BiPAP better than APAP?

I have been using a BiPAP for over a decade. It's been great! I upgraded my recalled device something or other for an Airsense 10 BiPAP, but used an AutoPAP version for about a week and it was great. I didn't notice when I bought the used Airsense10 that it was only a BiPAP. Still, it worked great. I'm averaging about one AHI with it. My Resmed got recalled and I received the Dreamstation 2 APAP and i'm averaging over 2 AHI's a night. After about a week, I'm noticeably more tired. I would have thought the APAP would be doing a better job. I even adjusted the pressure up to 9, but still below my prescription of 11. The Airsense is set at 8 and doing great. Any ideas why the APAP is not doing as good a job as the BiPAP?

RedSafety wrote: ↑

Tue Mar 05, 2024 12:43 pm

BiPAP better than APAP?

The terms are not mutually exclusive. Bilevel treatment may be auto-titrating just as non-bilevel treatment may be auto-titrating.

ResMed machines are often considered particularly comfortable. Even ResMed non-bilevel CPAPs and APAPs have something that feels and acts quite similarly to the way bilevel feels and acts, since the machines can deliver up to 3cm of EPR.

I previously used autobilevel but now use a non-bilevel ResMed APAP with EPR, and I find it to be virtually as comfortable and effective for me as the autobilevel was. My home-machine-reported AHI is usually less than 1 and almost always less than 2. My O2 also stays sufficient according to my occasional use of a recording pulse-oximeter. So I personally consider that good enough for me so that I do not see a need for me to use autobilevel anymore, myself.

Others need a form of bilevel or autobilevel for good sleep-breathing and O2. And still others find bilevel/autobilevel much more comfortable than non-bilevel forms of PAP. It can be highly individual.

May you find the best form of treatment at the best settings for you.

Using OSCAR for detailed analysis may help you to do that as it has helped many others.

RedSafety wrote: ↑

Tue Mar 05, 2024 12:43 pm

I have been using a BiPAP for over a decade. It's been great! I upgraded my recalled device something or other for an Airsense 10 BiPAP, but used an AutoPAP version for about a week and it was great. I didn't notice when I bought the used Airsense10 that it was only a BiPAP. Still, it worked great. I'm averaging about one AHI with it. My Resmed got recalled and I received the Dreamstation 2 APAP and i'm averaging over 2 AHI's a night. After about a week, I'm noticeably more tired. I would have thought the APAP would be doing a better job. I even adjusted the pressure up to 9, but still below my prescription of 11. The Airsense is set at 8 and doing great. Any ideas why the APAP is not doing as good a job as the BiPAP?

Some confusion... bi-pap is a Respironics trademark for bi-level... Resmed makes bi-level machines called Aircurve, the AC 10 and the (brand new) AC11. Airsense is the single-level line of Resmed. As lazarus noted, the AS line has EPR, exhalatory pressure relief, similar to how a bi-level (or bipap) machine does. 'Only a bipap' is confusing in that the CPAP and APAP machines are significantly less expensive and complex than the bi-level (Bi-PAP(tm)) machines... same exact hardware though.

So we're not sure which Resmed machine you had (that you liked)... but you said it was recalled? Why? Perhaps your provider took it back? Swear at them! There have been issues with the AS11 series but not with the 10 that I know of. I prefer the AS10 and have two of them.

A difference of 1 AHI per night is hardly noticeable... we need to see graphs to see what's really going on. Bi-level machines have three main settings, inhale, exhale, and PS (pressure support). The fact that you're giving us one number (understood as cm H2O pressure) tells me that you may not even be using bi-level or bipap machines.

Big fan of Resmed machines... by all means go back to the other machine if you like it. Please see if you can figure out exactly what your machine models are and what your detailed settings are and get back to us. There are many YouTube videos available showing you how to access the menus and settings of all machines. Download Oscar from www.sleepfiles.com/oscar and use it to read your night's data in hi-res... post a screenshot here and we can make informed guesses as to what's going on. Wear a recording O2 monitor to track your oxygen too. Good luck.