New to Bi-level/BiPAP

Dear Andrea,
I got a BiPAP today, and I’m scared and nervous about it. What tips do you have to make this easier? —Nervous NIV Newbie, USA

Dear Nervous NIV Newbie,
I won’t pretend to have all the answers, but I know starting noninvasive ventilation can be scary and full of unknowns. First, know there will be an adjustment period. The most important thing for you to do is to be patient, determined, and know that the results of using NIV are all worth the challenges you may have adjusting to it. 

Good communication between NIV user and respiratory care provider is a must! The best situation is one in which a respiratory care company staffs a Registered Respiratory Therapist (RRT) who keeps in close contact with the NIV newbie, calling after the first night or two of use, being available to come to the home to adjust settings and to answer a variety of questions at your convenience, and to offer additional interfaces (masks and nasal pillows) for you to try. 

A huge factor in comfort is the mask or nasal pillows. There are dozens of options, and you should try several. Masks fit and adjust differently sitting up versus lying down, so try them both ways. In the Breathe with MD Support Group, we keep a folder of “mask selfies” that help to showcase masks group members like and why. 

Another area of challenge can be device settings. Sometimes they need to be adjusted for comfort or even completely changed from the original prescription. A good RRT will be patient and identify options for adjustments and changes, communicating with you and your ordering physician along the way.

Identifying the right level of moisture and heat needed on your device’s onboard or stand alone humidifier can bring challenges too. You may need to experiment to identify which humidification setting is best for you so that nasal passages don’t dry out or get too much moisture. Allowing your nasal passages to get too dry can trigger over production of mucus, something you want to avoid. Conversely, the tubing can become “water-logged,” if the humidity is set too high. 

Some find that starting to wear assisted ventilation while watching TV, reading, or playing video games helps them to adjust. They gradually increase their usage time until eventually they are wearing it for an entire night of sleep. Insurance will require you use the ventilation so many hours each day or they won’t pay your rental and other associated fees. Check with your supplier to identify your compliance requirements. (Most follow a four-hour per night requirement, and many also allow an adjustment period with less usage.)

Lastly, reach out to others who use NIV to ask for their advice. No one understands like your peers in the NMD community! That’s why your friends in the Breathe with MD Support Group at
https://m.facebook.com/groups/breathewithmdsupportgroup are a great resource. Know that we will help you through it; you CAN do this! 

Wishing you the best sleep breathing,
Andrea