What kind of Apniac needs a biPap?

[dvejr]

I am a happy CPAP veteran (15 years on the hose). My current machine is an autosetting ResMed. I'm happy with it but have a question about Bi-Level machines:
who needs one? As in, what set of symptoms/problems would point an OSA sufferer to a BiPap rather than a CPAP as a therapeutic?

[jnk...]

The decision to use BPAP should be based on the clinician's judgement and needs of the individual patient. . . . In addition, treatment of other forms of sleep-related breathing disorders associated with hypercapnia . . . may require the use of BPAP. . . . To improve PAP adherence, BPAP has been used as an alternative to CPAP, in part due to issues of patient intolerance of high CPAP settings . . . The historically perceived benefits of BPAP are less likely to be relevant [now] since modified pressure profile technology, which also lowers expiratory pressures, has been integrated into modern PAP devices. --https://aasm.org/clinical-resources/pra ... uidelines/

That last statement hints at how modern ResMed CPAPs and APAPs now have EPR which can deliver a 3cm drop in pressure during exhale that is virtual bilevel of 3cmH2O, almost as comfy as bilevel.

Nice hat!

[dvejr]

Thanks. I wonder why Bi-Levels are thought to be better ventilators for COVID patients? Maybe a weakened patient needs very large difference between a high inhalation pressure and a very low exhalation relief pressure, perhaps even approaching zero?

[chunkyfrog]

$$$$$$$$$$$$$$$$
At least mostly . . .

[Okie bipap]

I have had a bilevel machine from the very start. My initial setting was 20 to 25 cm pressure with 5 cm pressure support. I still use high pressure (19 to 25), but I seldom go over 20 and I have changed my pressure support to 4 cm. My wife was also prescribed a bilevel machine when she first started. Her pressure goes over 20 frequently.

[jnk...]

Thanks. I wonder why Bi-Levels are thought to be better ventilators for COVID patients? Maybe a weakened patient needs very large difference between a high inhalation pressure and a very low exhalation relief pressure, perhaps even approaching zero?

If all someone needs is a little help with work of breathing to lessen issues with hypoxia, bilevel may help. One example is obesity-related hypoventilation. Otherwise, more may be needed.

[ChicagoGranny]

Here is the Philips recommendation on the use of CPAP/BiPAP to assist in the treatment of COVID-19.

https://www.philips.com/a-w/about/news/ ... erapy.html

[Miss Emerita]

I switched from a ResMed Airsense 10 Autoset to a ResMed Aircurve Vauto so that I could use EPR/PS greater than 3. I wanted that additional capacity to address flow limitations, which the Vauto has done pretty successfully at PS of 4.8. The difference allows me to sleep more restfully, despite the increase in CAs. I backed off from PS of 5.0 due to aerophagia, but I may try again in a couple of months, because there's a still a fair amount of mild FL that isn't getting flagged.