Auto CPAP vs BiPAP

Hi,
I realize this question has probably been covered many times in previous threads, but I can't go back and read em' all. I also understand that every users symptoms and remedies are individual.

Because of the hight titration pressure on my CPAP machine, and subsequent abdominal bloating, I called the therapist my Sleep doctor sent me to. She is the rep. for the company I lease my machine from. We all agreed a one month trial would be the wisest way to start.

I mentioned that maybe I need a BiPAP machine because of the hight titration value. She replied that the biPAP doesn't necessarily solve that particular problem, rather, it is designed to address other breathing problems. Her advice was to consider an Auto CPAP machine, which incidentally, my sleep doctor does not recommend.

Now I feel I'm on a roller coaster because I have so much advice coming at me. Obviously if it were the right machine, I'd buy the Auto CPAP, because it's much cheaper that the BiPAP. I'm told that one option on the more expensive machine is that it will go up to 25cm/H20, which might be useful later on.

Without wishing to open up a whole can of worms, anyone here have enough experience to have an opinion on the pro's and cons of each machine? After all, I really want to buy the right machine for me and I don't want to waste money.

Gordy.

Perhaps shoot for the best of both worlds? Respironics BiPAP Auto with Bi-flex. Can operate as just a bipap, or as a bipap/autopap at the same time.

If they wouldn't let me have the BiPAP Auto and I had to go one way or the other (autopap or bipap) then I'd opt for the Respironics REMstar Auto with C-flex.

The autopap would find the varying pressures needed throughout the night. Might be able to use a lot less pressure for you most of the night, or even most nights.

It's very possible you might not need the full titrated pressure that came out of your sleep study. I mean...might not need it all night long. Perhaps you need that single prescribed pressure only during "worst case scenario" which for most people is when sleeping on their back and in REM.

If they'd let you have the BiPAP auto, you could have two things going for you at once -- less pressure in general possibly for most of the night (the auto-titrating feature) along with the comfortable lower exhalation pressure of a bipap.

Good luck!

Gordyp wrote:Without wishing to open up a whole can of worms, anyone here have enough experience to have an opinion on the pro's and cons of each machine? After all, I really want to buy the right machine for me and I don't want to waste money.

Gordyp, I concur with RG's bottom line recommendation. If you can only choose one machine, then the one to get is certainly the BiPAP-auto.

However ( . . . this is where it gets tricky), as one of the few folks on this forum who own both the BiPAP-auto and the Remstar-auto, I can tell you that the answer as to which machine will provide better treatment for you is not at all clear-cut. Here are some of the considerations which I found made a difference for me.
- Do you require nearly constant pressure throughout the night? If so, an automatic machine, or APAP, will not reduce your aerophagia at all.
- Do you tend to mouth breathe, or have mouth "leaks" or "puffs"? If so, then BiPAP will likely exacerbate that problem, whereas with APAP, or CPAP, it seems that some of us find the issue resolves itself over time.
- Do you find one machine provides more comfortable sleep than the other? It happens. I actually get more sleep time and deeper sleep with straight BiPAP, but less aerophagia pain with APAP - go figure.
- Do you tend toward hyperventilation? If so, then a BiPAP may be a bit of a problem.

Bottom line - I think that the way you are trialing machines is the right thing to do. If your doc is stuck on BiPAP, then the path of least resistance is simply to request an IMMEDIATE swap-out with the Respironics BiPAP-auto. If that doesn't work out well for you, only then should you consider the Remstar-auto.

Also, while you are trialing the machines, do yourself a favor and make sure you get the software which allows you to monitor your nightly data. It's obvious that you want to take control of your therapy and make it work for you.

Regards,
Bill

Thanks for responding RG and Bill.

Lots to consider here. The plot thickens!

Gordy.

If my pressure was over 15cm, I'd definitely get the Bipap Auto.

While the cost for the Bipap Auto is double what the Auto is, its only your health and sleep. Worst case, you can make the Bipap Auto nearly simulate a Autopap still getting at least 2cm exhale relief. Set up a range and it can go from low to high.