CPAP/APAP

[Sleepqueen]

I agreed to try the bipap and am picking up the machine tomorrow to test it out. I am not feeling optimistic as from what I've read bipap doesn't seem like the right fit for me. I have mild apnea, mostly hypopneas. My pressure is low and I don't have trouble exhaling against. So I'm not sure why bipap is the next option. Especially when I told them how great I felt with the auto machine. If it doesn't work I'd really like to pursue the auto option but I wouldn't even know where to start. I really don't want to have to start this process over with a new provider. Ugh.

[Pugsy]

Geez.....BiPaps cost more than apaps but they (the greedy DME) gets to charge the insurance more and get more money that way because they use a different HCPCS billing code.
With the APAP....they get the same reimbursement rate for the CPAP because cpap and apap machines use the same HCPCS billing code which is E0601.

Your AirSense 10 CPAP will give you an AHI though...it's not a total brick...but what I call a half assed brick. It won't work with SleepyHead because SleepyHead needs other data files that the "CPAP" model doesn't gather. All you get is a generic AHI with no event category breakdown and no way to see if maybe you are having clusters of events.

Nice thing about the BiPap though...they don't make bipap bricks. They are all full data.
Oh..BTW...BiPap is actually the marketing term for Respironics bilevel pressure machines....ResMed calls them something else but they function the same with bilevel pressures. The actual term is "bilevel" but we have come to sort of use Respironics marketing term generically.

Wanna bet they give you a fixed bilevel machine and not the auto adjusting equivalent to the apap mode???? Guess why? Because the auto model costs more (just like the apap) and they get paid the same...by the billing code....E0470 is for bilevel without backup rate which you don't likely need....so pretty much a glorified cpap/apap.

[Sleepqueen]

Geez.....BiPaps cost more than apaps but they (the greedy DME) gets to charge the insurance more and get more money that way because they use a different HCPCS billing code.
With the APAP....they get the same reimbursement rate for the CPAP because cpap and apap machines use the same HCPCS billing code which is E0601.

Your AirSense 10 CPAP will give you an AHI though...it's not a total brick...but what I call a half assed brick. It won't work with SleepyHead because SleepyHead needs other data files that the "CPAP" model doesn't gather. All you get is a generic AHI with no event category breakdown and no way to see if maybe you are having clusters of events.

Nice thing about the BiPap though...they don't make bipap bricks. They are all full data.
Oh..BTW...BiPap is actually the marketing term for Respironics bilevel pressure machines....ResMed calls them something else but they function the same with bilevel pressures. The actual term is "bilevel" but we have come to sort of use Respironics marketing term generically.

Wanna bet they give you a fixed bilevel machine and not the auto adjusting equivalent to the apap mode???? Guess why? Because the auto model costs more (just like the apap) and they get paid the same...by the billing code....E0470 is for bilevel without backup rate which you don't likely need....so pretty much a glorified cpap/apap.

Wow. Well, thank you for the information. I figured I would try the Bipap machine to say I did so but if it doesn't work I am going to push for the auto.

[Sleepqueen]

Can the Resmed Airsense 10 auto also be set to a straight CPAP if needed?

[zoocrewphoto]

Can the Resmed Airsense 10 auto also be set to a straight CPAP if needed?

Yes. Any auto machine can be set to straight cpap.

[Pugsy]

Even the bipap you will be trying could be set to cpap mode if needed.

When you get the bipap come back with the exact full model name (or number) and let's see just what machine they give you.
Maybe you will get lucky and it will be an auto and if need be we can tweak some settings so that the bipap works exactly like the apap worked if that's what you end up wanting.
We can make the bipap do what the apap did as long as you have the auto adjusting mode available on the bipap.
Several ways to skin a cat as we used to say here in the hills where I live.

The bilevel machines are nice. Even with lower pressure needs it's nice to have that difference between inhale and exhale that bilevel offers. First time I got a chance to try a bilevel (and it was a fixed bilevel at that) I think it took me about 30 seconds to say to myself "you gotta get one of these things for yourself". My pressure needs weren't horribly high either and I was doing okay on the apap but it was nice to have the bilevel way of doing things. I really liked it...icing on the cake. Hurts nothing to have a little extra unless a person is one of a very small minority who has a problem with bilevel. Cross that bridge if/when we come to it.

[Pugsy]

how is a fixed bipap any different than a cpap with relief for exhale

as far as i could tell my bipap was a dumb machine that did nothing a cpap with EPR would not do

EPR exhale relief is limited to 3 cm.
Bilevel machines obviously can go much higher if needed for some reason than the 3 cm difference between inhale and exhale that EPR (Resmed) offers.
Flex relief from Respironics machines is limited to 2 cm even at the highest setting of 3 and that's only if a person breathes forcefully since the relief is flow based.

Bilevel machine can go to 25 cm if needed....cpaps/apaps are limited to 20 cm max.
Obviously not an issue with the OP here but could be a factor with someone else when 20 cm doesn't get the job done....not to mention the comfort aspect of exhaling against pressures in the upper teens.

I have used EPR at 3 in cpap mode...and I have used PS at 4 and 5 on bilevel and the difference in how it feels between each setting was remarkable. Now not everyone likes that difference but most will.

So while not hugely different the bilevel (even a fixed bilevel) has a bit more to offer than cpap/apap using available exhale relief.

And while I do prefer auto adjusting anything...sometimes we don't get what we want and have to make do if at all possible and in some situations it isn't all that difficult. I have both the ResMed S9 Adapt and an AirCurve 10 ST (fixed bilevel with back up rate available but not used). So I have both auto adjusting and fixed available. I prefer auto adjusting but I am able to be just as successful with the fixed bilevel of the AirCurve 10 ST. As to why did I get the AirCurve fixed bilevel when I prefer auto adjusting....it was cheap and I knew I could make it work and I wanted to test out the new AirCurve model line. It was used and cheap and no one wanted it and the person selling it wanted it gone because her husband (who was the user) had passed away.

I have no idea what you tried in terms of a bilevel device or why it failed. Could be any number of things. Would have been nice if maybe you had been here on the forum to share the reports before you shipped it back. All current models of bilevel devices are full data...no longer have to worry about bricks in the bilevel models like we used to.
Your history again really has no bearing in this particular thread. Maybe it would be better if you consolidated your history into a thread of your own and not continually muddying up threads with your stuff that really has no bearing on the thread originally started by someone else.
If you want to help people...help them with their stated problem and not go off on a tangent about your problems. They really don't care what your problems are...they just want their problem fixed.

[palerider]

how is a fixed bipap any different than a cpap with relief for exhale

as far as i could tell my bipap was a dumb machine that did nothing a cpap with EPR would not do

at least he's willing to occasionally *admit* to his colossal ignorance.

[ajack]

again, you want an automatic adjustment with the bilevel / bipap

[Sleepqueen]

The trial machine they gave me is an Aircurve 10 VAuto.

[Pugsy]

The trial machine they gave me is an Aircurve 10 VAuto.

Ahhh....Sweet machine. Keep it if you can. Full data and pretty much the cream of the crop IMHO when it comes to bilevel machines without back up rates. I have owned the slightly older prior version of that same machine by ResMed which was called the S9 VPAP Auto....it's like having 4 machines in one...
It has fixed cpap (single pressure) mode available.
It has fixed bilevel mode available.
It has auto adjusting bilevel mode available.
and as a 4 th option we could do some tweaking and make it function like an auto adjusting single pressure machine (apap). It's not an official mode but all it takes is a bit of tweaking to get it to work like apap but you might really like bilevel.

[Sleepqueen]

The trial machine they gave me is an Aircurve 10 VAuto.

Ahhh....Sweet machine. Keep it if you can. Full data and pretty much the cream of the crop IMHO when it comes to bilevel machines without back up rates. I have owned the slightly older prior version of that same machine by ResMed which was called the S9 VPAP Auto....it's like having 4 machines in one...
It has fixed cpap (single pressure) mode available.
It has fixed bilevel mode available.
It has auto adjusting bilevel mode available.
and as a 4 th option we could do some tweaking and make it function like an auto adjusting single pressure machine (apap). It's not an official mode but all it takes is a bit of tweaking to get it to work like apap but you might really like bilevel.

Well this is good news! We'll see how it goes. After doing more research on BIPAP, I still am feeling so silly to now be trialing such an expensive machine (I looked up the price.. wow!!) when I have such a low pressure! My current machine pressure starts at 4 with a high of 6.7. I know everyone's different but I'm still wondering what's up! If it goes well I do worry about getting it approved through insurance.

[silversleeper]

I use the aircurve 10 vauto and it is great. The machine will sense when you are ready to exhale or inhale, its called their easy breath algorithm. Truthfully, I could have probably used an APAP, however the Aircurve is soooo comfortable. Once you get used to it, you will not realize that you are on a machine and will look forward to putting the mask on. It is a more expensive option than an APAP but if you are going to use for five to seven years it is easy to rationalize the expense amortized over the life of the machine. If you have a high pressure requirement some people just cannot exhale. Good Luck!!

[Pugsy]

do you get different ones over there

...

Over where?

No...all AirCurve 10 VAutos are pretty much the same world wide.

Sounds like your DME had it set in fixed mode...maybe even CPAP mode if the PS/EPR was 3. With PS of 3 the bilevel essentially feels like EPR of 3 will feel. That's why we sometimes will call a cpap/apap using EPR of 3 a poor man's bilevel machine.
The VAuto has 3 separate modes available as I mentioned above.
Sounds like your DME either used cpap mode or maybe fixed bilevel mode.

[Sleepqueen]

I did not have good luck with the Bipap last night. It said it was on ramp but it sure did not feel that way. It was on inhale at 8 and exhale at 4. 8 is more than my highest pressure I needed on CPAP. I tried to give it a shot but I felt like I was filling up with air. My stomach and ears were bothering me from this pressure. My mask felt like a balloon filling up with air and the sensation was weird to me. I also felt like it was making me take longer deeper breaths than I usually do. I usually sleep on my back with the CPAP because my mask leaks when I lay on my side. I tried laying on my side which definitely seemed better. I didn't last more than a half hour with the machine and took it off. Not sure what to do now. It said it was on auto mode. Is there a way that the inhale could be lowered by the DME?