Please HELP me with statistics

[ozij]

Suppose you need a pressure of 18 for inhaling when you're on your side, but 22 when you are on your back, or when you're dreaming. And suppose, also, that when you inhale, 12 is enough on your side, but you need 16 when you are on your back, or when you're dreaming. An automatic bi-level machine will adjust the pressure to your needs. A fixed bi-level machine will have to be set for the worst case scenario: 22 on inhale all the time and 16 on ehxale, all the time. No drops in pressure for when you're on your side.

So, if you can afford an auto - go for it. You can set it on fixed pressures, if that's what you turn out to need - but you can never set a fixed bi-level machine on auto.
O.

[rested gal]

I'd get this one:

Respironics BiPAP Auto with Bi-flex (the pre-M series machine...the larger machine, less expensive)

or

Respironics BiPAP Auto with Bi-flex M series (the smaller machine, more expensive)

Either one will treat the same -- the way ozij described.

I would not buy the integrated humidifier for either one. I'd get a standalone heated humidifier, so I'd be able to use the humidifier with any brand of machine I bought in the future without having to spend money for yet another different "integrated" humidifier. I'd get this one:

Fisher & Paykel HC 150 heated humidifier (comes with a short connector hose to attach to the machine)

I'd especially not want an M series integrated humidifier. The integrated humidifier for the older BiPAP Auto is a good one. But since the F&P humidifier can be used with it as well as with other machines... the F&P humidifier would be handier to have if money is a factor.

Encore Viewer software works with both those Respironics models.

[sleepytexan]

Hi ozij and rested gal,

Thanks for the info. Do you know if my CPAP would be sell-able somewhere? What kind of resale value do they have?

Doug

[rested gal]

An M Pro cpap should be easy to sell, but I have no idea at what kind of price.

I'd check out cpapauction.com

One other thought about the humidifier... since you already have an M series humidifier for your present machine, you wouldn't have to buy another humidifier if you got the BiPAP Auto M series machine. You could use your current M humidifier with it.

[Snoredog]

Hey Guys,

Thanks for the posts and feedback.

I really like my Dr. (he is a GP) but I think he is VERY ignorant of this stuff. The people I do wonder about is the sleep lab and doctors there. I am going to go back to my GP and fill him in with all of my acquired knowledge (thanks to you guys and this site) and see if he will schedule another sleep study. I will also question his choice of labs.

I noticed that there are a couple of different bi-level PAPs. One is automatic (and more expensive). What is the difference and what do you recommend I speak to him about? The good news is my insurance covers the sleep studies 100%. The bad news is that, because of my high deductible, I have to pay for the equipment 100%. I am also not sure if it is too late to turn in my CPAP and upgrade or if I will have to eat that cost. Either way, I want to pursue the most beneficial treatment without having to go back. Please let me know what you think....

Thanks,
Doug

You can't blame your GP, he is just following bad advice given to him by the lab's doctor. The lab is the place that screwed up, they have a doctor associated and/or on staff that scores the PSG, they are the ones making the recommendation to your GP doctor. But we've seen here time and time again they recommend a plain jane CPAP at 18 or 19 cm, the machine can only go to 20 cm. When your pressure approached 15 cm they should have titrated you on bipap. But they make money by doing PSG's, if they can get you as the patient to come back 3-4 times they get paid 3-4 times. I wouldn't give that lab another dime. I'd buy a Bipap Auto, the software and card reader you already have will work with it. The bipap will go to 25 cm (vs. CPAP's 20 cm) so you have the pressure you need to splint your airway.

[sleepytexan]

Hi Snoredog,

Just so I know my options, do you think I could purchase a BiPAP auto and calibrate this therapy myself? (I ask this knowing it would be your personal opinion and you are not a medical doctor. I would not hold you accountable for your opinion )

Thanks,
Doug

[Snoredog]

Hi Snoredog,

Just so I know my options, do you think I could purchase a BiPAP auto and calibrate this therapy myself? (I ask this knowing it would be your personal opinion and you are not a medical doctor. I would not hold you accountable for your opinion )

Thanks,
Doug

I think you can quite easily. Just set EPAP Min to about 14 cm, IPAP Max at 25 cm and pressure support anywhere from 4 to 8 cm, it will automatically find your 90% pressure for both just like the Auto does. The difference is Pressure Support, that spread will make tolerating that higher pressure much easier.

This is WHY I asked for a simple Encore Daily report to see what the mix is between actual Obstructive Apnea and Hypopnea seen, as IPAP and EPAP pressure each handle these events where CPAP has to handle both. EPAP may stop when OA subsides then IPAP only needs to climb high to eliminate the residual HI's. In addition, you have Biflex which is nearly identical to Aflex. You will already be getting relief from having the two pressures and still have Biflex. You should be able to reduce your residual AHI as well as making therapy more comfortable. I wouldn't go back for another PSG, they are only going to do the same thing that the auto algorithm is doing. You have the reporting software you will be able to gage how well you are doing.

[rested gal]

Hi Snoredog,

Just so I know my options, do you think I could purchase a BiPAP auto and calibrate this therapy myself? (I ask this knowing it would be your personal opinion and you are not a medical doctor. I would not hold you accountable for your opinion )

Thanks,
Doug

I think you can quite easily. Just set EPAP Min to about 14 cm, IPAP Max at 25 cm and pressure support anywhere from 4 to 8 cm

I agree with that. The pressure support setting Snoredog mentioned is called "Max Press Sup" in the M BiPAP Auto's menu, and is called "PS" in the older non-M BiPAP Auto's menu. I'd set that to as much as it will let you run the setting up to. The most it will allow is " 8 ".

Here are a couple of links to discussions about the PS (Max Press Sup) setting:

viewtopic.php?t=22099
Jul 14, 2007 subject: What is 'Max Press Sup'

viewtopic.php?t=15666
Dec 08, 2006 subject: Question for BiPap users - UPDATED 12/14/2006

[sleepytexan]

GREAT! Thank you guys! All I need now is a prescription. I hope I can persuade my GP for the Auto BiPAP without a study.

[sleepytexan]

Hello Everyone!

Well, I was able to get the prescription for an auto BiPAP machine and had my first night last night using it. I know this is only one night's data but the AHI is still about 10. Could someone take a look at the report and give me some feedback on how I might improve the AHI?

The report can be found here:
http://www.iamtexan.us/report_BiPAP.pdf

Thanks in advance,
Doug

[sleepytexan]

Also I would like some feedback regarding if I am doing anything wrong? I am kind of doing this without my doctor as he is clueless. Just wanted to know if I am off base with any settings, etc.

The report can be found here:
http://www.iamtexan.us/report_BiPAP.pdf

Thanks in advance,
Doug

[elader]

[quote"]
Thanks for the info. Do you know if my CPAP would be sell-able somewhere? What kind of resale value do they have?

Doug[/quote]


I was shoppnig for one. I got the M series auto/aflex with 80 hours on it for $200 and found a new in the box M series Pro/cflex for $250

try selling it on craigslist.