Apap To Bilevel??

back in Jan i had an overnight Oximeter test and i just the results today i had 84 Desat events 9 per Hr, low O2 was 88% and was 1 time for only 8 sec and 89, 5 times 32 sec,12 sec,16 sec,44 sec and 2:16 here is what there recommendations and considerations are Oxygen It appears patient does NOT qualify For nocturnal Oxygen per medicare guidelines. (i don't have medicare i have medicaid SAGA).SLEEP DISORDERED BREATHING It appears this patient continues to have Sleep Disordered Breathing as they have 5 or more Desat Events on PAP.Prescribing BI Level therapy or a follow Up titration study in a lab maybe warranted . repeating the overnight test after any changes are made to determine effectiveness may be beneficial.


i am not sure what bi level means i am now on apap i do see my reg dr this tues should i be worried?

any advice would help thanks

Randy32 wrote:i am not sure what bi level means i am now on apap i do see my reg dr this tues should i be worried?

any advice would help thanks

I wouldn't be worrried. Bi-level is providing you separate pressures for inhale and exhale. When I was switched, it was a marvelous change for me as I was having difficulty exhaling against the pressure. Bi-level machines can also be automatic, which gives even more flexibility.

I'm sure some others will chime in with more helpful information. But don't be concerned about bi-level. A lot of people find it more comfortable to use.

i forgot to mention I went to my Pulmy today as well before i got the results she told me that i have Obstructive Airway Obesity Disorder i looked it up and all i could find was Obstructive Airway Disorder also the same as COPD. she also said if i have to have surgery on my knee she wants to talk to the Dr and let them know that i should be put in ICU overnight and left intubated because of the diorder that kinda worries me a bit

You have a bit of a jerk for a doctor. You have obstructive sleep apnea. Obesity can contribute to the problem, but it comes from lax muscles that block your airflow when you sleep. Many doctors think that only overweight people suffer from it, hence her goofy diagnosis, but that's not true. Losing weight would probably help your breathing, and make your knee surgery easier as well, but you would probably still have sleep apnea.

Yes, the OBS does have to be taken into consideration by the anesthesiologist. But I would wait to see what s/he has to say instead of letting your doctor terrify you. You will need to be monitored, but it may not necessarily be in an ICU. Ask the anesthesiologist about bringing your cpap or bipap to the hospital with you for use after surgery.

You'll probably like the bipap. I found it easier to breathe with than the cpap, once I got used to the changing rhythm.

Randy32 wrote: . . .Obesity . . . she also said if i have to have surgery on my knee she wants to talk to the Dr and let them know that i should be put in ICU overnight and left intubated because of the diorder that kinda worries me a bit

She may need to highlight the obesity to make sure you get bilevel, or something. She is likely trying to be helpful to you in doing that, I would think.

She is smart to make sure any anesthesiologist is aware of your need for extra consideration following surgery. That info could be life-saving to you. Anesthesia, pain meds, sleeping on the back is a bad combo for many of us. Personally, I would make sure to have that conversation with my medical team myself the day of the surgery to make sure everyone assigned to me that day was aware of my obstructive sleep apnea. Sometimes anesthesiologists get switched the day of surgery. That's why having the discussion that day is good.

No need to worry about the switch to bilevel to get the help with breathing at night, though. It is a good thing. Plenty of us are on bilevel and love it!

Thanks everyone for your reply's. i feel like i can come here and get the help and advice i need

ok so i went to my Reg DR today she wants everything to be passed on to my pulmy. but she is the one who ordered the overnight O2 study i thought i saw here right down Night time O2 on the paper but the O2 study says i do not qualify for it by medicare standards( i am only 32 i am not on medicare) anyway i had 84 desats most under 3 min's but she emphasized on that fact that i so many desats but the results do recommend bi-level therapy

It doesn't matter that you don't qualify for medicare..............most insurance companies use the medicare guidelines as the standard for their insurance--so the report or doc is really saying that you do or don't meet the standard for.....

Do not worry about bipap (Respironics) or vpap (ResMed).........I recently changed, and (specifically with advice from Slinky on this board) the switch was wonderful in so many ways. You don't mention what your current pressure is--I made the switch due to high pressure on apap.

Randy32 wrote:i forgot to mention I went to my Pulmy today as well before i got the results she told me that i have Obstructive Airway Obesity Disorder

Your pulmonologist probably had this in mind:

Obesity hypoventilation syndrome (OHS)
http://www.nlm.nih.gov/medlineplus/ency ... 000085.htm

A person with that can also have OSA (obstructive sleep apnea) of course.