Going from CPAP to BiPAP

BigGayBert · Post by **BigGayBert** » Tue Jan 01, 2008 8:18 pm

My New Year's Resolution is to take control of my OSA! So, I have been using CPAP for a while now but still having some problems because of my pressure--it's 20cmH2O. I have a Respironics Pro with C-Flex, and that exhalation relief is the only reason why I can use CPAP at all. But I really think that a BiPAP would make things alot more comfortable for me. Considering my pressure, I figure I won't have any problem talking my neurologist into it. Here's my question:

Will I need a whole new sleep study to find my EPAP and IPAP pressures, or can my doctor loan me an auto-titrating machine to use at home and then review the results?

I'm hoping to avoid the sleep study due to expense and because I have no idea how long it would take to get scheduled. I could probably get the BiPAP from my RT, who comes to visit me right in my office! She's really quick, so I could start sleeping better right away. (I was so amazed when she told me that she worked "on-site"....I had no idea that anybody did house calls anymore! How nice not to have to wait around at the sleep clinic! My neurologist referred me to her after I left my HMO's clinic.)

Thanks to everyone for your wisdom! Have a wonderful new year!
BGBert

P.S. Because of all of the feedback here, I now have my heart set on a Respironics Auto BiPAP! The C-Flex feels so natural...it's almost like magic! I can't wait to try Bi-Flex! I'm not going to settle for less....I'll tell my neurologist that I will lay on the floor and have a two-year-old-child-style temper tantrum if she doesn't! (You'd be surprised how often that threat works....I've only had to actually throw a tantrum once.)

lawdognellie · Post by **lawdognellie** » Tue Jan 01, 2008 8:45 pm

My sleep doc told me that for people with higher pressures, they generally prescribe BiPAP because excessive pressure makes it difficult to exhale. I apparently had "spontaneous arousals" on CPAP, but no long do now that I am on BiPap. Maybe it's because I can actually exhale. If you went for straight Bi-pap, it may require a new titration, but if you get an auto, then probably not necessary....?

Sarah

RosemaryB · Post by **RosemaryB** » Tue Jan 01, 2008 8:50 pm

If it were me, I'd read and re-read all the posts by DrBarryKrakow. I know that this is hard to absorb at first, lots of technical stuff, but I think he knows a lot about BiPaps and titration studies. Do you have to pay for the whole thing out of pocket or is it a percentage of what your insurance is paying? If the insurance is paying a percentage, I'd get a sleep study by someone who knows a lot about bipaps and how to titrate them.

The reason I'd do it this way is that I want the best quality sleep possible, not just a somewhat better quality. I'm hoping that I can eventually get another sleep study, one that is done right this time, one that looks at flow limitations (or UARS) for instance. At your high level, this may be the least of your concerns, but if you are going to do it anyway. . .

I understand that this is expensive, but if the insurance is paying part, you might want to consider paying the copay. If not, perhaps there's a way to do it without the sleep study. I don't use a bipap, but am wondering if one would help me with the UARS that showed up during my sleep study.

MartiniLover · Post by **MartiniLover** » Wed Jan 02, 2008 6:28 pm

The Key to your questions are Who is going to pay.

Your doctor could write a new script, BUT will the insurance pay with out another nights study?

Your DME will replace a Cpap with a BiPap, BUT who is going to pay the difference?

I would ask the insurance company what they require of the Dr, to get you a different machine.

I went from 9 on Cpap to 13-9 on BiPap.

I believe c-flex and bi-flex are basically the same thing.