30 May 2021

Can Different BiPAP Machines prevent Alzheimer's Dementia?

 “To create something exceptional, your mindset must be relentlessly focused on the smallest detail.”

- Giorgio Armani (Italian Designer – 1934 -)

Using different BiPAP or Bilevel auto adjusting pressure machines can prevent Alzheimer’s Dementia and Parkinson’s disease. By stopping REM sleep issues you may prevent up to some decades later a diagnosis of REM Sleep Behaviour Disorder (RBD). Subsequently, a possible diagnosis of Alzheimer’s Dementia and Parkinson’s disease and other neurodegenerative disorders and serious medical conditions such as Kidney disease and Type 2 Diabetes!

As detailed on previous blog posts, sleep disordered breathing (SDB) may cause a sequence of events to occur being hypoxia or oxygen desaturation, REM sleep issues, obstructive sleep apnea (OSA), insomnia and Awake Bruxism. From personal experience this sequence occurring during the REM sleep period between 4 and 5 hours of sleep led to the symptoms of dementia. 

To avoid confusion, BiPAP is a Registered Trademark owned by Philips Respironics. Bilevel refers to all other brands such as ResMed.  

The explanation of how I stopped and reversed the symptoms of Dementia is going to be done on a practical level based on my own personal experience. I am not a medical doctor and there will be others with more knowledge and a medical background who can explain better from a technical point of view.

By using a BiPAP and Bilevel auto adjusting pressure machine, I was able to stop sleep disordered breathing and the above sequence of events from occurring. I am now cleared of all the symptoms of Dementia. 

On the blog post for November 2020, I mentioned there was very little Awake Bruxism remaining. The great news is that after a few months of using the adjusted BiPAP/ bilevel machine settings, the Awake Bruxism issue has now completely gone! In addition, the slight shaking or tremor in my hand has stopped happening.

A tremor while at rest such as sitting is a common early sign of Parkinson’s disease.

https://www.parkinson.org/understanding-parkinsons/10-early-warning-signs

Personal experience is showing that up to the early stages of Alzheimer’s Dementia, the symptoms may be able to be reversed. By using BiPAP and Bilevel auto adjusting pressure machines, significant improvement can be made to a person’s medical health condition. Having cleared the symptoms of Dementia, I am back to waking up refreshed and energized each day.

It is my belief that with sufficient time using BiPAP and Bilevel machines and stopping and preventing hypoxia and sleep disordered breathing including obstructive and central sleep apnea, the neurodegenerative disorders in their later stages may also be able to be reversed to some extent or at least delayed in their progress providing a better quality of life for a person.This is supported by the following articles:

https://www.alaskasleep.com/blog/brain-damage-caused-by-severe-sleep-apnea-is-reversible

https://www.medicalnewstoday.com/articles/sleep-apnea-linked-with-alzheimer-like-changes-to-the-brain

Damage to the brain's outer layer caused by smoking may be reversible after quitting, but it could take years.

https://medicalxpress.com/news/2015-02-grey-loss-reversible.html

Neuronal death is at the heart of grey matter injury. The neuron cell bodies are responsible for keeping the entire neuron alive and healthy and that takes a lot of energy. Grey matter is therefore very susceptible to injury when oxygen levels are low (hypoxia) such as during an ischemic event. (For example, Stroke)

https://www.hydroassoc.org/whats-the-matter/

On the blog post Use BiPAP to prevent Alzheimer's Dementia, I mentioned that in addition to using the basic BiPAP and Bilevel machines, should they not provide optimal treatment, try an Adaptive Servo-Ventilation (ASV) machine with variable pressure support settings. An ASV machine will allow a person to have a lower starting IPAP and EPAP (inhale and exhale pressure) with higher pressure only “kicking in” when required to have a person to breathe properly again.

If the ASV machine does not provide optimal treatment, then use a BiPAP with AVAPS or Bilevel with iVAPS machine as detailed on the blog post in October 2020. On the next blog post, I will detail my personal experience using the “top of the range” Bilevel with iVAPS machine. It is my belief that these machines will be able to handle most if not all issues in relation to sleep disordered breathing up to going on a Ventilator. 

These machines have adjusting pressure support and two critical settings which other less advanced machines do not have, being Back-up Breathing Rate (BURR) and Target Ventilation rate for breathing. The machines are currently very expensive; however they are absolutely fantastic machines as they will enable you to have consistency every night with your sleep therapy so that you can wake up refreshed and energized each day.

Some people may question why I do not recommend CPAP. CPAP is not well tolerated by many people as mentioned on a number of previous blog posts including Why is CPAP Compliance Rate Low? and Are BiPAP and Bilevel and Ventilators reducing Deaths during Coronavirus? There is an estimated 80% or more than 15 million people who are non-compliant, failing and non-successful on sleep apnea therapy.

In addition, as detailed on previous blog posts (listed at the end of this post), it is likely you will need BiPAP or Bilevel machines to stop and prevent Alzheimer’s Dementia and Parkinson’s disease and other neurodegenerative disorders.    

On a December 2019 sleep article, Sleep medicine specialist Barry Krakow, MD advises:

Sadly, many sleep professionals, not to mention arcane insurance guidelines, are wedded to the belief that CPAP works for everybody. If that were true, then why is CPAP compliance the single most problematic aspect in the treatment of OSA? The answer is that CPAP does not work or work well except on prototypical sleep apnea patients, but that hasn’t stopped many sleep centers from attempting to force CPAP on patients who will never be able to adapt to it.

The biggest question about PAP modes revolves around how patients breathe out against incoming air. And, the answer may surprise many sleep professionals, because they probably haven’t given it that much attention, otherwise they would have ceased using CPAP as we did back in 2005.

Let’s dispel one myth. Unfortunately, many individuals working in sleep medicine have persuaded themselves that advanced PAP therapy such as ASV or autobilevel [ABPAP] are all about marketing and therefore about making greater profits with more expensive machines. As we have repeatedly demonstrated reversal of CPAP failure cases by using advanced PAP, we would like to think consideration would be given to how much money is saved by turning a failure into a regular user.

https://www.sleepreviewmag.com/sleep-disorders/insomnia/we-stopped-using-cpap-with-complex-insomnia-patients-we-use-more-advanced-devices/

A few years ago I asked a senior executive of a major equipment supplier what % of patients currently get issued with a bilevel machine and why more bilevel machines were not being issued to patients. On the blog page The Secrets to Success using CPAP and Bilevel, I detailed the response which may surprise many people:

“Currently, depending on Country, only 2% to 4% of total patients get issued with a bilevel machine. The medical specialists will not issue more bilevel machines as they fear that the machine will not work and that they will get sued!”

Why does the bilevel machine not work for the patient? As mentioned throughout this Blog, many of the sleep medical specialists are not educating themselves and their patients and they do not understand how BiPAP and Bilevel machines truly work!

I fear that unless the attitude and mindset of the sleep and respiratory medical specialists and other professional people who work in the sleep industry changes in the next few years, many more millions of people will end up going down the path towards Alzheimer’s Dementia and other neurodegenerative disorders! 

Making the issue of overcoming hypoxia and obstructive sleep apnea occurring during REM sleep more complicated is I may have to use very high pressure which may go above 20 cmH2O. As a result, I had to reconsider CPAP side effects and issues. Some of these issues are the same issues that I had already overcome some years ago such as mask leaks, aerophagia, air coming through the eye tear ducts and out the eyes and central sleep apnea. 

Using a bilevel auto adjusting pressure machine brought order and control to REM sleep disordered breathing when breathing may become erratic, irregular and shallow especially during what I believe is the critical REM sleep period of 4 to 5 hours of sleep. By doing so, I stopped and completely reversed the symptoms of dementia.

As detailed on previous blog posts, this sleep period is critical to preserve as long as possible so as to avoid progressing down the path of having the symptoms of Alzheimer’s Dementia and other neurodegenerative disorders and serious medical conditions. Everyone needs to get themselves through this period, ideally without waking up. You need to preserve the period of 4 to 5 hours of REM sleep for as long as possible!

In recent research study articles:     

New research explores the connection between sleep disturbances and deficiencies among older adults and risk of dementia and death, finding that risk of dementia was double among participants who reported getting less than five hours of sleep compared to those who reported 7-8 hours of sleep per night.

https://www.sciencedaily.com/releases/2021/02/210211113840.htm

People who clock six to seven hours of sleep a night had the lowest chance of dying from a heart attack or stroke when compared with those who got less or more sleep, according to a new study. This trend remained true even after the research team accounted for other known conditions or risk factors for heart disease or stroke.

https://www.sciencedaily.com/releases/2021/05/210505090300.htm

A great benefit of adjusting the bilevel machine settings due to having the symptoms of dementia is that I have more consistency each day in not waking up during REM sleep and having better oxygen saturation. As I am having better quality sleep, less sleep is required every night. 7 to 7.5 hours of quality sleep is all that I now require. Previously 7.5 to 8 hours was normal sleep time. Every day, I have an additional average 30 minutes of extra time each morning! This is great especially when you need to be somewhere in the morning.

Further details of the combination of REM sleep issues, obstructive sleep apnea, insomnia and Awake Bruxism and how they may be early warning signs or markers of a diagnosis of REM Sleep Behaviour Disorder (RBD) and subsequently Alzheimer’s Dementia and Parkinson's disease and other neurodegenerative disorders are on the following blog posts:

Oct 20: Use BiPAP ST with iVAPS or AVAPS for REM sleep issues

Nov 20: Use BiPAP and CPAP to treat REM Sleep and OSA issues which may cause Parkinson's and Dementia  

Dec 20: Stop CPAP REM Issues and Sleep Apnea causing Dementia: Use BiPAP

Jan 21: Stop Hypoxia, Alzheimer's, Bruxism using CPAP and BiPAP

Feb 21: Stop Insomnia, Hypoxia, REM sleep issues causing Alzheimer's: Use BiPAP

Mar 21: Use BiPAP to prevent Alzheimer's Dementia caused by REM sleep issues

Apl 21: What BiPAP Settings prevent Alzheimer's due to REM sleep breathing issues

Jul 21: Stop Alzheimer's Dementia using BiPAP with AVAPS or iVAPS

Aug 21: Can Alzheimer's be due to Sleep Position on Back using CPAP?

Feb 22: How to stop Alzheimer's Dementia and Amyloid Protein using BiPAP?

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

26 April 2021

What BiPAP Settings prevent Alzheimer's due to REM sleep breathing issues?

 “If somebody offers you an amazing opportunity but you are not sure you can do it, say yes – then learn how to do it later!”

- Richard Branson (English Business Magnate – 1950 -)

What BiPAP or Bilevel machine settings did I use in the treatment and stopping of my symptoms of Dementia due to REM sleep disordered breathing issues? Potentially I have stopped or prevented from having up to some decades later a diagnosis of REM Sleep Behaviour Disorder (RBD). Subsequently, a possible diagnosis of Dementia, Alzheimer's and Parkinson's disease and other serious medical conditions such as heart attack and strokes, kidney disease and Type 2 Diabetes.

To avoid confusion, BiPAP is a Registered Trademark owned by Philips Respironics. Bilevel refers to all other brands such as ResMed.  

The explanation of how I treated and stopped the symptoms of Dementia is going to be done on a practical level based on my own personal experience. I am not a medical doctor and there will be others with more knowledge and a medical background who can explain better from a technical point of view.

As detailed on previous blog posts, my dementia symptoms were due to hypoxia or oxygen desaturation occurring BEFORE obstructive sleep apnea during the REM sleep period between 4 and 5 hours of sleep. By using a BIPAP or Bilevel machine, I was able to stop hypoxia due to Sleep Disordered Breathing and a sequence of events from occurring. These events were obstructive sleep apnea, REM sleep issues, insomnia, Awake Bruxism and symptoms of Dementia.

On the blog posts Secrets to Success using CPAP and Bilevel and Guide to Success, I provide the explanation of how sleep apnea therapy using CPAP and Bilevel or BiPAP machines truly work so that you can have a 2nd opportunity at life. To be free of sleep issues controlling your life so that you can do all the things that you wanted to do such as visiting the grandchildren, travel overseas, work full-time and run a successful business.

This is the reason for the quote at the top of the page.

“If somebody offers you an amazing opportunity but you are not sure you can do it, say yes – then learn how to do it later!”

- Richard Branson (English Business Magnate – 1950 -)

The medical specialists and researchers seem to be a number of years away from coming up with a possible drug cure to stop and prevent Dementia, Alzheimer’s and Parkinson’s disease and other neurodegenerative disorders. More details are on these articles:

https://www.insidescience.org/news/failure-upon-failure-alzheimers-drugs

https://www.foxbusiness.com/lifestyle/alzheimers-brain-pharmaceutical-drug-test

It may seem difficult to teach yourself and/ or your carers how to use and adjust BiPAP and Bilevel machine settings. Having had and now cleared of the symptoms of dementia, I provide this opportunity for everyone to learn about BiPAP and Bilevel auto adjusting pressure machines to maximize your enjoyment of the rest of your life!    

Recent medical research is supporting my view that it is essential that you sleep through what I believe is the critical REM sleep period of 4 to 5 hours of sleep:

Sleeping less than 6 hours a night in midlife raises risk of dementia 30%, study finds.  

After following nearly 8,000 people for 25 years, the study found a higher dementia risk with a "sleep duration of six hours or less at age 50 and 60" as compared to those who slept seven hours a night.

In addition, persistent short sleep duration between the ages of 50, 60 and 70 was also associated with a "30% increased dementia risk," independent of "sociodemographic, behavioural, cardio metabolic, and mental health factors," including depression, the study said.

https://edition.cnn.com/2021/04/20/health/sleep-dementia-risk-study-wellness/index.html

Other reasons to seriously consider using BiPAP and Bilevel auto adjusting machines rather than CPAP is that they may improve any back and neck issues and CPAP use has been found to cause weight gain. From personal experience, on changing to a bilevel machine, my back and neck issues improved by 5% to 10% and I had weight loss instead of weight gain of 2 kgs. More details are on the blog post Stop CPAP causing Weight Gain: Use Bilevel.   

Dr Steven Park, Medical Surgeon wrote on a blog post 7 October 2020:

It turns out that overall, CPAP use has been found to increase weight significantly, in proportion to how long you use CPAP. The more hours you use CPAP every night and the more number of years, the higher the amount of cumulative weight gain.

https://doctorstevenpark.com/can-cpap-make-you-gain-weight

************************************************

What BiPAP or Bilevel settings do I use to bring order and control to sleep disordered breathing during REM sleep when your breathing may become erratic, irregular and shallow?

Since writing the blog post last month, I have adjusted the machine settings:

- increased starting EPAP (exhale pressure) to 13.0 cmH2O reducing pressure support to 5.2 cmH2O. Starting IPAP (inhale pressure) has stayed the same at 18.2 cmH2O. 

- changed breathing sensitivity for the cycle or exhale setting to Very High from High. The Trigger or inhale setting is the same at High.

These settings were changed as my breathing changed a little at night as I became more accustomed to the very high pressure. I was having tiredness in the afternoons and started waking up at night during REM sleep periods including the period of 4 to 5 hours of sleep.

More importantly, when pressure went over 19.3 cmH2O, I may have ZERO or low readings for Minute Ventilation (MV), Respiratory/ breathing rate (RR) and Tidal Volume of air (TV) and the sleep pattern outlined last month and shown below occurs.  That is, with the previous settings, I had no guarantee that ZERO readings would not happen for a night. On those nights I did not have ZERO readings, the sleep pattern still appeared and I had very low MV, RR and TV. Minute Ventilation is the total volume of air entering the lungs in one minute.

As detailed on the blog post Stop Insomnia, Hypoxia, REM sleep issues causing Alzheimer's, having ZERO readings or a 100% or total obstruction of the airway means that you may be only a few seconds from beginning to be unconscious! Should you have this sleep pattern, urgent consideration be given to amending your current machine settings or obtaining a BiPAP or Bilevel machine to stop the above sleep pattern occurring.

Below are sleep reports for a recent night with the amended settings. Slept through the night for 6 hours 33 mins waking up at 6.23am then slept/ dozed to 6.55am. Note the change in the Minute Ventilation, respiratory rate and tidal volume of air after this time. 

 


How did I work out that IPAP (inhale pressure) of 18.2 cmH2O and EPAP (exhale pressure) of 13.0 cmH2O were to be the starting pressures on the machine using pressure support of 5.2 cmH2O? How these pressures were the “sweet spot” or optimal starting pressures for me? 

The starting pressure of IPAP of 18.2 cmH2O and EPAP of 13.0 cmH2O was arrived at by “trial and error”. In the early stages of increasing the pressure, I was still having ZERO readings. I thought IPAP of 13 cmH2O to 14 cmH2O may be enough to stop these ZERO readings. When this pressure was attained I found it wasn’t enough. So I kept increasing the pressure until the ZERO readings stopped happening on a regular basis which was IPAP of 16.8 cmH2O and EPAP of 11.4 cmH2O.

When the ZERO readings didn’t occur, initially the minimum or bottom numbers were very low such as MV of 1.0 litre/minute, TV of 60 ml/ breath and RR 2 breaths/ minute. These numbers improved as the pressure was increased to IPAP of 18.2 cmH2O and EPAP of 13.0 cmH2O.

Looking at the latest sleep report compared to the previous month’s report, you can see the numbers have improved as follows:

                                           BEFORE          AFTER         

                                          22.03.2021      23.04.2021

Minute Ventilation (min)        2.63                   3.0

    (litres/ minute)

Respiratory Rate (min)          5.20                  6.40 

    (breaths/ minute)

Tidal Volume (min)                180                   160 

    (ml/ breath)

Min Vent (median/ av)           5.75                  6.38 

    (litres/ minute)

Tidal Volume (median)          380                    400

    (ml/ breath)

Exhale time (max)                 8.06                  5.58

    (seconds)

The “sweet spot” was when the pressure was increased until there was order and control during REM sleep in particular the critical period of 4 to 5 hours of sleep and there was consistency from one night to the next so that I slept for at least 6 hours before waking up. It was when my breathing and the machine were in sync with each other all night. As detailed on the latest medical research, less than 6 hours of sleep has an additional 30% risk of a person being later diagnosed with having Alzheimer’s Dementia.

It is my belief that every person needs to get themselves through the period of 4 to 5 hours of sleep, ideally without waking up. You need to preserve this period of REM sleep for as long as possible as detailed on the blog post Stop CPAP REM issues and Sleep Apnea causing Dementia. Otherwise, from personal experience you may start going down the path of having the symptoms of dementia and other neurological degenerative disorders.

To find the “sweet spot” or optimal starting pressures, I did the following:

1. Increased starting IPAP to 18.2 cmH2O and EPAP to 13.0 cmH2O and using auto adjusting pressure mode;

2. Have a tight range for inhale time TI Min of 1.1 seconds and TI Max of 1.2 seconds;

3. Using breathing sensitivity settings of Very High Cycle and High Trigger;   

4. Using pressure support being the difference between IPAP and EPAP of 5.0 to 5.4 cmH2O; 

5. Used Ideal Body Weight (IBW) or Predicted Body Weight (PBW) in setting the median Tidal Volume at 400 ml/ breath and Minute Ventilation at 6 litres/ minute; and

6. Have a median breathing rate of 14 to 15 breaths per minute. 

Using these settings will allow me to be adequately ventilated quickly and control the inhale time. Otherwise, the time may go to 3-4 seconds or more and throw your breathing out especially using high pressure resulting in central sleep apnea (no airway obstruction and no breathing) and sleep disordered breathing.

Central sleep apnea is a sleep disordered breathing issue and may happen when transitioning from exhale to inhale. This issue can be resolved using bilevel settings outlined above and using the high pressure to my advantage. You will note from the sleep reports that I have none or minimal central sleep apneas.

During the night my breathing will drop when asleep to a median/ average ratio of inhale/ exhale of 1 to 2.5 to 2.7 or high 14 to 15 breaths per minute. From the sleep report you can see that the maximum exhale time has now reduced to 5.58 seconds from 8.06 seconds. This was done to bring order and control to my breathing during the night and prevent central sleep apnea from occurring.    

To set the exhale pressure and exhale time to some extent (there is no exhale time limit on the machine), I count to 5 seconds and set the machine so that I finish breathing out and start inhaling in using the high trigger breathing sensitivity, tight range for TI Min and TI Max and very high EPAP pressure. These settings provide a little “kick” to get me to inhale. Essentially, I have set my bilevel machine to work like a basic Adaptive Servo-Ventilation (ASV) machine at a much lower cost. It has a little “kick” in it to get you to breathe. The ASV gives a bigger “kick”.

The advantage of having up to 5 seconds for exhale time is that should I wake up during the night, I found getting myself back to sleep could be done by controlling and slowing my breathing down especially during REM sleep. Otherwise, you may have insomnia as during REM sleep your breathing can become erratic, irregular and shallow. Further details on overcoming insomnia are on the blog post Stop CPAP causing Insomnia: Use Bilevel.      

Using IPAP of 18.2 cmH2O and EPAP of 13.0 cmH2O was the “sweet spot” or optimal starting pressures. When I set the starting pressures higher, I started having trouble with exhaling against the pressure and my breathing may go out such as starting to inhale before I had finished exhaling normally. It is going to be critical to you in order to attain quality sleep at very high pressure to have the timing of your breathing on inhale and exhale “spot-on” or optimal for you.      

A great advantage of having very high pressure means that pressure changes and disruption to your sleep during the night are minimized. You can see on the sleep report that the pressure is quite smooth and there is minimal “up and down” pressure.

In addition, I have stopped on some nights, two to three “flat” periods of 20 to 40 minutes of relatively low minute ventilation of 5.0 to 5.5 litres/ min and tidal volume of air of 300 to 350 ml/ breath. This has brought better order and control to my breathing during the night and I am back to waking up each day refreshed and energized each day. This may be a reason why some people are waking up tired and lethargic even though their AHI (apnea-hypopnea index) is less than 1.0. 

By having better oxygen saturation and not waking up during REM sleep, I am having better quality sleep and as a result now need less sleep every night. 7.0 to 7.5 hours of quality sleep is all that I now require. Previously 7.5 to 8 hours was the normal sleep. Every day, I have an average 30 minutes of extra time each morning. This is great especially when you need to be somewhere in the morning!  

Due to long COVID and bad flu from the second half of 2022 to 2023, I had to increase the starting IPAP to 21.8 cmH2O and EPAP to 16.6 cmH2O. Pressure support (fixed) of 5.2 cmH2O is being used. Top inhale pressure goes to nearly 23.0 cmH2O. These illnesses lead to the symptoms of dementia previously overcome to reoccur due to hypoxia (oxygen desaturation) and sleep disordered breathing. ZERO Minute Ventilation, Respiratory/ Breathing rate and Tidal Volume occurred during what I believe is the critical REM sleep period of 4 to 5 hours of sleep.

More details are at:

Stop Insomnia, Hypoxia, REM sleep issues causing Alzheimer's: Use BiPAP

Further details of the combination of REM sleep issues, obstructive sleep apnea, insomnia and Awake Bruxism and how they may be early warning signs or markers of a diagnosis of REM Sleep Behaviour Disorder (RBD) and subsequently Alzheimer’s Dementia and Parkinson's disease and other neurodegenerative disorders are on the following blog posts:

Oct 20: Use BiPAP ST machines with iVAPS or AVAPS for REM sleep issues 

Nov 20: Use BiPAP and CPAP to treat REM sleep and OSA issues which may cause Parkinson's and Dementia 

Dec 20: Stop CPAP REM issues and Sleep Apnea causing Dementia: Use BiPAP 

Jan 21: Stop Hypoxia, Alzheimer's, Bruxism using CPAP and BiPAP 

Feb 21: Stop Insomnia, Hypoxia, REM sleep issues causing Alzheimer's: Use BiPAP

Mar 21: Use BiPAP to prevent Alzheimer's Dementia caused by REM sleep issues 

May 21: Can Different BiPAP Machines prevent Alzheimer's Dementia? 

Jul 21: Stop Alzheimer's Dementia using BiPAP with AVAPS or iVAPS

Aug 21: Can Alzheimer's be due to Sleep Position on Back using CPAP?

Feb 22: How to stop Alzheimer's Dementia and Amyloid Protein using BiPAP?

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