Instead of an ASV

Still playing insurance games.
After completing a BIPAP Titration one month after completing my ASV titration and Eco Cardio .....

The DME exchanged my Auto CPAP for an Auto BIPAP (both Dreamstations)

BUT the Doctors orders had it set as a straight BIPAP at 16 / 11 ?

Sure feels strange since my CPAP was set 8 /12 with 90% below 11 ! When I tried my new unit, it inflates my mask and fills my lungs on every inhale.. no issue on exhale.


Feels like my progress is backwards. Tonight will be first time on machine I guess time will tell ?

rozenbob wrote:BUT the Doctors orders had it set as a straight BIPAP at 16 / 11?

Sure feels strange since my CPAP was set 12 / 8 with 90% below 11 !

*bilevel* 16/11 is a whole different beast than cpap at 8-12 (it's not correct to write cpap settings as something/something)

bilevel 16/11 means you're getting a pressure of 16 when you inhale, and 11 when you exhale. something that's not possible with cpap.

16 seems and feels High to me since it is a constant pressure on inhale. Also curious why the settings are not taking advantage of the Auto capability on the BIPAP.
On Monday, I will attempt to ask these questions to the Office Nurse.

rozenbob wrote:16 seems and feels High to me since it is a constant pressure on inhale. Also curious why the settings are not taking advantage of the Auto capability on the BIPAP.
On Monday, I will attempt to ask these questions to the Office Nurse.

But it drops to 11 when you exhale and that's the pressure you "feel".

I can feel the 16 "inflating my mask and lungs"

When you were using the APAP with 8 cm minimum that's what you had on inhale...and if you were using Exhale relief then it would have been lower on exhale.
Your maximum setting on the APAP was 12...that you never knew about because it wouldn't go there unless apnea events drove it up...and you would have to be asleep.

BTW...the best way to state apap pressures are x minimum and y maximum...not y/x
Doing it with y/x or x/y is confusing because it looks like bilevel pressures and it wasn't.

So now your exhale is 11 and inhale is 16....that's a big jump and it's going to feel every bit of that big jump. From 8 to 11 isn't so bad but then to go on to 16 is a huge leap.
I have no idea why they chose those settings but I assume there was a reason and as to why they didn't utilize the auto adjusting function...don't know that either except that auto mode isn't always the best mode when pressures are causing the centrals. So maybe that is why.

rozenbob wrote:Still playing insurance games.
After completing a BIPAP Titration one month after completing my ASV titration and Eco Cardio .....

The DME exchanged my Auto CPAP for an Auto BIPAP (both Dreamstations)

BUT the Doctors orders had it set as a straight BIPAP at 16 / 11 ?

Sure feels strange since my CPAP was set 8 /12 with 90% below 11 ! When I tried my new unit, it inflates my mask and fills my lungs on every inhale.. no issue on exhale.


Feels like my progress is backwards. Tonight will be first time on machine I guess time will tell ?

Bob, maybe the bi-level has to be tried and failed before an ASV is approved?