BiPAP vs APAP

[S-Dubya]

I went in for a sleep study on Wednesday night. The facility my GP referred me to says they can also act as my DME once the results are compiled. I mentioned to them that I would really like to move to APAP. After a pause the tech said, "We can look at moving you to BiPAP." My GP had told me that I can buy through the sleep lab, who she says leans toward BiPAP for some reason, or she has a DME that she has had great success with and who is very willing to provide whatever I want. This leads me to a couple questions.

1) Because I have only used CPAP, I would really love to hear from folks who have used both BiPAP and APAP. I'd like to know what you prefer and how you feel they are different/better.

2) Why would the sleep lab try to push their clients to BiPAP?

3) The study was done with a VPAP that the tech said operated like a BiPAP. It was a little strange to have the pressure changing with each inhale and exhale (I am sure I could get used to it eventually). Is APAP a more steady pressure? I know it adjusts to your pressure needs, but does it change with inhales and exhales like BiPAP?

4) Are there any APAP/BiPAP machines I should avoid? Any that are considered better than the others?

Thanks in advance. I was pretty excited about the possibility of moving to APAP, but now I am wondering if it would just be easier to stick with CPAP.

[Goofproof]

I subscribe to the K.I.S.S. policy, The simpler we keep things the better they go. APAP by all means for the data and the options, they cover CPAP too. BiPAP if needed, harder to get set up, more complex to set up, failure rate seems higher, may be failure to be set correctly.

If you need the extra pressure exhale relief, if you use high pressure, maybe intake air too much, have breathing problems, then BiPAP can be needed. The machine you need, needs to be matched to your needs.

It kind of sounds like the people you are dealing with, have planted a moneytree, and want you to water it. Jim

[Wulfman]

What's your pressure?
If your pressure is "high" (like, above 16 cm.), that could be a reason for migrating to Bi-PAP therapy.

Den

[S-Dubya]

My current pressure is 13, but that is based on my last sleep study which was 4 years ago. I won't have the results of this week's study for another week or two.

[Wulfman]

My current pressure is 13, but that is based on my last sleep study which was 4 years ago. I won't have the results of this week's study for another week or two.

If you have no other "issues" (like aerophagia) and your pressure hasn't changed substantially (higher), Bi-Level therapy seems like it would be "overkill" to me.

I'm another "K.I.S.S." subscriber. A person could buy several APAPs for what one Bi-Level machine can cost.
I've always been curious as to what a Bi-PAP felt like to use, but I'll probably never know.

Den

[Bluebonnet_Gal]

I agree completely with the answers you've received so far, but I wanted to add my recent experience with both Auto PAP and Bi-Level (VPAP).

My titration pressure was 14, but it was a split night study, so the titration study was less than 4 hours total. My ENT prescribed auto PAP for a trial to see if 14 was indeed the best pressure for me. My DME sent me home with a Resmed S8 Vantage. It has EPR (Expiratory Pressure Relief), but only in CPAP Mode. It doesn't have the Easy Breathe Technology like the newer S8 Autoset II. I only used it in auto mode, so I had no pressure relief. My pressure was going up to 16 and above and I was still having events. I felt like the higher pressure was lifting my mask off my face like a hovercraft on exhale, but it was okay on inhale. When I went to the ENT for a follow-up, I asked if BI-level PAP would be better. He said that at pressures 15 and above, they start looking at BI-level PAP. He gave me a script for a Bi-level PAP on a trial basis. The DME sent me home with a shiny new VPAP Auto 25 - Great Machine!!!

I noticed a big difference on exhale. It was easier to keep the mask on my face (at least until I had to raise my pressure even more, but that's another story). I wonder what Pressure Support they were using for you? I would think that if the Pressure Support is too great, the pressure change might be more bothersome. I use a Pressure Support of 4 and I like it! There are also many other comfort settings that can make a difference. The VPAP is a complicated machine.

I'm telling you all this because you state your current pressure is 13. My titration was 14 and I'm on Bi-level now. My VPAP is set in Auto Mode and my pressure usually sticks between 19 and 20.

I agree that if your pressure is below 14, you probably don't need Bi-Level. If it's 15 or above, it's something you might consider, but please remember there are many settings and getting them tweaked to what is most comfortable and effective for you is key to success with a Bi-Level.

Good luck with whatever you end up with and come here with your questions and experiences!