Questions about switching from Bi-PAP to straight C-PAP

[OxyJo]

Hi, Dear Friends on CPAPTalk.com:

It has been almost 2 years since my last posting on this forum. How is everyone? I had my 1st sleep study on Aug. '08, and started my Bi-PAP treatment on Nov. '08 with M-series Bi-PAP Auto + ResMed Mirage Quatrro Full Face Mask. My sleep doctor always considers me as one of his best and most cooperative patients because I always use the bi-PAP machine when I sleep at night. I only missed 7 days for the pass whole year. However, recently I still felt tired during the day, and my noctunal oximetry level dropped to 84 while I am using the machine. So he prescribed me to have the 2nd sleep study, and the result of that is he found out that I am better responding to CPAP instead of Bi-PAP. So yesterday (05/12/10) he had my machine (Resporonics M-Series Bi-PAP Auto) set to straight CPAP mode with the IPAP and EPAP all set to 10 without any auto flex feature (I was on Bi-PAP with IPAP on 18 and EPAP on 9 with Max Gap of 3 and auto flex). Right now I am in the way of adjusting myself to this new setting.

My questions are about this switching from Bi-PAP to straight CPAP:
1. Is Bi-PAP always better than CPAP? I mean, it sounds like Bi-PAP with auto flex has more technological features that may help me get a better sleep. However, the result of my 2nd sleep study seemed suggested the other way. Has anyone has the same experience about being switched from Bi-PAP to CPAP?
2. I have purchased the reading softwware and the professional manual, so I know how to adjust the setting of the machine myself. I wonder whether I can still set my machine back to Bi-PAP with a higher EPAP (above 10) to solve the problem? In order to find out which one is better for me, I am considering purchasing a Noctunal Oximeter with the recording feature so that I can find out and compare the oxigen level of my blood when I am on CPAP vs. Bi-PAP. Any good suggestion about which oximeter?
3. If CPAP is indeed better for me, then should I consider getting a better CPAP machine instead of using my M-series Bi-PAP in the CPAP mode? I am getting a little tired of my M-series machine because it is kind of loud. And it didn't come with auto flex or other feature when set in a straight CPAP mode. Any suggestion about a good and dependible CPAP machine? How about ResMed S9?

Again, thank you all for your help.

[kurth83]

What was your old prescription?

[Big Daddy RRT,RPSGT]

BiPAP is annoying to me but many others prefer it. You should still be able to use the flex, I think. A BiPAP set with the I and E the same is a CPAP. I can't think of an advantage to getting a straight CPAP, Can anyone else?

The S9 is quiet and awesome especially with the heated tubing.

[dsm]

Just a few thoughts on this ...

The Bipap with its two levels of pressure is often very helpful to people who are mouth-breathers as cpap for them can be a cause of excess aerophagia. That has all its own problems let alone the issue of OSA. In some respects bilevel is an ultimate form of exhalation relief.

But, even 2 pressures can create other problems.

The down side of an incorrectly tuned bilevel can be excessive centrals (what can become Complex Sleep Apnea or CompSA). One cause for this is that two pressures when inadequately applied to some people, cause a CO2 imbalance that then creates instability in respiration that can trigger hyper-ventilation and or hypo-ventilation. Hyper-ventilation is one of the body's ways of clearing out high levels of CO2 in the blood. Hypo-ventilation is when the body slows or stops breathing because too much CO2 has been expelled. At worst, the body can get into a cycle flip-flopping between hyper & hypo ventilation but that is the exception rather than the rule. That is a form of Periodic breathing.

Straight Cpap has always been the gold standard for OSA therapy.

Going to an S9 will offer you a very quiet machine (so quiet you will at 1st wonder if it is even on). It will also (as will the newer Respironics models) give you lots of useful data about your respiration if you are into looking at the data.

Both Respironics and Resmed machines offer good and effective exhalation relief.

Good luck

DSM

[OxyJo]

To KRUTH83:
My oldest prescription is Bi-PAP IPAP = 12, EPAP = 7, Diff = 3 w/ Auto Flex, and it has been changed several times by my doctor to IPAP =18, EPAP= 7, Diff = 3 w/ Auto Flex.


To DSM:
So how can I find out that my Bi-PAP setting makes me into a CompSA situation? Can it be revealed from the noctunal oximetry reading? My sleep doctor told me that after a couple weeks of trying, if I didn't feel improved, or if it is getting even worse, then just give him a call. So I think right now I have to keep trying this new setting to see whether it makes any improvement.

After 2 nights of trying, I found out that the straight CPAP did make me feel more uncomfortable when exhaling. So later if I need to stay with CPAP, I will probably get myself a good CPAP machine like S9. The only drawback of this is that I have to wait for 3 more years to get a new machine with its expense 50% covered by my health insurance.

[Big Daddy RRT,RPSGT]

Complex sleep apnea is having more respiratory events with pap than without, often central apneas.

Needing BiPAP to adjust to pap therapy and then later being more comfortable on CPAP is more common than you might think.

[SuperGeeky]

BigDaddy said

Needing BiPAP to adjust to pap therapy and then later being more comfortable on CPAP is more common than you might think.

That's exactly my case! I've been on a CPAP this past week after being on BiPap for two years. I can't believe the progress I'm making. I've begun walking three miles every day. Thinking clearly, getting things done. Better yet, six days with no apnea. Wonderful!

DSM, thanks for the excellent description of the Central Apnea I suffered under the BiPAP. I felt worse than ever in my life. Fortunately, I had enough sense to get a Sleep Study and it was quickly solved. Though, I think I'll look into getting an S9 to replace the Bipap as well.

Very affirming, thanks everyone


SG

[DoriC]

To KRUTH83:
My oldest prescription is Bi-PAP IPAP = 12, EPAP = 7, Diff = 3 w/ Auto Flex, and it has been changed several times by my doctor to IPAP =18, EPAP= 7, Diff = 3 w/ Auto Flex.


.

After 2 nights of trying, I found out that the straight CPAP did make me feel more uncomfortable when exhaling. .

I'm not familiar with your machine but can't you use Flex in straight Cpap for exhale relief?