Bruce has started sleeping with his, he is so much more rested, but he fought wearing it a long time.

Thank you all, as always! Last night he made it for about a half an hour. He is wants to be compliant and I am trying to be patient. I think I will make it more available to him during the day so he can get used to it.

Love and light to all!
Meg

Yes, wearing it during the day while watching a movie or something will help get used to it. I did not think I would be able to use it while sleeping, but before I knew it I was napping comfortably at times. Next step sleeping very good with it all night. There are times that I seem to wrestle with it but all in all good rest. Good luck to both of you!

Meg,

You've been given great advice here, from everyone!

The only thing I would add is to work with the respiratory therapist on mask selection. There are hundreds of mask types, but your RT will have a select few favorites and will be biased. Probably the least intrusive mask is called a "nasal pillow" mask. If he hasn't tried this, ask for it.

It can be difficult to get adjusted to. Some people have no trouble. Others do. Some never adjust to the bipap, with life-shortening consequences. Keep working at it. It is critically important.

-Tom

Another aspect to consider is the settings. PALS are often started on a default setting such as 8/4. But this is just a guess and not necessarily the most helpful IPAP/EPAP. If the S/T setting is enabled, the backup rate may be set too high or low. Check the data card or display to see what % of breaths are patient-initiated, what tidal volume is, etc. to get an idea of how well the machine is helping, or make sure someone else is eyeballing the data.

There have been some great points made here, some of which I forgot about even having been an issue for me. i.e. The "ramp" stage, and back-up rate.

When I first switched from regular bipap to avap bipap, the rt had it set to breathe for me for the first 15 minutes or so, and then after that, it gradually switched over to me, instead of the machine, controlling when a breath was taken. But, I didn't know he had done that, or that it is an optional feature. The way he had it set was too fast for me. I did figure out how to slow it down a little using the controls on the machine, but still didn't like it. I talked to my rt, and he removed this part of the configuration. It was a HUGE improvement for me! It still will take a breath for me if I don't breathe on my own after five seconds— which is fine—and needed. But, it forcing me to breathe on its timing rather than mine when I was trying to fall asleep just didn't work well at all. I hated it.

The beauty of the avap is that it measures tidal volume and compensates, and, importantly, it takes a breath when the user doesn't. Both make it superior to regular bipap; but, I had absolutely no use at all for it breathing for me in the beginning minutes of each session.

The 'ramp' function in similar in that it gradually increases the air pressure flow, not the speed one is forced to breathe though. When I first started using bipap, this was very helpful in acclimating myself, but, I grew to dislike the ramp (and discontinued it) because I wanted ALL of the air flow asap when I laid down.

Is your husband's machine set to breathe for him (regardless of if he misses a breath) in those first few minutes of use? It would be very good for you to understand if this may be part of the reason he's having issues with adjusting to it.

What kind of mask is he using? Nose or full face mask?

When I was being fitted for a mask they kept pushing the nose mask.

Problem is that my velum or soft palate is shot - so when I wear a nose mask I can't stop the air from blasting out of my mouth. There is no way for me to talk and I get very panicky trying to control the air.

Things are much easier with a full face mask. I can breathe through my mouth and talking is possible.

Conversely, if he doesn't have soft palate issues and is finding whatever he is using too obtrusive he should check out a nasal pillows mask as Tom suggested - basically a couple of plugs that go into your nose.

Good luck

I'm trying to get used of my bi pap by using in the day a few times as suggested. Today I had an issue with saliva.,,I seem to having a harder time swallowing then it builds up. When I opened my mouth saliva flew over inside the mask on my face. I notice when I go to sleep I yawn and then drool a bit. I keep a tissue by my pillow. I sleep on my side. Any suggestions? I really want to use this aid.

I used some kind of distraction during the day, like watching a movie, or he could watch a game on tv. It took me a long time to get used to it so that now i can sleep with it all night.