I'm new, and have been told I need a BIPAP machine....

[Rufus]

Hello all,

I had my sleep study, and the doctor's office notified me that the analysis revealed I needed a "BIPAP" machine. There does not seem to be much discussion on this type of machine or what the problems might be requiring this type. In reading, I would assume that it would be the same as a "bilevel."

I have not yet consulted with the sleep study guy, and was wondering if anyone could give me some insight into what questions I should be asking and what brand machine or features would be appropriate. I'm sure he will try and sell something that he handles, and I would like to know what my options are.

Don't know how this is going to work out, because it didn't seem as though I got any sleep during the test.... having to deal with the hose and mask didn't make it easy, but hopefully I will get used to it.

Thanks to any contributors for any insight as to what I might expect.

[Jaylee]

I have a BiPap machine. The pressure is different for inhaling than for exhaling. And my machine can adjust itself to give higher pressure when I require it.

Good luck

[JohnBFisher]

Hello all,

I had my sleep study, and the doctor's office notified me that the analysis revealed I needed a "BIPAP" machine. There does not seem to be much discussion on this type of machine or what the problems might be requiring this type. In reading, I would assume that it would be the same as a "bilevel."

I have not yet consulted with the sleep study guy, and was wondering if anyone could give me some insight into what questions I should be asking and what brand machine or features would be appropriate. I'm sure he will try and sell something that he handles, and I would like to know what my options are.

Don't know how this is going to work out, because it didn't seem as though I got any sleep during the test.... having to deal with the hose and mask didn't make it easy, but hopefully I will get used to it.

Thanks to any contributors for any insight as to what I might expect.

BiPAP is the name that Respironics uses. BiLevel simply means the machine uses two pressure levels. One is for inhalation (a higher pressure), the other is for exhalation (a lower pressure).

I would highly suggest you get a machine that allows you to track how you are doing with your therapy. The number of obstructions they observe. The amount of pressure, etc.

You might want to ask about an Automatic BiLevel machine. That is a machine that automatically adjusts its pressure to meet changes you might need. For example, you might need a higher pressure when you sleep on your back compared to your side. Or you might need more pressure if you had some alcohol, which tends to relax muscles in your throat - which increases the need for pressure to keep your airway open.

You will want to read the Wiki and the posts for new comers. Reading about the experience of others helps make it easier.

And believe it or not, you can get used to sleep with the machine. If you sleep better with it, you will learn to love having it available.

[Slinky]

I use a bi-level. I have a Resmed VPAP Auto. VPAP is Resmed's proprietary name for their bi-levels. Bi-PAP is Respiroonics' proprietary name for their bi-levels. The Resmed VPAP Auto is fully data capable and most of the data is easily available via the LCD screen. The Resmed VPAP Auto 25 is a newer version (July 2008) of my Resmed VPAP Auto.

I also have a Respironics pre-M Series Bi-PAP Auto w/Bi-Flex I purchased as a back up for my Resmed VPAP Auto. The pre-M Series has been replaced by the Respironics M Series Bi-PAP Auto w/Bi-Flex which MAY have a replacement in the new PR SystemOne series. I get good therapy w/my pre-M Series BiPAP Auto but the amount of data via the LCD is limited and not as easily accessible as w/my Resmed and I prefer my Resmed for that reason plus I find the Resmeds easier to assemble and disassemble when traveling.

Be aware of regardless of what your sleep doctor says SOME insurance companies insist that you try and "fail" CPAP therapy before they will pay for a bi-level as bi-levels are considerably more expensive than a CPAP or APAP.

[secret agent girl]

.

[Rufus]

I'm curious, what information - from the sleep study or other source - indicates that a Bi-PAP is the better choice?

I haven't received any real info yet. I just called the Doctor's office who set up the referral asking about the prescription and all the nurse said that the sleep study place said the prescription was for a BIPAP machine, and that they (test place)would be contacting me. I don't think the sleep place knows much more than how to conduct the tests and sell equipment. They send the test info out of their office for diagnosis.

Anyway, I feel I will have to contact them as they have not been particularly responsive so far, and I'm not in any hurry as I want to learn a little more about what I am dealing with.

[LinkC]

I'm curious, what information - from the sleep study or other source - indicates that a Bi-PAP is the better choice?

It's my understanding that if you need a pressure greater than 20cm, Bi-level is the choice. That way you aren't trying to exhale against a hurricane, but still get the higher pressure to keep the airway open.

[DreamOn]

I'm not in any hurry as I want to learn a little more about what I am dealing with.

That is an excellent approach, and you're definitely in the right place here for information and support!!! Knowledge is power, and it helps to be empowered.

I don't use a Bi-PAP machine myself, but quite a few people on this forum do. You're getting very helpful responses already. I just wanted to welcome you to the forum, Rufus!

~ DreamOn

[ozij]

A bi-level machine can supply higher pressures than other machines, as LinkC says - so anything above 20 -- and it's a bi-level Rx.

A bi-level may be prescribed the minute you need a pressure higher than 15, simply becase that's where insurance draws the line.

And a bi-level my be prescribed if it turns out you have major problem exhaling against any pressure you need.

Bi-level's are better for people with lung disease.

O.

[LinkC]

A bi-level may be prescribed the minute you need a pressure higher than 15, simply becase that's where insurance draws the line.

Cool! I did not know that. I was prescribed at 16...hopefully I'll never NEED BiPAP, but it's nice to learn something new.

[timbalionguy]

Bilevel machines may also be prescribed when you have a problem with 'central apneas'-- apneas where your brain doesn't trigger breaths vs the much more typical obstructive apneas, where collapsing tissues in your throat restrict breathing. Usually, both types of apneas are present. Some people also tend to develop central apneas when they are on CPAP therapy. (Evenryone has occasional central apneas, but not at a level where treatment is needed) The fact that your doctor prescribed a bilevel machine right away suggests that you either had notable problems with central apneas during your sleep study and/or significant problems breathing against the machine as mentioned by others.

Do the research, but take a look at all the different kinds of bilevels available. The autoadjusting machines that have been suggested are good choices. But it is also possible that your doctor might prescribe one of the more advanced machines, like an automatic servo ventilator (SV) class machine.

In any case, you have come to the right place to learn, and is you have something more than basic OSA, you have a lot to learn!

[JohnBFisher]

Bilevel machines may also be prescribed when you have a problem with 'central apneas'-- apneas where your brain doesn't trigger breaths vs the much more typical obstructive apneas, where collapsing tissues in your throat restrict breathing. ...

You might also receive a BiLevel machine if your sleep study records events of spontaneous arousals throughout the night on CPAP. Then if the sleep technican switches to BiLevel to try to reduce those, and it works, you might be switched to BiLevel.

That's what happened to me many years ago. The sleep technician noted that I would jump from deeper levels to sleep to lighter levels of sleep - without any apneas or hypopneas. They would probably now call it Respiratory Effort Related Arousals (RERAs). So, he switched me to BiLevel and titrated me for that. The sleep study CLEARLY showed that I did not tolerate CPAP, so BiLevel was prescribed and I've been using that ever since.

[shambharwani]

I wasn't doing well on a regular CPAP or an APAP - I couldn't breathe out against the pressure, so my doctor suggested I may be better off with a Bilevel. Suprisingly I didn't do well with that either. Finally trying different devices/brands I finally got the one which matched my breathing pattern - Respironics with A-Flex and Auto-Trak. (My pressures too were high >15)

The point I am making is try as many devices as you can, if that facility is available to you.