APAP VS BiPap

[BCman]

Is Bipap that much better? Im having extreme problems breathing against my APAP with a flex of 3. My therapist said he couldn't recommend or let me do a trial on Bipap because he needed doctor's approval from a sleep study which I can't get quick enough while I suffer with chest pains, heart palpitations, arrhythmia etc. He also mentioned Bipap only changes exhale pressure by about the same as my flex.

But I looked online and it said:

"With BiPAP, the IPAP setting may range from 4-24 cmH2O, while the EPAP setting may vary from 2-20 cmH2O. Typical initial settings for BiPAP are levels of 8-10 cmH2O IPAP and 2-4 cmH2O EPAP. These settings presume that the lower pressures will allow patient tolerance and training."

https://www.ebmedicine.net/topics.php?p ... eg_id=1094



That seems like a much broader difference in exhale pressure! Is the therapist wrong?

Has anyone switched from a machine with flex to Bipap and noticed a successful change?

*Im also working on getting a Holter Heart Monitor as we speak*

[Pugsy]

He also mentioned Bipap only changes exhale pressure by about the same as my flex.

He lied as you already have discovered.

That seems like a much broader difference in exhale pressure! Is the therapist wrong?

He's either ignorant or just a big liar. Neither of which I would want someone like that to be "helping" me manage my therapy.

The most reduction during exhale that you can get with using AFlex....is 2 cm even at that setting of 3....at that's IF you can breathe forcefully enough to get it since the amount of relief is based on your own breathing force.
From a hard to find Respironics manual.

[BCman]

My god...

I should've bought this machine weeks ago if not months.

[babydinosnoreless]

Lsat has a low hour bilevel for sale, for less than my first machine was with insurance. I got my back up machine from him.

viewtopic/t174009/For-SaleLow-Hour-Air- ... level.html

[BCman]

Talked to my therapist today and he said the Bipap wouldn't help as my air-way would close if I dropped the exhale pressure too much more than the inhale.

He also said Bipap if for people with Higher pressure needs than my own.

Any of that true?

I thought maybe I could rock a 12 inhale and a 7-8 exhale.

Anybody with Bipap experience that can comment on this?

[babydinosnoreless]

I have a bilevel auto. Mine is set for a min of 8 with a max of 24 with a p4 which I believe which gives me that much relief on my exhale no matter how high my pressure actually goes. In fact I rarely reach 20.

[Pugsy]

Where are you located?
And what are the credentials for this "therapist"?
Doctor, nurse, PA, RT...what?

he said the Bipap wouldn't help as my air-way would close if I dropped the exhale pressure too much more than the inhale.

Partly true but easily remedied if that should happen and often the added IPAP above EPAP helps out anyway.

He also said Bipap if for people with Higher pressure needs than my own.

Bullshit.
There are any number of reasons for people needing bilevel. Our forum member RobySue needs it an she uses 4 EPAP (exhale) and 8 IPAP (inhale) with a tight range of it going to a limit of 10 if needed and her insurance paid for it.

[BCman]

Where are you located?
And what are the credentials for this "therapist"?
Doctor, nurse, PA, RT...what?

he said the Bipap wouldn't help as my air-way would close if I dropped the exhale pressure too much more than the inhale.

Partly true but easily remedied if that should happen and often the added IPAP above EPAP helps out anyway.

He also said Bipap if for people with Higher pressure needs than my own.

Bullshit.
There are any number of reasons for people needing bilevel. Our forum member RobySue needs it an she uses 4 EPAP (exhale) and 8 IPAP (inhale) with a tight range of it going to a limit of 10 if needed and her insurance paid for it.

Respiratory Therapist.
He even brought in his manager who "has much more experience with Bi-level" and he agreed as well apparently.
They don't want to do anything until they've had a lab sleep study despite my horrible symptoms. I think its probably just a case of them covering their asses. But I wish they would do it in a way that I could trust them and not assume they have no idea what they're talking about.

Thanks for the info Pugsy.


EDIT: I wish I saw this before talking to him. I thought maybe they were just uninformed about the subject but the freaking corporate website has this which spells out exactly its function. Unbelievable.

[BCman]

I have a bilevel auto. Mine is set for a min of 8 with a max of 24 with a p4 which I believe which gives me that much relief on my exhale no matter how high my pressure actually goes. In fact I rarely reach 20.

Thankyou for the info! I appreciate it.

[Pugsy]

I don't know about Canadian laws as to what leeway these sort of places have in terms of machines, etc.
Instead of trying to feed you a load of BS...wonder if they could have just plainly states what their limitations might be in terms of dispensing machines without sleep studies to back up the need.
Honesty goes a long way in my book. Even if it is "my hands are tied" kind of thing instead of the blatant lies they told.
I don't know if they don't know their butt from a whole in the ground or their hands are tied by whatever medical legal system you all have up there.

I have used various bilevel machines for several years now...it's not rocket science.
There are some fancier high end bilevels for special needs but that's not you are needing or looking at.
You are looking for nothing more than something that will give you more exhale relief than what you are getting with your current machine.
Maybe they don't fully understand plain bilevel and those high end bilevels that do special functions. Pretty sad if that's the case.
Plain bilevel machines are nothing more than cpap/apap machine with more available exhale relief and potentially higher than 20 cm pressures if needed.

Too bad you didn't get a ResMed AirSense 10 AutoSet...it at least offers EPR of a full 3 cm and essentially can function as a bilevel with PS of 3.
It's better than maybe 2 you are getting.