Respironics Auto CPAP vs Respironics BiPap Manual

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Wed Mar 14, 2012 4:53 am

Thank you so much Pugsy .

My concern was mostly that a lot of the Hypopneas seemed clustered together and one was 54 seconds long. But since you say thats not to worry i wont


Love,
Deepak

heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Sat Mar 17, 2012 10:49 pm

Dear Pugsy,

I am trying to get mom use the CPAP machine one day to see if she records apnea events as she does snore and have high blood pressure. I am not sure yet if she will agree.

But if she does should I set the min and max pressure both at 5 ??


Love,
Deepak

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Pugsy
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Pugsy » Sun Mar 18, 2012 7:07 am

If your mom is comfortable at 5 cm then yes you could set min and max to 5. I tried this when I screened my sister..she wasn't comfortable at 5 cm...ripped the masked off telling me I was trying to kill her by suffocation.. So we ended up with 6 cm to start with.

I wouldn't worry so much about anything other than documenting the need for cpap (if there is one) and if there is a need...then worry about fine tuning the pressure after a need is shown or get her into a sleep study if she will go.

Bear in mind that their is therapy value at the lower pressures and it is possible that the lower pressures will prevent some events from being scored. Though if playing the odds, most people seem to need more than minimal pressure to dealt with things.

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Last edited by Pugsy on Sun Mar 18, 2012 7:29 pm, edited 1 time in total.
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avi123
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Re: Is a titration study needed ?

Post by avi123 » Sun Mar 18, 2012 12:15 pm

heartchakra wrote:So , my father has been trying a CPAP Auto and a Bipap manual machine.

The doctor here said using a CPAP auto negates the need for a titration study to see how much pressure is needed as the machine automatically decides that.


This is correct, but it is not as being fully tested as in a sleep study. For example, on the APAP you can't verify accurately Central Apneas and Hypopneas, or the source and level of UAR and Flow Limitation, and most importantly, sleep architecture and Oxygen desaturation.

Now my question is this - My father finds the Bipap machine more comfortable. As of now I keep it on a pressure of 6 and 8.

This is one of my own questions at this time. My recent sleep study prescribed an optimal pressure of 13 cm ON CPAP. If I use a plain CPAP and #3 EPR or Flex, it would reduce the exhaling pressure by 3 cm to 10 cm. The question is: am I comfortable to exhale into this pressure of 10 cm? Also, what if I'll need to raise the optimal pressure of 13 cm by a few cms? On the other hand using an APAP or a BiLevel in Auto mode, would change the pressures, at the XPAP's own discretion, and cause an instable respiration situation, which could wake me up.

Is there any way what would be the optimal pressure settings for him without a titration study and getting hooked up to all the sleep study machines again ?

Yes, he could ask any medical doctor to order an At Home Sleep Study. Check the above search box for this sentence.

With love, (are you a male or female?)
Deepak
p.s. about your question above about the nasal mask. If your Dad also mouth breathe to some degree, then a full face mask is the solution for better treatment.

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heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Mon Mar 19, 2012 7:11 am

Dear Pugsy,


The sleep doc here did not think its necessary to do a titration sleep study as he said the auto cpap would take care of pressure on own and as you know I have been then checking the events on sleepyhead. Is that good enough ?


Love,
Deepak

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Pugsy
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Pugsy » Mon Mar 19, 2012 7:37 am

Yes, your dad's sleep doctor is okay with using the APAP to find ideal pressure...his opinion is the one that matters the most.

Avi123 has some rather odd thoughts at times and may not know the whole history behind your dad or where you live. Not all parts of the world agrees with the way Avi thinks...heck not parts of the USA either. Avi was just trying to be helpful but may have confused you instead with his own personal opinions and problems. His situation is not the norm.

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heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Sat Apr 21, 2012 9:10 am

Dear Pugsy .

Hello ...again !

Are the other readings important to look into or AHI, Hypopnea and Leak are most important ? The technician who gave me the machine said these 3 important - rest ignore.

I am attaching a chart detailing some of this other stuff - Flow limitation, Pressure Pulse, Resp. related arousal efforts, vibratory snores etc.

Also since 2 days I am trying the Auto BiPaP machine on dad and attaching a chart. Please look . It sometimes seems to be going upto 15 IPAP level whereas the CPAP machine never went beyond 13.

http://www.flickr.com/photos/74904217@N ... /lightbox/

http://www.flickr.com/photos/74904217@N ... /lightbox/


Thanks always for being my guide.

Love,
Deepak

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Pugsy
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Pugsy » Sat Apr 21, 2012 1:19 pm

Hi Deepak,
I had been wondering about how your dad was doing.
First of all...the 3 main items....events (AHI, Hyponeas, etc), pressure and leak...yes, ignore the rest of them.
There is a link in my signature for the glossary of the terms. It will help explain them.
The flow limitations and RERAs....unless these numbers are grossly huge all the time..disregard. By grossly huge...double digit indexes every hour, all night and every night. What you dad has is not alarming.

The one time the pressure bumped 15...there was also a bit larger leak than normal. Sometimes the Respironics machines will try to fix a leak with more pressure...sometimes it helps and sometimes it makes things worse. I would disregard that particular happening. The other parts of the night everything is well under control.

Also...sometimes even without leaks (though I do think this instance the pressure increase was related to leak) the events might happen to need more pressure than normal in rare situations. I have seen it happen myself. Sometimes the auto pressure line never moves..sometimes never moves all nights but a couple nights a week I might come close to the max (when I was using APAP I used to hit 18 cm) but the times are rare and short lived. I didn't worry about them. I just said that the events were on steroids..extra mean and extra strong.
So when I used APAP....10 min and 20 max...some nights it never budged beyond 12 cm but on a rare occasion I would see 18cm and even bump the max...Might be REM stage sleep related..might be supine sleeping...or combination of both. Might just be a fluke.

In your dad's situation..Nothing to be alarmed about and I really don't see the need to increase the maximum based on that one episode.

Hugs right back at you,
Pugsy

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heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Mon Apr 23, 2012 9:17 am

Dear Pugsy,

Thanks .

Dad seems to be liking the Auto Bipap more than the Cpap. Could you please also have a look at yesterdays Auto-Bipap chart and tell me if the readings look fine.

Also, regarding the "Leak" - upto what level of leak is ok ??

http://www.flickr.com/photos/74904217@N ... /lightbox/

Love,

Deepak

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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Pugsy » Mon Apr 23, 2012 6:38 pm

Report looks great.
Leak...large leak isn't until someone hits near 90 L/min...you dad is a long way from getting near 90 L/min. That short spike was likely mask readjustment.

Looks like his baseline leak line is a little below 23 L/min and other than a little bit of spiking and a little increase that last part of the night....it stayed right around the baseline....even the worst spike was less than 35 L/min. It is going to vary a bit and that is normal...
Leak would have to be a whole lot worse to warrant worrying about. Like prolonged length of time over 60 and pushing towards the 90 L/min line

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Gerryk
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Gerryk » Mon Apr 23, 2012 6:52 pm

Hi Deepak,
I am rather late in the game jumping in here. it't great your keeping tabs on him and all. I used to check my data all the time and kind of forgot what was really important. How well I started to feel by being on the Cpap. So how does your dad feel since being on cpap?

I am also on BiPap, started out on straight Cpap and have been on BiPap for at least a few years now.


Gerry

heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Mon Apr 23, 2012 9:22 pm

Dear Gerry,

He surely feels better after he has starting using the machines. He does not doze in the day , is more cheerful and energetic - I can see the difference too.

He was using the Cpap for 2-3 months and now I am trying the Auto BiPaP ......he says he feels slightly better on the bipap .....

Which one do you like better and what difference do you feel with both ?


Love,
deepak

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Gerryk
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Gerryk » Tue Apr 24, 2012 10:05 am

I had a straight cpap then an auto pap then a BiPap. I could not tollerate the first two as my pressure was set to the max on those machines. I was finally able to tolerate the BiPap but the Dr had to lower the pressure a little because I was swallowing so much air.

I ended up having surgery, I had a UPPP. Removed the tonsils, reduced the Uvula down to nearly nothing then it was sewn up to the roof of my mouth so it would be gone once it healed properly and then my doctor did some work in my throat putting a few stitches in to tighten it up.
About a year later I had another surgery. I had Turbinate reduction and a deviated septum fixed. Once I recoverd, I was able to breath like I had never been able to in my life. I was still on cpap but the machine was set to auto and about six months after the first surgery, I had a new sleep study done. I didn't sleep much that night for some reason so very little data was collected. What was collected didn't indicate sleep apnea. But because I was waking up not as rested and with a headache when I didn't use the cpap, my Dr wanted me on it.

For me the BiPap worked the best and I liked it the best. If someone doesn't need or require a BiPap then don't get one as they are much more expensive.

Fortunately you have the capabilites to collect the data. Mark down how he feels when he uses a specific machine and different masks, then compare the data you have. You may be surprised and you may not, but the main objetive here is the he feels better.
He will feel better with some masks than with others and the one that is best is not always the one he likes the best or is the most comfortable.


Once you figure out which is the best, keep an eye on the data. You don't have to check it daily but a few times a month at least. I have been slowly getting more tired, worn out and cranky over the past year. I didn't put two and two together, I just figured it was every day stress. Unfortunately I had put weight on and had not been checking my data regularly. My machine was set for an auto max pressure of 14. I got a new machinelast week and the max pressure was opened up wider and I felt immediately better after using this machine.
I went in today and my DME compared the two machines and data. Now, if I had been paying a little better attention I would have been living a better life. Stupid my, my fault but now I know better.

Good luck

Gerry

heartchakra
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by heartchakra » Wed Apr 25, 2012 9:21 am

Dear Pugsy,

Once in a while, the data does not read from the card when I try to download it onto the Sleepyhead software- it says no new data to download or something - it happens once in a few days - even though I am quite sure the card is properly put inside the machine ......any idea why this may be happening ?

How is your mom doing now ?

Love,
Deepak

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Pugsy
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Re: Respironics Auto CPAP vs Respironics BiPap Manual

Post by Pugsy » Wed Apr 25, 2012 10:13 am

My Mom had to have another surgery Monday..Toe amputation due to bone infection that we have no idea how she got it. Wasn't a surprise about the surgery since it was originally scheduled during the time of the last hospitalization for her gall bladder....so had to be postponed.
Doing okay for a 79 year old woman with a shortened toe.... She is pretty tough. I am heading over there shortly to do a grocery run for her.

Unsure why the no new data. Even if the SD card is totally left out of the machine over night we only lose one graph because the machine stores the bulk of the data in the machine and will put it back on the card.

You might try creating a new location next time instead of using the same location. Maybe SH forgot where to look for the new data. Also...next time no new data.. remove the SD card from the computer and insert it back into the cpap machine...watch to make sure that the machine sees the card and does its thing..won't take but a few seconds...then remove the card and try again in the software.

I will send you a private message in a minute with alternate software to try along side of SleepyHead. Just for a precaution. Random corrupted files can happen from time to time but not a common occurrence.

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