APAP or BiPAP auto?

[HanzT]

Hi, I've been having some strange readings while on testosterone shots. My obstructed apnea is under control (usually under 0.5 max 1), but my hypopnea seems to increase as the pressure goes up, but my RERA goes down as the pressure goes up. That plus a random periodic breathing seems to happen with no correlation to anything I can see. I'd post a chart, but that's not my question (but if anyone thinks it will help I will post it). My questions is: what can a BiPAP handle versus a APAP? I get each can change pressure and respond to events, but the definition is difficult to follow: "BiPAP autoSV Advanced—System One was specifically designed and validated to give you the peace of mind to not only treat patients with Complex Sleep Apnea, Central Apnea or Mixed Apnea, but the ability to manage their future needs in an effective way." I don't have central apnea at this time. Is that the main purpose of a BiPAP? Any other thoughts? Do you think an APAP will is likely to work? I realize noting is "for sure". I am looking at the PR System One REMStar 60 Series Auto CPAP Machine and I have to pay cash (since the insurance got me a machine 3 years ago) so the cost difference is a big thing for me.

Thanks for the help!!!!!
H

[Julie]

"Plain" bipap is generally used by 'plain' OSA patients who need fairly high pressures, sometimes above 20, that regular Apaps don't handle well, if at all (20 being the highest most of them go). Any other version (ASV, Vpap, etc. etc. are targetted as your article said for centrals, complex events, etc.

[HanzT]

Thank you for the info. Is what I am going through considered "complex"?

[palerider]

bipap is the phillips trademark for a bi-level machine.
vpap is the resmed trademark for a bi-level machine.

a bi-level machine is indicated when you either need higher pressures (often over 15cm) or when you have too much trouble exhaling against the pressure, even with max pressure relief of a regular machine, (which only do 2-3cm pressure relief, whereas bi-level machines can go to 10cm pressure support (the difference between epap (exhale pressure) and ipap (inhale pressure).

there are fixed pressure bi-level machines, as well as auto adjusting bilevel machines (like the vpap auto that i have).

ASV machines, which stands for adaptive servo ventilator, are for people that have complex sleep apnea, which is a type of mixed sleep apnea, where as you raise your pressure enough to overcome the obstructive apneas, you start having central apneas... an ASV can take over and boost the pressure on a breath by breath basis and essentially breath for you when you stop breathing on your own.

the autoSV advanced and the VPAP Adapt are types of ASV machines, if you don't have a lot of central apnea events, it's not anything you should be concerned about.

sometimes a bilevel machine can help with central events, sometimes an ASV is needed.

that answer your questions?

[Julie]

Only the MD who diagnosed you can say that - it would have been a 'result' on your study. Without graph printouts etc. from your overnights, using software on your computer, it would be difficult at best to guess.

[robysue]

Thank you for the info. Is what I am going through considered "complex"?

and

My obstructed apnea is under control (usually under 0.5 max 1), but my hypopnea seems to increase as the pressure goes up

Is your AHI usually under 1.0? Or is it just the AI that is less than 1.0? When you say the number of hypopneas go up, just how much of an increase are we talking about? An increase in AHI from 0.5 to an AHI of about 2.0?

And what is your treated CAI on a typical night?

If both your treated AHI < 5.0 and your treated CAI < 5, then you do NOT have compex sleep apnea. Complex sleep apnea is when a person with obstructive sleep apnea develops a serious problem with pressure induced central apneas after starting PAP therapy. A clinically significant number of central apneas is basically an average of 5 or more CAs per hour of sleep with a PAP---i.e. a CAI greater than or equal to 5 while on PAP therapy.

[Pesser]

ignore julie, she tends to talk about things she doesn't know anything about.

bipap is the phillips trademark for a bi-level machine.
vpap is the resmed trademark for a bi-level machine.

a bi-level machine is indicated when you either need higher pressures (often over 15cm) or when you have too much trouble exhaling against the pressure, even with max pressure relief of a regular machine, (which only do 2-3cm pressure relief, whereas bi-level machines can go to 10cm pressure support (the difference between epap (exhale pressure) and ipap (inhale pressure).

there are fixed pressure bi-level machines, as well as auto adjusting bilevel machines (like the vpap auto that i have).

ASV machines, which stands for adaptive servo ventilator, are for people that have complex sleep apnea, which is a type of mixed sleep apnea, where as you raise your pressure enough to overcome the obstructive apneas, you start having central apneas... an ASV can take over and boost the pressure on a breath by breath basis and essentially breath for you when you stop breathing on your own.

the autoSV advanced and the VPAP Adapt are types of ASV machines, if you don't have a lot of central apnea events, it's not anything you should be concerned about.

sometimes a bilevel machine can help with central events, sometimes an ASV is needed.

that answer your questions?

You almost started a fight with Julie. No entertainment yet! Darn!

[palerider]

You almost started a fight with Julie. No entertainment yet! Darn!

I see someone undeleted my post... last I looked, someone had marked it as 'spam'...

[Pesser]

You almost started a fight with Julie. No entertainment yet! Darn!

I see someone undeleted my post... last I looked, someone had marked it as 'spam'...

just because I think some cute white cats shouldn't play with the keyboard when they don't know what they're talking about.

I like the halo between the horns. But you’re bad! Julie helped me a lot!!!!

[palerider]

You almost started a fight with Julie. No entertainment yet! Darn!

I see someone undeleted my post... last I looked, someone had marked it as 'spam'...

just because I think some cute white cats shouldn't play with the keyboard when they don't know what they're talking about.

I like the halo between the horns. But you’re bad! Julie helped me a lot!!!!

I'm both!

yeah, I was bad.... julie has helped a lot of folks