Different Bilevel Settings Example

“Blinding ignorance does mislead us. O! Wretched mortals, open your eyes!”
-Leonardo da Vinci (Italian Inventor, Painter and Engineer – 1452 – 1519) 

Optimize your sleep by using different Bilevel or BiPAP pressure settings. I use in three different situations so as to wake up refreshed and energized each day. On this Blog Post, is an Example of the results using my actual sleep data and SleepyHead reports when using the Bilevel auto adjusting pressure machine. You may have other circumstances which another situation may arise. The three different situations that I use are as follows:

1.       Normal day;
2.       Eating and drinking late at night; and
3.       Hard day at work and/ or many hours of driving. 

On the blog post Use Different CPAP and Bilevel Pressure Settings, I mention that many users of sleep apnea machines will have experienced for themselves that at least 1 to 2 days per week up to every day of the week; they are waking up tired, lacking energy and are unrefreshed. I was once in the same situation that many people have found themselves in. Should you be having some “bad” days or are having the feeling of “is this as good as it gets”, CHANGE what you are doing. 

Your pressure needs may change on a daily basis and will depend on many factors. Such factors may include sleep hygiene and lifestyle factors such as exercising daily and eating food late at night and medication and other health conditions that you may have. For some people, you may be doing similar activities each day. For optimal treatment, having the one set of pressure settings on your sleep apnea machine may be all that you require. 

However, should you find yourself in different situations on a regular basis; serious consideration should be given to also adjusting your sleep apnea therapy as required. I found from personal experience, that by doing so I achieved a great improvement in sleep apnea therapy. The improvement is most noticeable comparing to when I first started on sleep apnea therapy where I was very tired and feeling lousy on a regular basis. 

On the blog post Change or Reset your Circadian Rhythm, when I use a Bilevel auto adjusting machine with different settings, I have a different circadian rhythm or sleep cycle for each different setting. By using the Bilevel machine I have optimized my sleep every day.

Circadian rhythms are your body's internal clock or sleep/wake cycle which repeats roughly every 24 hours. Ideally, wake up at the end of a sleep cycle not in the middle of one otherwise you may feel tired and sleepy all day.

In addition to sleep apnea, I also have a genetic disorder, Hemochromatosis. This disorder is characterized by having too much iron absorption from the foods that you eat. Where your iron levels are too high, you may feel incredibly tired and lethargic and may lead to health issues such as cirrhosis of the liver, heart disease and diabetes.

Body iron level helps regulate our circadian rhythms and their link to metabolism. You can read more at this article.

Importantly, Research is supporting that a brain's ability to clear a protein closely linked to Alzheimer's disease is tied to our circadian cycle.

Rensselaer Polytechnic Institute. "Clearance of protein linked to Alzheimer's controlled by circadian cycle: Ability of immune system to destroy Alzheimer's-related protein oscillates with daily circadian rhythm." ScienceDaily. 10 February 2022.


On the blog page Guide to Success using CPAP and Bilevel, I list the 4 steps that I believe are the The Secrets to Success.

Applying the 4 steps to my own personal situation, whilst I am using different bilevel settings, from the Example (below), note the following: 

1. Minimum Pressure used is between 9.2 cmH2O and 9.8 cmH2O depending on the situation, even though my maximum pressure may go to 17 cmH2O during the night. 

2. Minimum Pressure is changed by using different Pressure Support of between 5.0 cmH2O and 5.6 cmH2O depending on the situation. 

Further details are provided in the Notes attached to the Example. In addition, an example is provided of how I use the bilevel machine in a typical week at the blog post Athletes need Maximum Performance: Use Bilevel. Observe what I have done and apply the principles to your own situation. 

3. Minimum EPAP (exhale pressure) is the same in each situation at 4.2 cmH2O. 

4. Minute Ventilation (MV) being the total volume of air entering the lungs in a minute is 6 litres/ minute or lower. Further information https://www.normalbreathing.com/

5. The two components of Minute Ventilation being Respiratory Rate (breaths/ minute) and Tidal Volume have similar numbers, no matter what situation has occurred. For median Tidal Volume of 400 ml, I found the optimal setting was to use Ideal Body Weight not actual body weight. More details are on the blog post Use Ideal Body Weight on CPAP and Bilevel. 
By using Pressure Support of 5.4cmH2O in the Normal situation, I have substantially reduced the median/ average IPAP and EPAP (inhale and exhale pressure) by 22.1% and Minute Ventilation by 13.1% when compared to using a CPAP machine. Refer to the blog page CPAP Vs Bilevel Settings Example. Now I wake up refreshed and energized each day!  
More importantly, by using a bilevel auto adjusting pressure machine I have stopped the many CPAP side effects and issues. 
The Example using my actual sleep data and SleepyHead reports are below. 
Since originally writing this blog post, in early 2021 I began using a very high starting IPAP of 18.2 cmH2O and EPAP of 13.0 cmH2O (inhale and exhale pressure). Ideal Body Weight was used in setting the median Tidal Volume and Minute Ventilation. This was essential to stop hypoxia (oxygen desaturation) and sleep disordered breathing causing the symptoms of Dementia. More details are on the blog post:
What BiPAP Settings prevent Alzheimer's due to REM sleep breathing issues? 

You have only one opportunity at life. Make the most of each and every day, free from pain and suffering.  

Should you be having side effects and issues with your sleep apnea therapy; CHANGE what you are doing so that you can wake up feeling refreshed and energized each day. 

Have courage. Be adventurous and Go for it! Overcome your fear.” 
- Mrhelpful 

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