respiratory muscle weakness and bipap

Hi everyone! I have a very long sordid medical history, including a 6 month trial of cpap 2 years ago. I tried a search with several different terms but nothing came up, so I apologize if these questions are repetetive!

I now have a tentative diagnosis of resp. muscle weakness with MIP's and MEP's waaaaaay below expected for age (59). I think they are less than 50% of predicted. They are most definitely accurately done. It would explain many of my persistent symptoms, including SOB with exertion despite well compensated CHF and a pulmonary artery pressure of 25mean. I also get severe resp. muscle fatigue at times, like during a party or long social function. At that time I feel like I need a vent, and it isn't the same as SOB at all. I have been on oxygen at night for over 4 years now. Extra O2 during these episodes does help. I continue to be very tired all the time.

I moved and just saw a new sleep doctor. This guy and my regular pulmonologist both think I need bipap at night to un-load the resp. muscles. I am on SSD for the heart things and thus on Medicare with a supp.

My questions :

What are the medicare criteria for bipap without a specific diagnosis for the resp. muscle weakness? (I had a muscle biopsy and it is still pending.)

What is v-pap and how is it different from the bipap?

I had a sleep study last night to qualify but had no REM sleep so I didn't desat much, off O2, and no apnea. The tech thinks I will not qualify. Would I still need only an AHI of 5?

If I do qualify, what is the most appropriate machine for me?

What other questions should I be asking?

Thanks in advance, Margaret

ps. I remember Rested Gal from my previous trial of cpap

I don't remember the qualifications off the top of my head and if I have a few minutes later I will check, but I do know that Respironics website has a Bipap or RAD qualification flow chart that is what most insurances go by. I have seen quite a few patients without a definate diagnosis qualify. MIPs and MEPs alone may do it, I will have to check.

Bipap and vipap are brand names for a bi-level machine. The first is made Respironics, the second by Resmed.

Respironics is the only company the makes an Bi-level machine that automatically adjusts its pressure, called (of course) Auto BiPap.

O.