It’s too soon to tell if it’s helping, but 4 weeks ago I started on a trial of home Bipap. Essentially Im sleeping hooked up to a non -invasive ventilator. I’ve been using a full face mask which Im gradually getting used to. Right now I’m averaging about 4- 5 hours per night on the machine. I have no problem falling asleep with the mask strapped to my face, but after about 3 hours I wake up short of breath anyway and have to remove it to take a neb treatment. Getting back to sleep after the neb treatment is much harder with the mask on, but Im working on increasing my total mask time to 6 hours a night.
Though I do have a degree of sleep apnea, the primary reason Im using BIPAP is because of my asthma.My symptoms intensify at night, making solid sleep near impossible. There’s some evidence out there to suggest if you stent the airways open while sleeping, it can lesson nocturnal bronchospasm. This can usually be accomplished using standard CPAP which provides positive pressure during expiration, but because my small airways are so narrow and tend to close up, I sometimes have a difficult time inhaling as well. The BIPAP helps with this by providing positive pressure during the inspiratory cycle as well as the expiratory cycle. Hence the “BI” in BIPAP, meaning bi-level positive airway pressure, instead of just continuous pressure during exhalation (CPAP).
This is in no way a product endorsement, but the machine I use is pretty cool. It has sensors that adjust the flow and set pressure to your breathing pattern and the motor is virtually silent. Except for an occasional air leak around the mask, I can’t hear a thing. Like most of these modern sleep assist units, it hooks up to the internet so that insurance companies who pay for this kind of therapy can monitor to see if the patient is actually using the machine. There’s a lot of waste in this area of healthcare, because many patients who have CPAP or BIPAP machines don’t actually use them.
I’ll give it a solid 3 months to see if my quality of sleep and/or night time asthma symptoms improve. If they do, I’ll consider BIPAP a permanent part of my ongoing therapy and another tool to help me live a little better.
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I wondered how BiPAP affected your nocturnal asthma. What EPAP and pressure support settings do you use?
Hi Stephen,
Thank you so much for your informative blog. I’ve read quite a few of your posts and am amazed by your resilience. I’ve had severe asthma since I was 7 and I’m now 24. Just a few months ago I was diagnosed with early-onset COPD (chronic bronchitis). I wanted to follow up with you and ask if the bipap machine has been helping you at all. I have too much trouble at night; if I lay down, I can’t breathe. Sleeping on an incline doesn’t seem to help either and besides, I have chronic pleurisy which makes me want to lie on the painful side. I also wanted to ask you if you had bronchial thermoplasty done on you. I did, and as long as I was living in California it seemed to help, but as soon as I moved to India to be with my husband I’ve been having wheezing, rales, rhonchi etc. every day as I do not respond well to humidity. Would definitely appreciate your feedback…sleep deprivation is awful to have to deal with when we are already exhausted all day from trying to breathe!
Hello,
Thank you for writing. Im sorry to hear that you’re having breathing and sleep difficulties.
Personally, I didn’t find bipap very useful in helping me breath easier at night, but I think it helped me sleep a little deeper, giving me more rest . You might find it helpful, but If you have excessive secretions, as many do with chronic bronchitis, you may want to try a nasal mask before trying a full face mask. Also, if you never used CPAP or bi-level, it can take a while to get used to. I would recommend that you have a full sleep study done before considering bipap .
Regarding BT, I dont qualify because my lung function is too low. Most of the damage to my lungs is in my smaller airways, which BT doesn’t help.
For many people suffering from obstructive lung disease, humidity can make symptoms much worse. If possible, you need to be in a drier climate or at least a controlled drier indoor environment.
Best of luck to you.
Steve
Thanks a ton for your reply. Does using bipap with the full mask generally increase secretions? I’ve been on it several times before in the ICU prior to intubation, but I was also getting suctioned at regular intervals. I have pretty bad secretions and was given the Vest Airway Clearance system to help with that when I was 16 even though I don’t have CF. Unfortunately, I left it in the States because I thought my breathing issues were getting better, but like you said, the humidity levels here (between 80-100%) here have made me more symptomatic than ever.