CPAP=exhaustion BIPAP=energy

Speaking for myself - have tried almost all types but really like Bilevel machines, but, I haven't yet tried EPR but am assuming it is just like Bilevel except I can't tune the rise & fall times etc: and it does have an algorith that will reduce the ipap/epap gap if it detects breathing problems.

I do find the VPAP III models to be noisy (I can cope with the fluctuating blower sound but my wife can't). They use a blower that changes speed & thus create a 2 level hum that is problematic. Resmed seem to have really fixed this problem in the new VPAP Adapt. It has a dual impeller blower & is very quiet. The VPAP IIIs record excellent data (as does the Bipap Pro 2 & the Bipap Auto).

With Bipaps (incl the Bipap Auto) Respironics keep the blower running at a constant speed and use an 'air valve' to change the pressure. This allows for a constant sound that is far easier for people to adjust to.

My only gripe with all the Bipap range is that they seem to have difficulty coping with people who have constant nasal congestion (flip between epap & ipap far too soon as the AUTOTRAK feature gets confused with small airflow but long nasal breathing). They do appear to be fine for people who can nose breathe comfortably. They seem to have no problems in this respect for mouth breathers.

I would vote the PB330 the best of all except it doesn't record any nightly data. It is quiet, small, highly adjustable and works like a charm.

As an opinion, each person really does need to try these machines out for themselves. They do differ.

DSM

I am having a hell of a time getting used to a bi-pap machine. It occurs to me there HAS to be an alternative to sleeping with a machine. Surgery to remove throat tissue, pills for relaxation, something like spireva, but for the throat instead of the lungs, an inhaler type device but for the throat/nasal passages. I am on a mission tomove the technology forward. I am only three weeks into this and going nuts. i am talking(or trying to) to the Mayo clinic, NIH, Harvard Medical
school, and reading everything I can find. Losing weight(only 8-10 lbs for me), reduced alcohol,(not easy) and going from 3-5 cigarettes to none are step one for me. Anyone tried anythig different? so help me, I am not going to sleep with a machine. don't say it gets better. I've heard that 100 times. What is outside the "box"?

How long have you been on it?

Has anyone out there said "No" to the bi-pap, and found an alternative? Spireva for throat, inhaler for nasal passages, surgery to remove throat tissue?

I have an APAP that is in CPAP mode with a pressure of 11 and it does great for me I have had no problems and have seen and felt the benefits in my life. I am glad that you found a machine that works for you.

Depends on how severe your OSA is.

My OSA is severe. During the titration phase of my sleep study, I woke up when I was switched to Bi-PAP. Several times. I felt a definite "clicking" sensation when the pressures changed between inhaling and exhaling. Sound was not the problem; I could feel the pressure change throughout my respiratory system. The constant pressure was much smoother for me. Now, I love my S9 Elite with pressure at 13 and EPR at 2. I don't need Bi-PAP and don't want the extra expense. Of course, different people have different experiences and needs.

pinebank, have you looked into dental devices? There is some talk on SleepGuide right now about a device called the Oral Systemic Balance device that two members had relief with. I believe that most dental devices work on moving the lower jaw forward to make more room in the back of the oropharynx to prevent collapse. Besides the MMA I haven't heard much positive about palate or tongue surgery. Enlarged tonsils or problems with the nasopharynx can be addressed with some success (again, unprofessional, annecdotal information).
Good luck, keep us posted.