What are my choices for a high pressure machine? (over 25)

Hi, all! I've been on CPAP for a while, no luck, then switched to BiPAP, then finally got an ASV titration, and boy was it enlightening. My doctor is recommending that I have an EPAP of 26 and a PS min of 5-6. I haven't gone back to ask my doctor about this, but after browsing around it seems like this is a really unusually high pressure. Neither of the two main ASV machines, the VPAP adapt or the Respironics, can handle pressures that high. Do I have any other choices, or am I going to need some kind of roll-on ventilator cart? The seriousness of those numbers is kind of scaring me. I've heard about something called the "NIPPY" which can go up to 38 but it seems like they only prescribe that in Europe.

Does anyone have any ideas here? Thanks in advance for your help -- this board has really been a godsend while trying to sort through these issues...

Check out air compressors at Home Depot for that pressure! Just kidding - afraid I have no clue on a helpfull answer, but the thought of 25 isn't pretty. Can you even keep a mask on that high?

SuperGuest wrote:Hi, all! I've been on CPAP for a while, no luck, then switched to BiPAP, then finally got an ASV titration, and boy was it enlightening. My doctor is recommending that I have an EPAP of 26 and a PS min of 5-6. I haven't gone back to ask my doctor about this, but after browsing around it seems like this is a really unusually high pressure. Neither of the two main ASV machines, the VPAP adapt or the Respironics, can handle pressures that high. Do I have any other choices, or am I going to need some kind of roll-on ventilator cart? The seriousness of those numbers is kind of scaring me. I've heard about something called the "NIPPY" which can go up to 38 but it seems like they only prescribe that in Europe.

Does anyone have any ideas here? Thanks in advance for your help -- this board has really been a godsend while trying to sort through these issues...

What are the credentials of the Doc and the clinic that suggested an EPAP of 26 cm?

The poster John Fisher has a machine that's goes up to 25 cm on IPAP and EPAP. See it here:

Click on Specs

https://www.cpap.com/productpage/3538

Believe it or not, my Headrest nasal mask managed to stay largely leak-free throughout the sleep study. The sleep tech offered me a full-face mask, but I turned him down. When you find something that works...

avi123 wrote:

SuperGuest wrote:Hi, all! I've been on CPAP for a while, no luck, then switched to BiPAP, then finally got an ASV titration, and boy was it enlightening. My doctor is recommending that I have an EPAP of 26 and a PS min of 5-6. I haven't gone back to ask my doctor about this, but after browsing around it seems like this is a really unusually high pressure. Neither of the two main ASV machines, the VPAP adapt or the Respironics, can handle pressures that high. Do I have any other choices, or am I going to need some kind of roll-on ventilator cart? The seriousness of those numbers is kind of scaring me. I've heard about something called the "NIPPY" which can go up to 38 but it seems like they only prescribe that in Europe.

Does anyone have any ideas here? Thanks in advance for your help -- this board has really been a godsend while trying to sort through these issues...

What are the credentials of the Doc and the clinic that suggested an EPAP of 26 cm?

It wasn't Hollywood Upstairs Medical College, if that's what you mean...

It was a reputable hospital in Connecticut with a dedicated sleep study wing. The guy seemed to know what he was talking about, and I am a little on the heavy side...about 300 pounds. I find it almost impossible to sleep in any position other than supine, too. For what it's worth, I had a great night's sleep during the titration.

You guys are starting to make me even more worried, now...

What's a Headrest nasal mask, did you mean this Everest?



If this it then how do you tie a chinstrap?

Er, sorry. I mistyped. Meant to say nasal pillows. Headrest is just the brand...I think it's made by AEIOMed.

Yeah, that's the one.

My bipap is set at 24. I don't know how high it can go.

jaybee72 wrote:Check out air compressors at Home Depot for that pressure! Just kidding - afraid I have no clue on a helpfull answer, but the thought of 25 isn't pretty. Can you even keep a mask on that high?

My mask stays on just fine.

cpap/bipap pressures are not that high. at 20 you're only at around .25 psi. so 30 wouldn't be as high as .3 psi. you think not? put a balloon on the air outlet and you'll see at the highest pressures the machines don't even blow up a balloon. vents are in the range of 80 cm/h20.

check out ResMed VPAP™ Auto 25 with H4i™ Humidifier. it goes 4 to 25 cm H2O Maximum single fault pressure: 30 cm H2O

Respironics offers machines that go to 30 cm. This one for sure. I didn't look at the others to check specs.
For sure the PR S1 Bipap AutoSV Advanced
http://bipapautosvadvanced.respironics. ... eet_EN.pdf
http://www.healthcare.philips.com/us_en ... rature.wpd

http://www.healthcare.philips.com/us_en ... efault.wpd

Wow, cool. I didn't realize there was an older Respironics ASV that went up to 30. Definitely going on the "maybe" list.

There's still the question of the inspiratory pressure, though...I'd only be able to get up to 4 cm h20 of pressure support. Aren't there any machines that go up to 32 or 33?

SuperGuest wrote: I didn't realize there was an older Respironics ASV that went up to 30.

I wouldn't want an older model if it were me...the new PR S1 models have been available since last summer.
Not sure if my link was for the new or old as it bounced me around a bit getting there but this machine here is the latest in that particular model and it does indeed go to 30 cm.
https://www.cpap.com/productpage/PR-Sys ... anced.html

I have never heard of any non invasive machine that would go above 30 cm pressure.

Edit: my error...when I went to the Respironics website and clicked on the PR S1 BipapAutoSV Advanced literature page it sent me to a spec page for the older model which did go to 30 cm and I didn't catch it because there was no image.

The Respironics PRS1 ASV Advanced DOES NOT go above 25 cmh2o. The only machine that currently does that is the older classic Respironics ASV Advanced, they are still available from Respironics brand new. If however you need to go above a pressure of 30 cmh2o you will need a ventilator, there are many on the market. Don't let the word "ventilator" scare you, they can still be used in a non-invasive mode with a mask. Depending on the ventilator you get you MAY be limited in the type of mask you can wear with it.

Here is the link to the PRS1 ASV specs http://www.healthcare.philips.com/asset ... cSheet.pdf


Keep us updated on your progress in getting the appropriate machine for your needs. Feel free to PM me if you have more specific questions.