...me again....back to sleep center

for a second titration study,,,first one I woke every hour and not "enough data collected"...the doctor said that I have a "severe" case (I think she said 65 events per hour on initial study) and that may need a bipap machine.....and to think that I was about to understand cpap, now I have to restart wit bipap..HELP!!!!!...what does this mean?...if a bipap machine is needed, which is recommended?....what kind of mask?...different for bipap vs cpap?.....I do sleep with mouth opens most of the time and was told to try to use a "full face"mask...nOT a "total face"mask, as recommended, by some of you friends...yes I am beginig to feel that the people here are real friends since they invest so much time an effort in keeping us "innocent" "victims" informed...lol

Ralph L...

First of all, the severity of your apnea does not necessarily dictate what machine or pressure you need. There are people who tested over 100, but only need low pressure settings to open their individual airways, and others who tested 15 and need high pressures to open their narrow ones. Apples and oranges, so don't let the techs scare you!

svo wrote:may need a bipap machine.....and to think that I was about to understand cpap, now I have to restart wit bipap..HELP!!!!!...what does this mean?...if a bipap machine is needed, which is recommended?....what kind of mask?...different for bipap vs cpap?....

first.. "BiPAP" is a trademark name by respironics, like "Xerox" instead of copier. what you're talking about is a bilevel machine.

bilevels are nothing to fear or worry about, they give you a higher max pressure capability, and they have different different pressures for inhale and exhale... that's pretty much it. it's like having a lot more exhale relief than a regular cpap can give, if you need it.

there's a number of folks on the forum that use a bilevel simply because they prefer how it feels to breath with one.

I prefer the resmed vpap/aircurve machines, they're more tailorable to your exact wishes, and quieter than the respironics.

svo wrote:for a second titration study,,,first one I woke every hour and not "enough data collected"...the doctor said that I have a "severe" case (I think she said 65 events per hour on initial study) and that may need a bipap machine.....and to think that I was about to understand cpap, now I have to restart wit bipap..HELP!!!!!...what does this mean?

A bilevel (BiPAP) machine has two distinct pressure settings: one for exhalation (EPAP) and one for inhalation (IPAP). They can also be set up to run in CPAP mode. The maximum pressure can be set as high as 25cm, which is 5cm higher than a CPAP.

The difference between IPAP and EPAP can be set to be wider than what can be achieved with exhalation relief systems on CPAP machines.

It's a bit unusual, but not unheard of, for a doc to recommend a bilevel as the first machine. While the pressure needed to fix the OSA is not dependent on the severity of apnea, it could be that during your first titration study something happened that indicated that you might do better on a bilevel. It could be that you were titrated to a pressure up around 15-20 cm, and at these pressures, some people are more comfortable with bilevel machines because the IPAP - EPAP difference makes it much easier to exhale against the pressure.

It could also be that the tech who ran first study noticed something like increased restlessness with increasing pressures. Or it could be as simple as no suitable single pressure was found to manage your OSA.

...if a bipap machine is needed, which is recommended?....

The two most common bilevel machines on the board are the Resmed VPAPs and the PR BiPAPs.

The newest Resmed VPAPs are the AirCurve 10 VPAP and AutoVPAP. The newest PR BiPAPs are the DreamStation BiPAP Pro and the DreamStation BiPAP Auto.

An Auto bilevel has some advantages in terms of flexibility. But the Auto algorithms of the Resmed and PR machines work differently. If your sleep doc really wants you on an Auto bilevel, he may make a specific recommendation based on the differences in the algorithms. Then again he might not.

The biggest difference in the two Auto algorithms is that the Resmed machines use a fixed PS algorithm. So on a Resmed auto bilevel, the IPAP and EPAP increase and decrease together as the pressure needs change. The PR machines us a variable PS algorith. So on a PR auto bilevel, the IPAP and EPAP can increase and decrease independently of each other.

what kind of mask?...different for bipap vs cpap?.....

Same mask choices for both machines.

I do sleep with mouth opens most of the time and was told to try to use a "full face"mask...nOT a "total face"mask, as recommended, by some of you friends...yes I am beginig to feel that the people here are real friends since they invest so much time an effort in keeping us "innocent" "victims" informed...lol

Any of the full face masks that folks around here recommend will work with a bilevel.

...thank you my friends for all your advise....things are begining to make sense...still hating to go and the second tritation study..can't stand the "gooey" stuf on the head and face to attach the electrodes or contacts or whatever, I guess I will try to have a short sleeping time in the preceeding 24 hours so I can fall asleep sooner and stay asleep next Mondat when I have the tritation done...thanks again...will report ....

Ralph L...