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titration study over - Using bipap in interim

Posted: Fri May 19, 2017 12:46 pm
by WillowtheHen
Hello. Just got diagnosed with OSA and finished my titration study - I need a pressure of 11. We have an unused bipap machine so I was wondering if there was any harm in using that in the meantime while I wait for my new machine. I don't know yet whether my doctor will prescribe a cpap or bipap. Is there any concern with using a bipap if I need a cpap? From what I have read it doesn't sound like it but I wanted to ask those who know better.

How do I adjust the pressure on a Philips respironics?

Re: titration study over - Using bipap in interim

Posted: Fri May 19, 2017 1:05 pm
by WillowtheHen
Oooooh I found the secret menu!

These are the current settings:

Mode AutoB
Max Ipap 11
Min Epap 6
Max PS 4.5
Flex Type Bi-Flex
Bi-Flex 2
Ramp time :30
Ramp start 4.0
tubing type off
Tubing type 22
SYSTEM 0
Lock SYSTEM ONE Off
System ONE humification on
Humidifier 3
Auto on - on
Auto off - on
Mask alert - off
Mask fit check - off
Show AHI/Leak/PB on
Split Night off

How does that all look?

Re: titration study over - Using bipap in interim

Posted: Fri May 19, 2017 1:37 pm
by raisedfist
Just put your bi-level in CPAP mode and set the pressure to 11cmh2o and you're done. In bi-level mode you can also just set IPAP/EPAP to the same pressure of 11, but the former makes way more sense.

Re: titration study over - Using bipap in interim

Posted: Sat May 20, 2017 1:43 am
by kteague
I have never been prescribed or titrated on a bi-level but one "fell into my hands" so I tried it and was surprised at how much more natural my breathing felt. I was content with the continuous pressure, but chose to stay with the bi-level due to comfort with my creeping increase in pressure needs to 14. Most time a bi-level isn't prescribed unless there's some extinuating circumstances. Even if you don't need it, doesn't mean you can't use it. Disclaimer: If there's anything out of the ordinary about your condition, ask if there's any reason to not use the bi-level.

Re: titration study over - Using bipap in interim

Posted: Sat May 20, 2017 2:28 am
by Holden4th
While a few people respond better to a straight CPAP pressure setting, APAP or BiPAP can definitely enhance your therapy, as I found out. A few ideas for tweaking your machine.

Set the Max IPAP to 20. If you don't go that high (which you shouldn't) then it doesn't matter as the option is there. Personally I'd raise the min EPAP closer to that 11 you were prescribed (8 or 9 might be good) as it will give the machine less work to do when responding to events. Some would rightly recommend that an EPAP 11 minimum might be a good way to go but if you set it a bit lower you can tweak things from there.

Pressure support will be the interesting setting. I've been running mine with a range of 1 to 5 but reset the PS min to 2.5 which brought about an immediate improvement in my hypopnea and RERA scores. I like the more comfortable way that BiPAP works for me so my APAP machine is now my backup.

Sleep titration tests tend to come up with one treatment number (in your case 11) and unfortunately many DMEs see this as a way to prescribe a straight pressure machine. If this happens to you then either ask for an auto machine or even better, save your money and keep using the BiPAP as it can be set to CPAP, APAP or BiPAP mode.

Finally. I am using Biflex but don't have the faintest idea of what it is doing. If you turn Biflex off then you need to enter a Rise Time setting.