CPAP vs. BiPAP

[Pene_Sleep]

Hi All,

My husband was diagnosed with sleep apnea years ago. He was given a BiPAP machine (Philips respironics system one bipap with humidifier) and used it for years. Well it finally died last year and could not be repaired. His doctor wrote him a script for a new machine and the cost startled us. Our insurance has a high deductible so we would basically be paying for this machine 100% out of pocket which we can't do at this time. He is trying to follow up with his doctor about the possibility of getting a cpap vs. a bipap due to cost but I wanted to hear from others if you've had an experience with this and what would cause the need for one over the other. His numbers in 2010 were 16/12. Anyone have a bipap recommended but used a cpap instead?

[greatunclebill]

BPAP and CPAP are designed to fix different kinds of apneas. I believe BPAP can be used for CPAP but not the other way around. Tell the doctor you can't afford it, he may know of local places that give away donated machines.

[Julie]

Try secondwindcpap.com - they're great to deal with, very reliable and their (rehab'd) machines are always good. And yes, there are reasons for bipap vs cpap, but you might now want to look into whether he still needs the bipap - possibly a new home (vs lab) study might help.

[MrsRinPDX]

My understanding is that BiPAP users have a difficult time tolerating the straight pressure of a CPAP machine on exhaling. The BiPAP adjusts the pressure downward.

[Julie]

No, you're confusing exhale pressure relief (or Cflex) with Bipap... not the same thing. Bipap is for those who need higher than normal pressures (over 20).

[MrsRinPDX]

No, you're confusing exhale pressure relief (or Cflex) with Bipap... not the same thing. Bipap is for those who need higher than normal pressures (over 20).

Not true, my pressures are not over 20. I use a BiPAP.

[Julie]

I meant they are usually very high compared to the majority.... what are yours?

[MrsRinPDX]

I meant they are usually very high compared to the majority.... what are yours?

Correct me if I am wrong, but I believe C-flex is limited to a range of three. BiPAP is not. My inhaling pressure is 18; exhaling 14. The spread is greater than a CPAP can handle, thus, I have a BiPAP machine.

[Julie]

Yes, but you're still mixing up features. Your min. pressure IS high (as predicted, ahem) at 18.

Now, C-flex, A-flex and EPR (exhale p. relief) are separate optional features that lessen pressure when exhaling at ANY pressure on most machines because some people have difficulty doing that. None of those has ANY bearing on whether or not you use a Cpap, Apap, Bipap, ASV, machine. Different things entirely.

[TedVPAP]

Hi All,

My husband was diagnosed with sleep apnea years ago. He was given a BiPAP machine (Philips respironics system one bipap with humidifier) and used it for years. Well it finally died last year and could not be repaired. His doctor wrote him a script for a new machine and the cost startled us. Our insurance has a high deductible so we would basically be paying for this machine 100% out of pocket which we can't do at this time. He is trying to follow up with his doctor about the possibility of getting a cpap vs. a bipap due to cost but I wanted to hear from others if you've had an experience with this and what would cause the need for one over the other. His numbers in 2010 were 16/12. Anyone have a bipap recommended but used a cpap instead?

Without knowing more info, it is very possible that a CPAP will serve just fine. Modern CPAP machine allow the exhalation pressure to be lower than the inhalation pressure, but it is not as flexible. Bi-level machines also enable higher pressures and can help when there is significant Central Apnea problems.

Most modern CPAP machines can not deliver 16/12 but it can deliver 16/16-13.
Often when a patient requires inhalation pressures of 16 or more, the prescription will be for a bilevel machine which enables the exhalation pressure to be lower than IPAP by more than 3. I was prescribed bi-level 19/15 which I used for 8 years until it broke. I replaced it out of pocket with a new Auto-PAP ($450) and my AHI is low. The auto allows you to set a range of EPAP (mine is set from 16 to 20). I set the exhalation to be 2 lower. I could set it up to 3 lower but I don't. The auto machine adjusts inhalation pressure (IPAP) based on the settings and what it thinks you need and the EPAP follows based on the delta.

[chunkyfrog]

I meant they are usually very high compared to the majority.... what are yours?

Correct me if I am wrong, but I believe C-flex is limited to a range of three. BiPAP is not. My inhaling pressure is 18; exhaling 14. The spread is greater than a CPAP can handle, thus, I have a BiPAP machine.

You are right--you know YOUR machine.
Julie uses a regular cpap (same as my backup)
The OP's hubby needs a bilevel machine, as per the prescription.
I would not risk using a lower level machine.
I have noticed that Intellipap has a bilevel machine;
which you might want to check into.
If open box or lightly used is OK, Secondwindcpap.com might be your answer.

[Julie]

Well, to be picky, it's a regular Apap. but I know what you meant .

[palerider]

My understanding is that BiPAP users have a difficult time tolerating the straight pressure of a CPAP machine on exhaling. The BiPAP adjusts the pressure downward.

And much, MUCH more than that.

[Pene_Sleep]

Thank you everyone for your input! Also thanks for the recommendation for secondwindcpap.com. After reviewing it last night I think we found a bipap machine we can afford! He's excited and I'm happy that we can both get sleep again LOL. I appreciate the help!

[Matt00926]

I have a ResMed AirCurve 10S (regular bi-level with set IPAP/EPAP pressures, there is nothing automatic about it) that you can have for real cheap. I bought it from secondwindcpap and barely ever used it. Send me a PM if you're interested.