bipap vs autoadjusting bipap diff

[rux1960]

what about the difference between bipap bilevels and the autoadjusting bipap? besides the prices? Thank you all who have responded.

[THier]

Lets take me for example,, on a standard BiPAP, my Inh is 14, doesn't change, my exh. is 6 doesn't change,,, NOW with my AUTOBiPAP, Inh is set min of 11, to max of 20, so as machine senses snores it will raise pressure, up to 20,,if no snores it can go as low as 11,, my exhale can be from 2 - 6 depneding on needs.


Simple huh?
Tom

[dsm]

What the Autoadjusting Bipap (Bipap Auto) does is provide the following benefits

1) Can be set to run in Cpap Mode - (single pressure & BiFlex exhale relief can be activated)
2) Can be set to Run in Bipap Mode - (two pressures (ipap/epap) & BiFlex exhale relief can be activated)
3a) The tank (older) BipapAuto can be set to run in Bipap Auto Mode - (two pressures - no BiFlex, but the machine can vary epap & ipap to deal with detected breathing issues)
3b) The M-Series (current) BipapAuto can be set to run in Bipap Auto Mode - (two pressures - BiFlex can be activated, and the machine can vary epap & ipap to deal with detected breathing issues)
#2 (above 3b point added per follow up posts pointing out the change)

The Autoadjusting Bipap (& same for Vpap) are the top of the line therapy for normal use. You get the best of all approaches.

Specifically referring to the Respironics Bipap Auto...
The main thing with it in Bipap AUTO mode is to set the base epap pressure at a good starting CMs setting & if the machine
detects snores or obstructive apneas it will adjust the epap pressure upwards along with the Ipap pressure. If you set the epap base for say
10 CMs then the machine itself will start off (in this example) with epap=10 & ipap = epap+2 = thus 12 CMs. So it starts with 10/12. If the
machine detects snoring or obstructive apneas it will raise epap (and usually ipap at the same time depending on the gap at that instant) but
the machine can also detect hypopneas & repeated flow limitations & can raise the ipap pressure in response to them and it can do this
separately from adjusting the epap prssure (pretty clever). The minimum gap the Bipap Auto machine will maintain in Bipap AUTO mode is
2 CMs but you can set a maximum gap to say 6 CMs (I would not set it any more than that. the actual max gap can go up to 8 but 8 as a gap plain dumb)). Thus in this example with max gap set to 6 CMs, the machine might decide to raise Ipap pressure to 16 if it is detecting lots of hypopneas & flow lims but no obstructive apneas & snores. On the other hand it may raise epap from 10 to say 13 (which would push ipap up to 15) if it is only detecting snores & obstructions.

The machine cleverly tries to balance the ipap & epap pressure settings to counter the two different types of apnea problems AI & HI (Apnea & Hypopnea)
One problem (obstructions) gets dealt with by raising epap, the other (repeated hypopneas/flow lims) by raising ipap. By tuning the start pressure & the max gap, you can get very effective bilevel + auto functioning therapy.

As already said, setting your max gap between ipap & epap to 8 is plain dumb & would only be recommended by someone who has never tried sleeping with a gap over 6 CMs. For people with specific respiratory disorders (serious ones) Bipaps with gaps over 6 CMs are used. But the Dr is most likely treating someone with damaged lungs vs the arousals that gap creates.

The old tank model was the best of this type of machine. I have no doubt that as Respironics improve the M-Series, it too will match the
quality the tank already offers.

DSM

[-SWS]

Can be set to run in Bipap Auto Mode - (two pressures - no BiFlex, but the machine can vary epap & ipap to deal with detected breathing issues)

...The old tank model was the best of this type of machine. I have no doubt that as Respironics improve the M-Series, it too will match the
quality the tank offers.

DSM, I know the M-Series can run in BiPAP Auto Mode with BiFlex enabled according to the manual. Can the tank run auto w/ BiFlex or is that dual capability an M-Series enhancement? Thx.

[Wulfman]

Can be set to run in Bipap Auto Mode - (two pressures - no BiFlex, but the machine can vary epap & ipap to deal with detected breathing issues)

...The old tank model was the best of this type of machine. I have no doubt that as Respironics improve the M-Series, it too will match the
quality the tank offers.

DSM, I know the M-Series can run in BiPAP Auto Mode with BiFlex enabled according to the manual. Can the tank run auto w/ BiFlex or is that dual capability an M-Series enhancement? Thx.

Yes.

The modes of the Legacy model Auto Bi-PAP:

Bi-Level - BPAP
Bi-Level with Bi-Flex - BFLE
Auto Bi-Level - ABPAP
Auto Bi-Level with Bi-Flex - ABFLE
CPAP mode - (IPAP and EPEP are set to same pressure setting)

Den

[-SWS]

Thanks, Den!

Another question for the gang. Does anybody know if there are any functional differences between the tank auto BiPAP and the current M-Series model? Or was that a form-factor transition only? Thx again.

[Wulfman]

Thanks, Den!

Another question for the gang. Does anybody know if there are any functional differences between the tank auto BiPAP and the current M-Series model? Or was that a form-factor transition only? Thx again.

Do the "blue lights" count?

RG would probably know if there really are, but from everything I've read here and in the provider manuals......it was just a form-factor change.

Den

[dsm]

SWS, Hi - hows things -
Den, Tks for that update re BiFlexbeing active in Auto mode on the new M-series.

When I pulled apart the Bipap Auto tank model, it had the fixed speed blower & AirValve unit used in all the tank
model Bipaps. I understand (but am open to correction), that the new M-Series Bipap Auto, uses a variable speed
motor to change pressure which would make it quite different to the tank model. I believe a number of people
commented about the motor whine. That was the part of the M-series needing improvement.

If the M-series Bipap Auto does used the airvalve & fixed speed motor than it can be fairly called a form
factor change.

As I don't plan to dismantle an M-series Bipap Auto series any time soon, we will need some expert opinion on what
is actually inside it But, I can say that the BipapAutoSV is identical inside to the Bipap S/T - gray model which
in turn is similar to (air valve, fixed speed motor etc: ) the tank Bipap AUTO & tank Bipap Pro II.

DSM

#2 there is one test that will confirm to me what is probably inside. When an M-Series Bipap Auto is turned on,
does it delay for a couple of seconds (while making a motor running up sound sound), make a mild 'thump' noise
then start pumping air, *or* does the air flow immediately you push start. It it starts immediately then it is most
probably as I said, a variable speed motor with no airvalve which in turn would be a complete redesign.

Another test is the shake test. All the tank Bipaps with airvalves (a brilliant mechanism for controlling airflow)
will appear to have something loose inside if you pick it up and move it around quickly. That is the slide on
the airvalve. It is very very obvious on the airvalve based models.

D

[THier]

I currently have a Respironics BiPAP legacy,(tank) and I have an M series BiPAP on the way, (I have REAL good insurance, and an understanding doc) so I will give MY opinion after I use the M series for a while.

Tom

[SeaPappy]

dsm,
you are starting to make all this make sense enough that when my new setup gets here (a couple of hours) I should be able to get a nap, sign on and ask some questions , tweak and get a good night's sleep That is if it all goes by my Master Plan

James

[dsm]

Tom,

Looking forward to your labratting re the diff between tank & M-Series

SeaPappy,

Good luck with the machine. I am confident we can all help you make it the best possible experience.

DSM

(an admitted Bilevel devotee)

[lookin4sleep]

SWS, Hi - hows things -
Den, Tks for that update re BiFlexbeing active in Auto mode on the new M-series...


#2 there is one test that will confirm to me what is probably inside. When an M-Series Bipap Auto is turned on,
does it delay for a couple of seconds (while making a motor running up sound sound), make a mild 'thump' noise
then start pumping air, *or* does the air flow immediately you push start. It it starts immediately then it is most
probably as I said, a variable speed motor with no airvalve which in turn would be a complete redesign.

I have the M series Bi flex, with the blue lights (hey, I like them, gives that grotto look to the bedroom! )
When it turn it on (the machine that is), the airflow starts immediately. So, variable speed motor?

When I cleverly changed the menu into clinician or DME mode, thanks to the tip to unplug, hold 2 buttons, and replug, one of the choices I now have is

"Bilevel Auto Bilevel"..... I have Auto Bilevel selected. Since I didn't understand most of the above thread, just hung in there in case something I needed showed up, can someone tell me what the difference is between the two, and reasons to select one or the other? I'm a newbie, 8 days today!!!! and feeling better, plus saving up for the software!
Chris

[Snoredog]

SWS, Hi - hows things -
Den, Tks for that update re BiFlexbeing active in Auto mode on the new M-series...


#2 there is one test that will confirm to me what is probably inside. When an M-Series Bipap Auto is turned on,
does it delay for a couple of seconds (while making a motor running up sound sound), make a mild 'thump' noise
then start pumping air, *or* does the air flow immediately you push start. It it starts immediately then it is most
probably as I said, a variable speed motor with no airvalve which in turn would be a complete redesign.

I have the M series Bi flex, with the blue lights (hey, I like them, gives that grotto look to the bedroom! )
When it turn it on (the machine that is), the airflow starts immediately. So, variable speed motor?

When I cleverly changed the menu into clinician or DME mode, thanks to the tip to unplug, hold 2 buttons, and replug, one of the choices I now have is

"Bilevel Auto Bilevel"..... I have Auto Bilevel selected. Since I didn't understand most of the above thread, just hung in there in case something I needed showed up, can someone tell me what the difference is between the two, and reasons to select one or the other? I'm a newbie, 8 days today!!!! and feeling better, plus saving up for the software!
Chris

From the manual:

1.4.1 Bi-flex CoMfort feAture
The BiPAP Auto M Series device consists of a special comfort feature called Bi-Flex. When the
device is in Auto Bi-level with Bi-Flex or Bi-level with Bi-Flex mode, the Bi-Flex attribute adjusts
therapy by inserting a small amount of pressure relief during the latter stages of inspiration and
during active exhalation (the beginning part of exhalation). In the following diagram, the bold
lines represent Bi-Flex in comparison to the dashed line representing normal Bi-level therapy. Bi-
Flex levels of 1, 2, or 3 progressively reflect increased pressure relief that will take place at the end
of inspiration and at the beginning of expiration.

[lookin4sleep]

lug, hold 2 buttons, and replug, one of the choices I now have is

"Bilevel Auto Bilevel"..... I have Auto Bilevel selected.

From the manual:

1.4.1 Bi-flex CoMfort feAture
The BiPAP Auto M Series device consists of a special comfort feature called Bi-Flex. When the
device is in Auto Bi-level with Bi-Flex or Bi-level with Bi-Flex mode, the Bi-Flex attribute adjusts
therapy by inserting a small amount of pressure relief during the latter stages of inspiration and
during active exhalation (the beginning part of exhalation). In the following diagram, the bold
lines represent Bi-Flex in comparison to the dashed line representing normal Bi-level therapy. Bi-
Flex levels of 1, 2, or 3 progressively reflect increased pressure relief that will take place at the end
of inspiration and at the beginning of expiration.

[/quote]

Got it, thanks.

Chris

[Snoredog]

what about the difference between bipap bilevels and the autoadjusting bipap? besides the prices? Thank you all who have responded.

bipap= Respironics version of a basic bilevel machine, can be compared to a basic CPAP machine. Once pressure is manually set it doesn't move from those settings unless Ramp feature is enabled. It has separate settable pressures for Inhale (IPAP) and Exhale (EPAP).

bipap auto = Respironics version of a auto adjusting or auto titrating bilevel machine. Can be compared to a Autopap but with two
separate pressures. Like a CPAP Auto, this machine should find your 90 IPAP/EPAP pressure. Digital auto track detects and automatically adjusts rise times etc. Like having 2 Autopaps in one machine, it automatically adjusts IPAP/EPAP pressures based upon the type and events seen.

The bipap auto address Hypopnea with IPAP pressure and Apnea with EPAP pressure. Vibratory Snore, FL can be handled by either or both pressures.

http://biflex.respironics.com/