Respironics New BiPAP-Auto machine

[rested gal]

Well, well, well....a new "combo" machine!!



The text on Respironics's ad picture in Sleep Review Magazine Sept. 2005, reads:

The new BiPAP Auto brings together a unique
combination of our patented technologies
to give your patients another opportunity for
therapy success.

Auto Adjust maintains the minimum effective
pressure to deliver only the level that's needed,
when it's needed.

Bi-Flex makes the breathing cycle much more
natural and comfortable - and only we have it.

At the heart of our technology is our patented
Digital Auto-Trak Algorithm - our way of making
therapy more natural by tracking, and reacting to,
a patient's natural breathing pattern.

Advanced reporting with Encore Pro SmartCard
includes AHI, leak and snoring data for better
compliance monitoring and therapy management.

To see how the new BiPAP Auto can help you
improve sleep therapy Acceptance, Comfort and
Results, call 1-800-345-6443.

[dsm]

Yes very

So is this the convergence of CPAP, APAP & BiPAP ?

A triple mode machine ?

Cheers

DSM

[Fatigue Fighter]

Yippee....This appears to be exactly what I need. I'm having quite a time with constant BiPAP pressures at 17/13. Glad I have a rental that I can exchange. I hope this is really on the market. Thanks for keeping an eye out on all things XPAP, Rested Gal.
FF

[wading thru the muck!]

Looks like Respironics is concentrating on improving the technology of their machines rather than Just repackaging their same Algorithm in a new slick box ala ResMed.

Looks like a very interesting machine. RG, how prescient that you've been lab-rating Bi-paps lately.

[bigcat]

So.....Time to buy some Respironics stock?

[dsm]

[quote="bigcat"]So.....Time to buy some Respironics stock?

[rested gal]

Some interesting comments from -SWS:

I wonder if this is just a Remstar Auto with BiFlex instead of
C-Flex? That wouldn't be such a big change: exact EPR versus
relative EPR. I believe that is the only distinction between C-Flex
and BiFlex: "relative relief" versus "exact relief" (and I could be
wrong). I do know the common denominator for the Respironics
"Flex" features happens to be that EPR comes to an end at
some mid-point (kind of near the end) of expiration. A higher
IPAP equivalent pressure is achieved before the human expiration
cycle is even complete.

C-Flex= "relative" EPR w/IPAP-equivalent pressures achieved before
the end of human expiration

BiFlex= an "exact" EPR w/IPAP-equivalent pressures achieved before
the end of human expiration

BiPAP= an "exact" EPR maintained throughout the entire human
expiratory cycle

Gee, when you look at the differences and similarities, there are
basically two variables: 1) whether the EPR is relative or exact, and
2) when the higher IPAP (or IPAP-equivalent) pressure is achieved.

So I wonder if this is simply a Remstar Auto with BiFlex (meaning that
BiFlex mode as described above can simultaneously run with AutoPAP mode)...
or if this machine can ALSO run AutoPAP mode in tandem with BiPAP mode
(as described above).

If it can do both BiPAP and BiFlex modes in tandem with AutoPAP mode,
then that's quite a machine!

If it can only run BiFlex mode in tandem with AutoPAP mode then it's
not so different than your RemStar Auto with C-Flex. It would be an
improvement, nonetheless!

-SWS

[christinequilts]

But no ST model from the looks of it ...guess I have to wait for ResMeds Autoset CS2 and hope it is different enough then their VPAP II STA so it actually stops more of my centrals. I would love it if any of the new technologies can get me to a more acceptable AHI- 30ish was good in comparison to the 65 I had without BiPAP ST at first, but after 2 years I am litterally tired of it and I want more (or less, as the case may be).

[sthnreb]

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, bipap

[christinequilts]

Some interesting comments from -SWS:
I wonder if this is just a Remstar Auto with BiFlex instead of C-Flex?
-C-Flex= "relative" EPR w/IPAP-equivalent pressures achieved before the end of human expiration
-BiFlex= an "exact" EPR w/IPAP-equivalent pressures achieved before the end of human expiration
-BiPAP= an "exact" EPR maintained throughout the entire human expiratory cycle

So I wonder if this is simply a Remstar Auto with BiFlex (meaning that BiFlex mode as described above can simultaneously run with AutoPAP mode)...or if this machine can ALSO run AutoPAP mode in tandem with BiPAP mode(as described above).

If it can do both BiPAP and BiFlex modes in tandem with AutoPAP mode, then that's quite a machine![/i]

Remember they have BiFlex on the BiPAP Pro currently- and have for a few years. BiFlex is similar to CFlex, but it goes a little below the prescribed EPAP (lower, exhale pressure) for a fraction of a second or so instead of just going below the single pressure CFlex does on the on CPAP/autoPAP. It is BiPAP with a little extra kick- or extra relief on exhale above and beyond the normal relief with striaght BiPAP. I would think to get past FDA and insurance billing codes it would have to run in BiPAP all the time- not only when auto is off. It could, potentially, run autoBiPAP without BiFlex- even if it did, you would still have the relief on exhale with the difference between IPAP & EPAP. What will be interesting is to see how they handle the both pressures in auto mode- is the pressure difference going to varry or will it be set so they are always the same difference between IPAP & EPAP for each particular user?

Any idea on when it will be available?- it would seem that if they are advertising it that its near the end of the FDA approval process. I know with medications they cannot advertise it until it is approved & tenative release date set. The only way I would think they could have gotten around full FDA approval process is to claim its not new technology and that since autoPAPs=CPAP as far as billing & such then autoBiPAP=BiPAP, so they don't need to do a full ransomized trial & such for approval.

I couldn't resist- I checked the FDA approval database- they are going for "Modified Design/Substantial Equivalence" approval and recieved FDA approval June 15,2005: http://www.fda.gov/cdrh/pdf5/K050759.pdf
Here are the highlights: Auto algorithm from RemStar Auto w/CFlex added to the BiPAP PRO 2 w/BiFlex...2 additional modes [in addition to BiPAP, CPAP, BiPAP w/Cflex & CPAP w/Cflex?]: AutoBiPAP & Split Night AutoBiPAP...goes on to state that "Pressure relief upon exhalation (Bi-Flex feature) may be enabled during Auto Bi-Level therapy", so I guess that answers SWS's question and this will be 'quite the machine' . Further down, it goes into Clinical Efficacy Study- autoBiPAP is as effective at deternining optimal pressure an manually titrated BiPAP...autoBiPAP maintains lower average treatment pressures (as defined by average IPAP & average EPAP as compred to manually titrated fixed pressure BiPAP therapy), and the AHI will remain below 10 during polysomnography. There was no mention of use with CSA or Mixed Apnea- probably will be done in after market research. Does anyone care to guess why or who crossed out the word ONLY after OSA on Respironics application letter?

I hope they are working on something for BiPAP STs, similar to what ResMed is doing....Respironics managed to keep this one below the radar until they were ready to start marketing it. I wonder what the price range will be- it seems autoCPAP's (as I guess we better start calling them with autoBiPAPs coming into the picture) cost about 50% or $200-300 more then the equavilant straight CPAP at cpap.com. BiPAP PRO 2 w/BiFlex is $1399, so I would think the lowest autoBiPAP w/BiFlex would be is $1700, if not more...I would guess at least $2000 to start. So when is Rested Gal putting her order in ...you know you have to try it! I would be the first in line if it was an ST model.

[rested gal]

christine, thanks for digging into the FDA site! Absolutely intriguing info!!

[wading thru the muck!]

Sounds like they are finally admitting to ALL the potential benefits of an auto-adjusting cpap, or bi-pap in this case.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, auto

[SickAndTired]

Any idea when this device will be available for purchase?

[john5757]

Is Respironics saying that it is not new technology for this just a software add-on to the Bi-CPAP that been out for a few years? No new box or better humidifier integration and charge $1700 for it? Do we need new prescription for the Bi-CPAP or could a standard autocpap prescription work?

[christinequilts]

Is Respironics saying that it is not new technology for this just a software add-on to the Bi-CPAP that been out for a few years? No new box or better humidifier integration and charge $1700 for it? Do we need new prescription for the Bi-CPAP or could a standard autocpap prescription work?

There saying its proven technology that they are putting together to create a new product. The $1700 was a just a guess at about the lowest I could see it going for at on-line DMEs, using the trends in pricing difference between CPAP & autoCPAP...it could very well be higher and it would suprise me if it was much under $2000- IMHO. Considering the BiPAP Pro II goes for $1400- adding auto technology is going to raise the price....no one knows how much yet. BiPAPs do need to have a prescription that says BiPAP/BiLevel specifically- a CPAP or autoCPAP script won't do as far as I know, but you could ask cpap.com specifically for their policy. For insurance purposes you will need a script for BiPAP at the least- if not autoBiPAP specifically. Insurance companies don't want to pay for things that are not truely needed and even on my titration with a very clear case of pure CSA they had start the titration with regular CPAP and work up from there to prove I actually needed BiPAP ST even though my doctor had already said I would be on BiPAP ST & the titration was for BiPAP ST specifically. Just because a doctor says you need something doesn't make it medically necessary- they have to have data to prove it is.