CPAP withEPR vs BiPap

Curious what is the difference between an Auto CPAP set with an EPR of 2 or 3 versus a BiPap??

With a bilevel machine the difference between inhale and exhale isn't limited to 2 or 3 like EPR is limited to 3.
Also with a bilevel machine the maximum pressure is 25 and not the 20 you see on apaps.

Bilevel machines can go to higher pressure (25 cm H2O) and have a much higher pressure relief from IPAP to EPAP. My machine is set for IPAP of 20 - 25 cm H2O and EPAP of 15 - 20 cm H2O which is a pressure support (PS) of 5. CPAP machines normally have a maximum pressure difference of 3 cm H2O between inhale pressure and exhale pressure.

a few can go to 30

The reason I was asking is that to support approval of my ASV, I must now take a BiPap titration,
My RXs over the past ten years has never been over 14 and the ERP has never been above 2.
I do not understand why a BiPap might be the solution over my Auto Cpap when the doctor thinks I need the ASV??
I guess this will be one of my questions when I hopefully get to meet with him soon.

rozenbob wrote:The reason I was asking is that to support approval of my ASV, I must now take a BiPap titration,
My RXs over the past ten years has never been over 14 and the ERP has never been above 2.
I do not understand why a BiPap might be the solution over my Auto Cpap when the doctor thinks I need the ASV??
I guess this will be one of my questions when I hopefully get to meet with him soon.

You can choose to bypass the bipap by be willing to pay for your own ASV. It is because you want someone ELSE to pay for it, that it is a requirement. A gentleman that I talked to at the Sleep Clinic last week while waiting for bro had a split study - half the night was bipap and IF THAT FAILED, the other half of the night was ASV. Try running that by your insurance company to see if they are willing to work that one out especially if you have strong indications of ASV need.

If you didn't have any centrals at the most recent sleep study I fail to see how a bipap titration to reduce centrals is going to help things.

Now if you did have enough centrals on that most recent sleep study to warrant concern then trying regular bipap before going ASV is a logical step to take and many insurance companies will require that step.

Pugsy wrote:If you didn't have any centrals at the most recent sleep study I fail to see how a bipap titration to reduce centrals is going to help things.

Now if you did have enough centrals on that most recent sleep study to warrant concern then trying regular bipap before going ASV is a logical step to take and many insurance companies will require that step.

Hmmm... I had SSA when I started this therapy. No centrals. After a few months on straight cpap, my doctor said she thought I'd do better with bipap and somehow got approved for it by Medicare. Of course, that was six years ago. Is having centrals the 'only' reason for bipap? If there are other reasons, what might they be?

Lucyhere wrote: Is having centrals the 'only' reason for bipap? If there are other reasons, what might they be?

No, there are other reasons for using bilevel pressures besides centrals.
Other reasons like problems exhaling against regular single pressures or high pressures or maybe just aerophagia even at lower pressures.

rozenbob wrote:I do not understand why a BiPap might be the solution over my Auto Cpap when the doctor thinks I need the ASV??.

because procedures.

Because accountants get to write the rules--not doctors.