Going in for a BiPAP today

Background: My wife has been having sleep problems for quite some time and I tried for YEARS to get her in to do a study. Finally she told me that she would go if I did, so I went in. The dr and I were pretty surprised that I has severe OSA and I have been on the mask for 2 months. My wife actually went in the day before I did, but she did not have real issues until REM so they had to do a study another night. Sadly we still had to wait the same 2 weeks for the referring dr to "read" the study results and then tell her to go back.

Fast forward another month to today: We are meeting with our DME to get a BiPAP. She was given pressures of 15/11 at her study with moderate OSA.

I've been doing all of my reading on CPAP and APAP devices, so I am a little clueless about BiPAP. I have my mind set on a ResMed VPAP Auto 25 since we're used to the ResMed devices and have the reader and software already.

Are there any questions specific to BiPAP that I should ask? She currently wears a Quattro, any masks she should consider? She prefers FF and hates nasal pillow or anything that puts pressure on her upper lip.

15/11, 15 will be the inhale pressure with 11 as the exhale pressure. It sounds like you're doing fine. If your wife likes the Quattro it's compatible with the ResMed machines. I'd just ask the DME rep if there is anything special you need to know. I still consider myself a newbie- have been on BPAP since September and found it easy to adjust to with the lower exhale pressure. Some of the pro's here probably can give you more detail. The machine you've picked out is a fine machine. Good luck and keep us posted.

Mary Z.

I have been on Cpap Therapy since June of 2005. In July of 2007 I got a Bipap, the best thing that has happened to me since I started cpap therapy.

Patrick, mind if I ask why? As I said above I don't know much about BiPAPs yet, but from an outsider perspective it seems like the only real difference is the ability to set a explicit cm drop for exhalation relief?

Is this for comfort purposes only or to reduce central apneas or both?

A quick question for those in the know, are the in/out pressures locked in or can they float like an APAP without a range?

I am on a BIPap also but my pressure is much lower now than originally because I have lost weight and had surgery. I was unable to do the cpap but with the BiPap the lower exhale pressure was enough relief for me so I could use it.

Gerry

BAsic BiPAP machines are like basic CPAP machines-- they have fixed pressures. Machines like the VPAP auto 25 you are looking at can autoadjust (different brands do it different ways)(Lots of people here like that machine). Beyond that, you get into the high-end machines like the servo-timed machines and the automatic servo ventilators. Those can be minutely fine tuned, and there are long discussions on this list from people doing just that. They also have prices to match.

Llama wrote:Patrick, mind if I ask why? As I said above I don't know much about BiPAPs yet, but from an outsider perspective it seems like the only real difference is the ability to set a explicit cm drop for exhalation relief?

Is this for comfort purposes only or to reduce central apneas or both?

A quick question for those in the know, are the in/out pressures locked in or can they float like an APAP without a range?

As already mentioned, a straight bilevel applies two pressures (in/out) and there are Auto bilevls put out by the main vendors. My fondness is for bilevels ever since I got one & I would not go back to straight cpap / auto unless using one of them for travel.

Must admit I have never been convinced that an Auto bilevel did much more than be an experiment by vendors to try the idea out. But from plain logic it sure looks like a great idea.

But on just bilevels, having 2 pressures has always struck me as solving the majority of problems one normally encounters, but we all differ and there are lots of folk here who I am sure are very happy with using bilevel autos.

Bilevels do add some complexity in that having those 2 pressures can be counter productive to some people. The higher ipap pressure may introduce centrals for some folk, but the good thing is the pressures & gap can be tuned. It is fairly typical to start with a gap of around 3 CMs between epap & ipap, I am using a gap of 3.8 CMs after some years of years of running a 3 CMs gap (10/13). The reason I adjusted the pressures recently was I discovered that by lifting the gap it seems to have eliminated years of nocturnal leg cramps that have plagued me since before I got onto cpap therapy. Magnesium (& bananas) weren't helping enough. I can't fully explain why such a cure appears to have worked based on the adjustment I made but I did it based on material I had read in regard to how adjusting bilevel pressures can change your CO2 rebreathing & thus blood CO2 levels. blood CO2 is a known influencer of things like cramps. Point I am making re this is that bilevls do add some complexity & these mysteries are still being learned & explored. For some of us, the rewards of successful setup can greatly exceed any downside.

Cheers

DSM

Hi,
I am on autopap and a newbie. Out of curiosity, when would BIPAP be prescribed? Is it only prescribed when there is some chronic obstructive lung disease or for neurological problems? Or is it prescribed for comfort as well?

Mine was prescribed once it was documented that I had failed on cpap. My insurance required a failure on cpap in order to cover a BiPap. It allowed me to exhale easier which was one of the problems I had.

Gerry

I originally bought my Bi-Pap Machine out of pocket. While I was on Cpap I would get up every morning and vomit. I would start coughing then I would vomit. I talked to my doctor about it, she said I didn't need a Bi-Pap machine . While I was traveling my machine quite so I got a Remstar Pro-2 Auto w/Cfle/cflex. I still got ill in the mornings but finally got a Bi-Pap Auto M-Series, I have not gotten sick in the mornings since. I talked to an RT and he said that the auto was good for me because it relieve the pressure when I exhale. They said that by doing that I quit having the acid reflux/gerd that was filling my throat with stomach acid and my stomach with air......I know that sounds lame but that's how he explained it in layman terms instead of 500 dollar words.

Ms.Snuffleupagus wrote:Hi,
I am on autopap and a newbie. Out of curiosity, when would BIPAP be prescribed? Is it only prescribed when there is some chronic obstructive lung disease or for neurological problems? Or is it prescribed for comfort as well?

I believe that they will be prescribed when a patient has compliance problems with CPAP, typically as a result of exhaling against the single pressure, even with pressure relief.

I recently swapped to a ResMed VPAP Auto 25 from an AutoSet II, and MUCH prefer it.

I started on CPAP this past June, but I had consistently high AHI (and AI) on my Elite II. The Autoset II was a lot better, but neither I nor my doc were happy with my therapy, as I was feeling no better. We finally did a two-week trial on the VPAP Auto 25, and my doc went ahead and prescribed it, as I feel much, much better. My AHI and AI are much better too.

I find that with the improved exhalation relief, I no longer puff air out my mouth. I was running CPAP/APAP on EPR3, but that extra 1cm full time seems to make a difference for me.

I have to say I love my machine. It helps me get good rest, which I hadn't had in y-e-a-r-s!