Going from CPAP to BIPAP tomorrow - Help!

galilee416 · Post by **galilee416** » Sun Apr 03, 2005 6:35 pm

Hi! I just found this site and I am so excited. I am not the normal CPAP user. I am a 30 year old male. 5ft 9in and weigh 180lbs. Ok - I have been on the CPAP for about a year and a 1/2. When I started my pressure was on 4. About 6 months later I went to 7. I gradually got to the point where it felt like I had nothing on. I would wake up with blurred vision and a monster headache. I got the pressure put to 9 about 3 weeks ago. First night I slept like a brick. Ever since then it's down hilll again. My doctor wanted to send me for a 3rd study, (for narcalepsy) I persuaded him to let me try a bipap because I felt trouble exhaling. I have had the nose mask, full face, and have settled on the pillows (I feel comfortable with them.). I do have to use a chin strap b/c I am a mouth breather. I am excited about getting the bipap tomorrow b/c I think I might actually awake rested on Tuesday AM. But, I also don't want to get my hopes up. What kind of experiences have you guys had?

LDuyer · Post by **LDuyer** » Sun Apr 03, 2005 6:46 pm

Hi,

Welcome!
I look forward to hearing how you do with your bipap.
I have a bipap, which I've been using since November. I have it for slightly different reasons, because I have hypoventilation. I have a high pressure on my bipap, and that makes it kind of a struggle for me. So, I'm hoping to hear good news for you. Let us know how it goes!

Linda

Mikesus · Post by **Mikesus** » Sun Apr 03, 2005 7:02 pm

Ok, first thing you need to do is NOT get a BIPAP for comfort.

I asked the question at the ASAA lecture regarding the use of BIPAP for comfort.

the answer was, as far as he is concerned, BIPAP should NEVER be used for comfort/compliance. There are 2 CPAP machines that have a feature that makes exhalation easier. (he was referring to Cflex and SoftX) The problem with BIPAP (or more correctly Bilevel) is that it is really a tool to augment breathing, not to treat apnea.

My suggestion is to ask specifically about Cflex, (click the word cflex and print the documentation) take the documentation to him and ask if you could get a machine with Cflex. Additionally, if he is concerned about comfort, then you also should suggest an auto titrating CPAP.

MartiniLover · Post by **MartiniLover** » Sun Apr 03, 2005 9:33 pm

I used a Cpap for 3 months and Dr moved me to BiPap because I was struggling.

I went from 9 to 13/9 and I like it a lot better. I awake and can not even tell I have a machine on, unless I open my mouth and then I can tell.

My usage went up from 3-4 hours per night to over 8 per night. I avg 8.2 per night on this machine.

Hope your change make it ok for you.

rested gal · Post by **rested gal** » Sun Apr 03, 2005 10:30 pm

Mikesus, I'm really surprised that the lecturer (Dr. Rappaport?) made a statement like that. Did he say these exact words..."The problem with BIPAP (or more correctly Bilevel) is that it is really a tool to augment breathing, not to treat apnea."??

I've never used a bi-level machine myself. I'm a big, BIG fan of autopaps for most situations. Nor am I a doctor. I personally think that given the number of times galilee416's pressure has been changed, and the pressure he's presently prescribed, he'd be better off with an autopap - specifically the Respironics REMstar with C-Flex (with the c-flex set at "3" for greatest exhalation relief) and heated humidifier - and the autopap set for a range of 7 - 14. Just my opinion.

But back to the ASAA lecturer's comment... really surprises me. Seems that there are many people on this board and other message boards using bi-level machines for a degree of comfort that they really have to have to be able to stick with this kind of treatment. Did the lecturer qualify his remark with anything about people who are prescribed high pressures? I know from experimenting with my auto that C-Flex doesn't make an appreciable dent at all in very high pressure.

galilee416 · Post by **galilee416** » Mon Apr 04, 2005 1:59 am

Wow. Now I am freaked out. Hope I didn't suggest the wrong thing to my dr. So what really is the difference between a CFlex and Bi-pap? They pretty much sound like the same thing?

LDuyer · Post by **LDuyer** » Mon Apr 04, 2005 2:44 am

galilee416 wrote:Wow. Now I am freaked out. Hope I didn't suggest the wrong thing to my dr. So what really is the difference between a CFlex and Bi-pap? They pretty much sound like the same thing?

Hopefully someone knowlegable (like Mikesus or Rested Gal) will chime in early and explain it, because I certainly can't, and I have the bipap. Sorry. I know you were hoping for a quick answer.

Everyone tries to explain it to me and just when I think I'm about to understand it, I get a brain freeze. People tell me the bipap is more like a ventilator to help you breath, but aren't all the types of cpap machines? They say the C-flex is the reduction of the exhalation pressure to aid in comfort, which is in the bipap and most autos. But I still get confused by the bi-level stuff, for like you, I thought that was the same thing. So I hope you get a sensible explanation, then you can explain it to me. Again, sorry. If you don't get a suitable answer here in time, be sure to ask your questions to the doctor or DME.

Linda

Mikesus · Post by **Mikesus** » Mon Apr 04, 2005 5:11 am

RG- Yes he did. I will transcribe that part of the Q/A.

Paraphrased he said that it in his opinion doesn't have a place in treatment for OSA. Other breathing disorders yes, but not for comfort/compliance.

Mikesus · Post by **Mikesus** » Mon Apr 04, 2005 5:35 am

OK, I have just the two questions that I asked regarding autotitration and BiPAP on my server. It might not stream correctly as the server is fairly low bandwidth so if it doesn't stream well, hit the pause button and wait a bit, it should buffer and then allow uninterupted playback.

Link Here

Joe A · Post by **Joe A** » Tue Apr 05, 2005 4:21 pm

The sleep lab that I use, prescribes Bi-Level devices for anyone whos pressure is above 12 or 13. There rationale is...

Pressures greater than 12 are difficult to exhale against so compliance is comprimised.

The average pressure is lower, reducing the risk of inducing centrals or Aeophagia.

Bi-Level is used to treat mixed OSA/Centrals. If Centrals show up on a sleep study even infrequently, it is just cause for a Bi-Level Prescription.

My top # is 16CM and I am a bi-level user. I need 16CM to keep my airway splinted. I Tried setting my old machine to CPAP@16....it sucks! It wakes me up 5-6 times a night!

It's all about compliance once the machine is setup correctly. The best equiptment or most accurate titration does you no good if you can't keep the stuff on your face and sleep!

GALALEE: =IF YOU DON'T GET A RESPIRONICS MACHINE...MAKE SURE THE MACHINE IS SYNCHRONIZED WITH YOUR BREATHING OR YOU WON'T GET PROPETR TREATMENT! Look for my thread on BiLevel Success and How I got there. Bring this with you when you get your machine! Bi-Level is great when set up correctly!