Bpap vs Apap

[plumtuckered]

I have been on a Cpap for 2 months now and my Dr. reviewed the data. He says I am not responding well to Cpap, AHI too high, so he wants to switch me to an Apap/Bpap. Do these machines work similarly? I checked Cpap.com and noticed that the Resmed Bpap is far more expensive than the Apaps.

Also, should my DME take back the Cpap and give me credit or will I be stuck with 2 machines?

Mike

[Pugsy]

Also, should my DME take back the Cpap and give me credit or will I be stuck with 2 machines?

Did you purchase the machine outright or did your DME set up a "rent to own" thing? All depends on your insurance and how the machine was "sold" to you.

[twokatmew]

I just switched from CPAP to auto BiPAP. That is, I switched from the Elite II to the VPAP Auto 25.

I bought my own backup machine (an AutoSet II), and with that I was able to determine my titrated pressure was far below what I really need. I took my data to my first visit with my doc (almost three months after beginning CPAP), and when I described my issues and showed him the data, he ordered a two-week trial using the VPAP Auto 25. Based on the results, he changed my prescription from CPAP to auto BiPAP.

I found that I do better on APAP than CPAP, but I do even better on the VPAP.

I bought the APAP out of pocket, so I will keep it, as it makes a fine backup machine. The Elite II I got from my DME, so they took it back and started billing my insurance for BiPAP instead of CPAP (different insurance codes).

I believe I now start my 13 months' capped rental again, but I'm not sure. By the way, my DME has billed my insurance $120/mo for CPAP and $240/mo for BiPAP. Of course, what the insurance co. authorizes is less, and my co-pay (after my secondary insurance kicks in) is quite small. (Thank goodness!)

I prefer APAP over CPAP, as you have a pressure range instead of one fixed pressure, so the machine can adjust to varying needs. The AutoSet II (like the Elite II) has EPR (exhalation relief), so I maxed that out at 3 full-time. The VPAP Auto 25, however, is an auto BiPAP, so BiPAP gives me two pressures with additional exhalation relief that doesn't suspend during events. The auto BiPAP means I also have a pressure range to accommodate my pressure needs as they change throughout the night.

If your doc switches you from CPAP to APAP, your DME should swap machines (and bill your insurance the same) as long as you are early enough within the rental period. BiPAPs are more expensive, and insurance generally requires additional documentation from your doc, but I'm very glad I switched.

All this said, if you're no longer early enough within the rental period for your DME to make the swap, you might be better off buying a new machine online. It'll be much less expensive that way.

[jweeks]

I have been on a Cpap for 2 months now and my Dr. reviewed the data. He says I am not responding well to Cpap, AHI too high, so he wants to switch me to an Apap/Bpap. Do these machines work similarly? I checked Cpap.com and noticed that the Resmed Bpap is far more expensive than the Apaps.

Mike,

Each of the machine type work differently. A CPAP runs at one single pressure all the time. Some have CFLEX, which can slightly drop the pressure on exhale to make it a bit more comfortable. A BiPAP machines runs at 2 pressure levels, higher for inhale, lower for exhale. There are some conditions where a BiPAP is needed, and it is easier for people at higher pressure levels. An auto machine (APAP) is like CPAP, but the pressure levels can adjust during the night to raise when you are having events, and lower when you are sleeping OK. They are supposed to actively seek out and treat events within limits of the pressure levels. An APAP can have AFLEX to give some exhale relief. There are also auto BiPAP machines where both pressure levels can adjust. I have no clue how VPAP is different. There is no machine type that is better than another--everyone has different requirements, and people respond to different machines in different manners.

-john-

[cflame1]

a VPAP... is Resmed's version of a BiPAP.