BIPAP vs CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
joeljjk11
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BIPAP vs CPAP

Post by joeljjk11 » Mon Jun 29, 2015 10:58 am

Hi everyone - so I am having trouble getting my AHI to a reasonable level with my machine. At my last sleep doctor appointment she mentioned I may have to switch to a different machine, which I would assume would be a BIPAP.

I don't know anything about them, what are the advantages to them? Are they simply for people who require a higher pressure? I am currently on min of 17 and max of 20 and am still having high numbers. Would a BIPAP be the best solution for me?

Joel

popcpoo
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Re: BIPAP vs CPAP

Post by popcpoo » Mon Jun 29, 2015 3:59 pm

Bipap machines provide a lower pressure during the exhale portion of the breathing cycle. With the higher pressures, some people find it hard to exhale against the higher pressures.

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Krelvin
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Re: BIPAP vs CPAP

Post by Krelvin » Mon Jun 29, 2015 4:42 pm

joeljjk11 wrote:I am currently on min of 17 and max of 20
I'm sure it would help. Not sure what the protocol is though.

My initial RX years ago was for 20/27. There was no question about using a Bilevel then. At the time even normal machines didn't go that high so I got cranky ST unit until I got the level reduced to 16/20 three weeks later and got a normal Bilevel which I used several years after then, which is lower than your current pressures.
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JDS74
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Re: BIPAP vs CPAP

Post by JDS74 » Mon Jun 29, 2015 5:28 pm

With your pressure numbers, I'm surprised that they didn't start you on a BiPap right from the beginning. Straight CPAP only goes to 20 cmH2O leaving you no headroom to increase pressure. BiPap machines can go to 25 while still allowing the exhale pressure to be lower in line with your 17 from the sleep study.

I am assuming that you are not having any central apnea issues that would require a still different machine.

Get a copy of your sleep study reports and see what they say.

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Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
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joeljjk11
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Re: BIPAP vs CPAP

Post by joeljjk11 » Mon Jun 29, 2015 7:25 pm

My doctor prescribed me min 10 and max 19. I was not having good luck with this and my numbers were pretty high. I asked for help on the forum and recently I've been doing 17 min and max 20. Last night my AHI was 7.7, this still seems high.

JDS74
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Re: BIPAP vs CPAP

Post by JDS74 » Mon Jun 29, 2015 7:30 pm

It is. Do you or can you get your own reports to see what the makeup of the 7.7 AHI is?

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
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joeljjk11
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Re: BIPAP vs CPAP

Post by joeljjk11 » Tue Jun 30, 2015 6:09 am

It is always Obstructive.

JDS74
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Re: BIPAP vs CPAP

Post by JDS74 » Tue Jun 30, 2015 6:36 am

For plain vanilla obstructive sleep apnea, 7.7 events per hour is high. It is in the mild sleep apnea range and would be justification for prescribing a CPAP machine. You already are on a machine and the implication is that your pressures are not providing you with a correct therapeutic level of treatment. The switch to a different machine would likely be to a BiPap as it can provide pressures above 20 cmH2O that is the top pressure your machine can provide. Since you are on an auto machine now, it would make sense to move to an auto BiPap machine instead of a fixed bi-level one. The reimbursement code is the same and the cost to you will be the same but the functionality will be better.

Until that happens, you might try setting your machine to a single pressure of 20 cmH2O by making the range 20/20 instead of 17/20 as it is now set. Then you can see if there is any improvement.

As always, check with you doctor before changing the pressures so the both of you are on the same page.

It will also be helpful if you could use the User Control Panel to post your equipment profile (using text mode). That way, folks who are using exactly the same equipment can chime in.

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

joeljjk11
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Re: BIPAP vs CPAP

Post by joeljjk11 » Tue Jun 30, 2015 6:48 am

Thanks. I will try this.

Last night was a bad night as my AHI was 10.9. I will try straight 20/20 tonight.

Joel

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Susie Kay
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Re: BIPAP vs CPAP

Post by Susie Kay » Tue Jun 30, 2015 9:21 am

JDS74 wrote:For plain vanilla obstructive sleep apnea
I don't think his obstructive sleep apnea should be called "plain vanilla".

His apnea is caused by a drug he is taking - see his earlier thread.

JDS74
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Re: BIPAP vs CPAP

Post by JDS74 » Tue Jun 30, 2015 5:08 pm

Susie Kay,

I just reviewed his prior thread about untreatable OSA.
It's clear that his issues are complicated.
That said, I did not say anything in my post about the nature of his OSA. Rather, the statement you quoted was a generalization about the reported AHI level that was described as all obstructive.

It is still true that for anyone with "plain vanilla" OSA, an AHI level of 7.7 untreated qualifies for a cpap machine.
For the OP, having this level with treatment calls for changing his therapy in some manner. His doctor seems to be suggesting a BiPap machine which may allow a higher pressure to deal with whatever is the underlying problem that may actually be the medication Saphis.

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

joeljjk11
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Re: BIPAP vs CPAP

Post by joeljjk11 » Fri Jul 03, 2015 2:19 pm

Good news! I switched my pressure to 20/20 and my AHI was 4.6 last night. This is the lowest I have ever had in my treatment and I am pretty excited about this! The only thing is that the mask leakage was very high, I will have to tighten my F10 a bit more I think.

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ChicagoGranny
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Re: BIPAP vs CPAP

Post by ChicagoGranny » Fri Jul 03, 2015 2:42 pm

joeljjk11 wrote:the mask leakage was very high
Numbers (l/min) please!

joeljjk11
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Re: BIPAP vs CPAP

Post by joeljjk11 » Fri Jul 03, 2015 2:51 pm

According to the MyAir site it was about 17 or 18.

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ChicagoGranny
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Re: BIPAP vs CPAP

Post by ChicagoGranny » Fri Jul 03, 2015 4:00 pm

joeljjk11 wrote:According to the MyAir site it was about 17 or 18.
If that is all it was, it is not high - many think anything below 25 and the machine is still able to prevent events.

The problem with myAir data is that is an average. So it could have been, for example, you ran at zero leak much of the night and say 75 (High!) for part of the night.

Have you considered using Sleepyhead software so that you can see the detail of what is happening at night? (See Pugsy's tutorial at top of the index page.)
joeljjk11 wrote: I will have to tighten my F10 a bit more I think.
That mask is designed to be worn loosely and "float" on the face. Be careful about overtightening.

Several members have reported improved results/less leaks when using a mask liner with that mask - http://www.padacheek.com/PACAirFitSeries.html