Going for a BiPap Titration Study

[Thatgirl]

You may remember a few weeks ago me asking if bipap could help even with low pressures, since I'm having trouble with feeling like I'm gagging on the air, and feel like the machine is forcing me to breath quickly and shallowly and that's causing me to feel dizzy. I don't see my pulmonologist who started me on cpap again until April.

Interestingly, in a strange twist of events, I had to be referred to a neurologist for unrelated issues. I called Big Neurology Group here and got an appointment. The neurologist I was set up with is a sleep medicine specialist and happened to be the doctor that read my last sleep study. He asked me if I decided to try cpap and how it was going. I told him about some of the issues I'd been having. He said immediately, "It sounds like you should try bipap." So I'm going for the titration study. I'm not sure if I'll get a bipap even if insurance will pay, but I'll be curious to see what the titration is like.

Interesting comment he made: "You mild sleep apnea doesn't really put you at risk for long term health issues, it's more a quality of life matter." I'm sure the vast majority of people here (and my pulmonologist) would beg to differ.

If I do end up getting a bipap, is the Aircurve line the way to go?

[Wulfman...]

You may remember a few weeks ago me asking if bipap could help even with low pressures, since I'm having trouble with feeling like I'm gagging on the air, and feel like the machine is forcing me to breath quickly and shallowly and that's causing me to feel dizzy. I don't see my pulmonologist who started me on cpap again until April.

Interestingly, in a strange twist of events, I had to be referred to a neurologist for unrelated issues. I called Big Neurology Group here and got an appointment. The neurologist I was set up with is a sleep medicine specialist and happened to be the doctor that read my last sleep study. He asked me if I decided to try cpap and how it was going. I told him about some of the issues I'd been having. He said immediately, "It sounds like you should try bipap." So I'm going for the titration study. I'm not sure if I'll get a bipap even if insurance will pay, but I'll be curious to see what the titration is like.

Interesting comment he made: "You mild sleep apnea doesn't really put you at risk for long term health issues, it's more a quality of life matter." I'm sure the vast majority of people here (and my pulmonologist) would beg to differ.

If I do end up getting a bipap, is the Aircurve line the way to go?

If you're using the range of pressures in your profile, I can easily imagine how you would have those feelings/sensations.


Den

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[Thatgirl]

I am. But it never goes above 11.

[Wulfman...]

I am. But it never goes above 11.

Even going from 6 to 11 could take quite a bit of time and could allow too many events to occur.
Could be any number of explanations for your feelings you're describing.
Have you ever posted any reports on the forum for folks to look at? (I'm sorry, but I haven't had time to look back through your posts) There might be some clues in those reports.


Den

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[Wulfman...]

OK, I did find some of your reports from the end of December (in the thread titled "Struggling")
But, they didn't show any AHI events, which would make me suspicious.

So, maybe I'm missing something.......


Den

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[Thatgirl]

I've posted a few. No full nights. Increased the minimum to 6 from 4 and turned off ramp based on advice I received from those reports.

If I can tolerate the BiPap for a decent amount of time, this will be my first titration study, so I'm excited about that, too.

[mgaggie]

I felt like I was suffocating on 6. I was starved for air

[Thatgirl]

Based on all data I have, I exclusively have apnea during REM. I think my AHI was 0 on those because I was never getting into REM.

[49er]

I felt like I was suffocating on 6. I was starved for air

Same here. When my bipap titration was started at 9/6, I had to take a Temazepam to be able to tolerate it. Yet, this is seen as the gold standard? I don't think so.

Thatgirl, I have an RDI of 23 that includes an AHI of 5.9. My condition definitely does not feel mild and there is no doubt in my mind I need to use something which right now is the pap machine. Interestingly, my sleep doctor called this a mild condition but my ENT called it moderate apnea. Based on my experiences, I vote for the ENT's version.

Lots of luck with your study.

49er

[purple]

Not sure if it is relevant for you. However: In my Titration Sleep Study for a Bi Level machine (Bi Pap is a term from Respironics, Resmed calls theirs Variable Pressure, well VPAP.) They also started me with a pressure of 7, when the in and out of the pressure was immediate, and the mask was popping up and down every three seconds or so. The tech took one look and said, "I am increasing your pressure." so at least that effect of shallow quick breaths for me was pressure being too low. Sounds like your beginning pressure is far too low.

Bi-Level for me was the real improvement I needed to breathe better. I may need one pressure to stent my airway open, like 11, but I needed the second higher pressure on inhale to actually get air fast enough to fill my lungs before I started the exhale. This Bi-Level machine ended much of my GERD problem. Also for me, I need my AHI to be like .2 instead of the standard of less than five to feel rested.

I tried to do my Bi Level titration on my back, as part of proving I needed Bi Level.

Keep in mind, like most sleep studies, you might not sleep much at all until the pressure is adjusted up a bit.

I think it was Pugsy who said she tried a friends Bi machine for one night, and said, "I got to get me one of these." The difference of comfort is remarkable. Likely when the doc said it was for comfort, He did not mean that xPAP is not a great life quality improving, life extending technology (which lets one have more fun in life, and be able to work). He probably meant that Bi Level machines in place of regular APAP is more comfortable. For some, a Bi Level machine is about getting successful treatment.

Therein lies the rub. Medicare rules says that to get a Bi machine (which costs them more money) that I must fail CPAP or have certain medical conditions (like MS). One can not get a Bi Level machine if ones need is defined as "For Comfort." When leaving the Sleep Study, you will be asked several questions, while you should answer honestly, be guarded as to giving the information that a standard CPAP/APAP is adequate for your rest. I can not tell you exactly how to answer the questionnaire, one because I do not know, but what you report in the morning of the sleep study is important to qualify for insurance paying for Bi Level machine.

[Greg Riddle]

Bi level is very comfortable. My pressures are at 16.8 epap and ps of 7.2 and it didn't feel like any pressure. I told sleep tech to start me out at my cpap pressure of 13. Abby less felt like not enough