I don't think there is any real consistency of opinion on this amongst the sleep profession.
I was first titrated at IPAP 13, EPAP 8 and the script didn't include a number for Pressure Support but my VPAP Auto (bi-level) arrived set at a Pressure Support of 4.
My second bi-level titration ended up w/IPAP at 10, EPAP at 5 and the script included a Pressure Support of 5.
A very good PSGT friend has said that a Pressure Support of 6 has been successful for him and at his sleep lab.
The experienced PAPpers in this forum when offering advice on APAP pressure settings usually recommend 1-2 cms BELOW the titrated pressure and 2-4 cms ABOVE the titrated pressure which would give a pressure range of 4-6.
jnk gave us an EXCELLENT description of how the Pressure Support differs between the Resmed and the Respironics bi-levels and how the settings for the one brand should differ from the settings of the other brand. And dsm added a further way of clarifying the differences.
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(Note, however, just for the record for those doing the math at home, IF it is a ResMed autobilevel set with a minimum EPAP of 6, a maximum IPAP of 19 and a pressure support of 3, the machine would, with those settings, have a full 10 cm of distance to range in--from a low of 6/9 to a high of 16/19.)
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I think you may misunderstand the differences between the two machines and how each machine must be set. They are both good autobilevels, but you can't set either of them up correctly by attempting to use the numbers that were used on the other brand of machine. You have to think about the numbers and translate them for how you want the other brand of machine to run.
As an illustration, think of inhale and exhale as being two dancers. On the Respironics dance floor in the Respironics world, the two dancers dance two different dances without caring what the other dancer is doing. You simply set the size of the dance floor and you tell the dancers the maximum distance they are allowed to get from each other during their separate dances (there is an automatic minimum to keep them from bumping into each other), and they each do their own thing. Sometimes they dance close to each other, and sometimes they dance far apart. That distance varies. On the other hand, on a ResMed dance floor in the ResMed world, the two dancers do the same dance and are always the exact same distance from each other, but they can still roam the full dance floor, as long as they do it together. So if you mistakenly set the fixed distance of the dancers to be the same size as the dance floor, you keep the dancers from moving at all.
In other words, for the Respironics machine, you set the maximum IPAP and minimum EPAP (the size of the dance floor), then you set the MAXIMUM pressure support, or maximum distance allowed between the two separate pressures (dancers). For the ResMed, you similarly set a maximum and minimum (the dance floor), but then you set the ACTUAL pressure support, the fixed distance (or, difference) between inhale pressure and exhale pressure for the night. On that machine, those two pressures increase and decrease TOGETHER, NOT SEPARATELY, moment to moment, during the night (since the two do the same dance together).
It seems that the person who set up your machine didn't understand that difference between the two machines and set up the ResMed as if it were a Respironics. That is incorrect. If you want the ResMed to run as an auto, make sure the pressure support number is a number LESS THAN the distance between Max IPAP and Min EPAP so the dancers have some room to move. If the machine isn't set up correctly, it is the person who set it up who has kept the machine from running as an auto. That is not a limitation of the machine; it is a limitation of the person who set it up. That person was confused. So don't blame ResMed.
As for which approach to autobilevel dancing is best, I don't know. I just know the two approaches are different and that before you set up one brand after using another brand, you had better learn something about dance floors and choreography in the other world and translate from one to the other, if you want to see a dance.
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there is nothing wrong with keeping the dancers pinned, if that's what a person wants to do. Some like the feel of a ResMed autobilevel in auto mode (because of how Easy-Breathe feels) but don't want the pressures to move around at night. So to get straight bilevel while the machine is in VAuto mode, they purposely make the pressures stay the same by setting pressure support the exact distance between Min EPAP and Max IPAP. But if a person wants to use a ResMed autobilevel as an autobilevel, the stick has to be shorter than the walls or the pressures won't vary.
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from dsm
Here are a few words that I hope might (for some) clarify this difference. I am going to add dancing up the floor (higher pressures) & dancing down the floor (lower pressures) ...
The Bipap Auto starts off (no user input can set this ) with a minimum gap of 2 CMs between epap & ipap (lets call this 2 feet between the dancers named ipap & epap ) - as the night progresses, the epap dancer may try to move up the floor because epap feels uncomfortable down the floor thus pushing the partner (called ipap) at least 2 feet ahead any time epap dances up the floor. But ipap may dance up the floor & leave epap behind so the gap may widen beyond 2 feet (but there is that rope tying them together called Max PS (or max feet apart)) - If ipap dances so far from epap that the rope gets tight, ipap will drap epap along up the dance floor providing ipap doesn't hit the wall first in which case ipap can't go any higher up the floor.
Now with the Vpap dance again we have epap & ipap BUT, the rules of the dance are that these two will always stay a preset gap apart (this could be set to 3 CMs or 4 or whatever). There is also the max pressure (or distance up the floor ) that ipap can dance to (before hitting the limit set. Epap may dance up the hall but will always push ipap this preset gap ahead.
For Bipap machines the gap between epap & ipap varies as each pressure gets adjusted Independently (never less than 2 & never greater than PSMax (usually ).
For Vpap machines the gap between epap & ipap gets pre set & stays that way as long as epap can push or pull ipap within the boundaries of their dance area. They always stay the same distance apart vs Bipap where the gap varies depending on how epap & ipap each feel.
I just hope this addition doesn't mangle the whole dance routine
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After all this is said and done - choose your own poison. Good luck!
Slinky