CPAP vs APAP vs BiPAP (poll)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.

Do you use CPAP or APAP?

CPAP, machine is not capable of auto
33
12%
CPAP mode, machine is auto capable
50
19%
APAP mode, machine is of course auto capable
124
46%
BiPAP/VPAP, machine is not capable of auto
9
3%
BiPAP/VPAP fixed settings, machine is auto capable
16
6%
BiPAP/VPAP automatic mode
38
14%
 
Total votes: 270

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teachcsg
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Re: CPAP vs APAP vs BiPAP (poll)

Post by teachcsg » Sun Apr 01, 2012 12:06 am

Very well said JNK...good response surrounding the APAP vs CPAP question.
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chunkyfrog
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Re: CPAP vs APAP vs BiPAP (poll)

Post by chunkyfrog » Thu Apr 05, 2012 9:31 am

Every morning, I enter the data from my Sleep Report screen in a small notebook,
adding my blood sugar reading, Lantus dosage from the previous night,
and which mask I wore.
My doctors all like my little notebook.
My sleep doc especially.

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Sparky123
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Re: CPAP vs APAP vs BiPAP (poll)

Post by Sparky123 » Mon Apr 09, 2012 1:16 pm

The question in the poll almost sounds like a "what do you like best" thing. The following is simply a sleep techonologists perspective. Not meant to diagonose anyone or determine what's best for any specific person out there. When a physician is determining the form of PAP therapy, there is a specific reason why one therapy is used over another. Standard CPAP is used to treat the garden variety Obstructive Sleep Apnea. The constant delivery of air pressure will prevents the airway from collapsing during sleep. The AutoPAP responds to obstructions to airway obstruction by delivering an increasing level of pressure until the air way is open. Some of the best reasons for using APAP is when a diffinitive Effective Pressure setting cannot be determined in the sleep lab setting. Or, if a person has a dramatically different pressure requirement when in REM stage sleep vs. non-REM, or when they are in supine position vs. lateral position. The APAP can also be used as a "bridge" therapy while a patient is waiting for a titration study. It can also be used if a doctor is contemplating a pressure change to CPAP. The patient uses the APAP for a couple of weeks and then it is downloaded to see what pressures were actually used. BiLevel PAP is used for patients who have high pressure requirements. In many circumstances high PAP pressure can illicit Central Sleep Apnea events, or make it difficult for some people to properly expel CO2 when exhaling. The lower exhale pressue allows for a better exhange of gases and ventilation. It is also used for comfort when patients cannot tolerate high PAP therapy. The ASV is a devise that is used specifically to treat the combination of Obstructive/Central Sleep Apnea called Complex Sleep Apnea. Some patients who have some degree of cardiac deficiency will develop Central Apnea only when placed on CPAP. It is theorized that the increased difficulty of exhaling against PAP creates a build up of CO2 in the blood stream which prompts a hyperventilatory response upon awakening. The resulting lower levels of CO2 then fail to initiate that hypercapnic drive (higher CO2 levels) which is also called the respiratory drive. The time that it takes for the CO2 to build back up is when the Central Apnea occurs. The ASV provides a backdrop of pressure to keep the air way open for obstructive events. The Servo Vent (SV) operates in a auto mode which identifies the cesation of breath and boosts inhaling pressure up breath by breath in order to ventilate. This keeps the CO2 levels stable, preventing the central events from occuring.

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Slinky
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Re: CPAP vs APAP vs BiPAP (poll)

Post by Slinky » Tue Apr 10, 2012 3:47 am

Thanks for the explanations, Sparky!!!!

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robysue
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Re: CPAP vs APAP vs BiPAP (poll)

Post by robysue » Fri Apr 13, 2012 3:59 pm

Sparky123 wrote:BiLevel PAP is used for patients who have high pressure requirements. In many circumstances high PAP pressure can illicit Central Sleep Apnea events, or make it difficult for some people to properly expel CO2 when exhaling. The lower exhale pressue allows for a better exhange of gases and ventilation. It is also used for comfort when patients cannot tolerate high PAP therapy. (emphasis added.)
I simply want to point out that there are a few of us who were put on Bi-levels by our docs even though our pressures are very low.

I simply could not tolerate CPAP, CPAP with EPR, and APAP with EPR due to severe aerophagia, air getting into my eyes via my tear ducts, and very fragmented sleep even though my original titrated pressure was only 9cm. About two months after I started therapy at yet another semi-emergency meeting with the sleep doc's PA, she stunned me with the statement that she and the doc had talked about my case and had decided to ask me if I was willing to undergo another titration study with a bi-level machine. It had never even crossed my mind that I might need a bi-level. But I was desperate for sleep and I agreed to another sleep study. My first titrated bi-level pressure settings were IPAP = 8; EPAP = 6. And even at those very unusual pressure settings for a bi-level, the switch to made a positive difference, but it didn't solve my aerophagia problems. Several months later another formal titration study came up with settings of IPAP = 7; EPAP = 4. I could finally sleep without waking up feeling like I'd swallowed a basketball every night, but in practice 7/4 was not quite enough to control all my events all the time.

And hence a month or two later the PA ordered me switched to the narrow Auto BiPAP range that I continue to use: Min EPAP = 4; Max IPAP = 8, PS on the PR System One = 4, which effectively means 4 <= EPAP <= 6 and 6<= IPAP <= 8cm. It's a working compromise: On nights where I need the pressure at 8/6 for long periods, it quickly gets there and stays there and I run the risk of waking up with some serious aerophagia. On nights where I don't need the pressure at 8/6, it sits at 7/4 and 8/4 for most of the night with a few small bumps in the EPAP curve and I don't get aerophagia.

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Suzjohnson
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Re: CPAP vs APAP vs BiPAP (poll)

Post by Suzjohnson » Thu Jun 07, 2012 7:52 am

Wow, excellent thread! Glad it popped up.

Suz

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chunkyfrog
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Re: CPAP vs APAP vs BiPAP (poll)

Post by chunkyfrog » Thu Jun 07, 2012 9:14 am

My data indicates that my 95% pressure fluctuates as much as 4 cm. from one night to the next,
yet my psg indicated there was little positional component to my apnea.
Once I switched from the Elite to the Autoset, my comfort level increased exponentially.
On the other hand, my husband's apnea is almost entirely supine,
therefore, an Autoset is the only machine that would have worked for him.

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terryD

Re: CPAP vs APAP vs BiPAP (poll)

Post by terryD » Fri Nov 30, 2012 12:46 pm

Does anyone know of a bi-level machine with similar pressure wave-form and timing to C-flex? I have to move up to "bipap".
The only cpap that worked for me was Remstar M auto on c-flex setting. Pressure falls immediately on exhalation and increases
about 1 second later, whatever I do - and stays on until next exhalation. Hope someone can help as I'm going to be in trouble -
automatic does'nt work because I wait for pressure to be applied before I breathe in; bipap s/t machine (harmony) works,but not very well. Any suggestions welcomed

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chunkyfrog
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Re: CPAP vs APAP vs BiPAP (poll)

Post by chunkyfrog » Fri Nov 30, 2012 1:22 pm

My college roommate was titrated with a pressure of 18, straight CPAP, no exhale relief, no efficacy data.
Needless to say, she has been non-compliant for a number of years, even though she also suffers from fibro.
I am going to offer to let her try out one of my Apap machines, but I strongly believe she needs a bilevel, probably an Auto.

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fredr500
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Re: CPAP vs APAP vs BiPAP (poll)

Post by fredr500 » Wed May 01, 2013 8:47 am

I answered as of today. I've been going back and forth between CPAP and APAP lately, switched back to APAP last night so that's how I answered. If the next couple nights go like last night my answer will change to CPAP on an APAP capable machine.

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deerslayer
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Re: CPAP vs APAP vs BiPAP (poll)

Post by deerslayer » Wed May 01, 2013 8:43 pm

until further notice i will be on straight pressure & actually seems to be working with less oa & leaks.with modem on machine we must walk the straight & Narrow

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Re: CPAP vs APAP vs BiPAP (poll)

Post by packitin » Tue Nov 04, 2014 2:44 pm

last used bipap (currently using MAD device; not on any *pap; gave up after 10 yr)
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