Sleep Study for Bipap Titration

Tomorrow I have to have my third sleep study to be fitted for a bipap. I was wondering how does this sleep study differ from a regular cpap sleep study? Also, are there any bipap machines considered bricks? Im trying to avoid getting another brick machine like my cpap is. Is there a machine I should request? Thanks in advance.

Respironics used to have a brick BiPap. It had "Plus" in the name like your current brick but I haven't seen one in the new PR System One model line. As far as I know if it is BiPap PR S1 (Respironics)...or S9 VPAP (ResMed) they are full data machines.
I am not familiar with any other bilevel pressure machines. They are out there but not commonly dispensed.

Your titration study will be pretty much like the other titration study only they will use a bilevel machine to figure out which pressures work best for you. They are quite comfortable (bilevel machines) and should be a piece of cake for you.

It's pretty much the same. You may want to ask them to give you a little bipap before your study to breathe with to get the feel for it before you go to bed. It should be easier but sometimes it's a bit odd of an adjustment.

Respironics PRS1 or ResMed S9 bilevels are easier to access data from.

By the way, BiPAP is a trademark, as is VPAP. "Bilevel" is the generic term. Individual models vary, but there's no real difference between the terms as far as the patients are concerned. Lots of people misuse BiPAP as a generic term.

Bi-level / Bipap is wonderful for me.

I had trouble exhaling on straight CPAP pressures over 10

The key for me to remember is to breathe normally and ignore what the machine is doing.

I almost hyperventilated the 2nd night. I started breathing faster and the machine matched my breathing and off to the races we went.

LOL

Ok, Im back to update. My sleep study went ok. I used a nasal mask for the first time and I fell in love with the extra freedom they provide. Too bad they do not make that particular mask anymore. It left a sore spot on my head for a few days. That's why the sleep tech said they stopped making that particular mask. I do not know the name of it but it had a dark blue gel around it. Anyway my pressure is 8-14 versus my old settings of 18 on the cpap. In the sleep study I found myself adjusting to the bipap quite well because I fell asleep so easily with i. I hope tonight goes smoothly. Lately, I have been getting these excessive nosebleeds that last over a half hour. I went to my doctor to get checked out. My doctor thinks they are caused by the cpap. So my DME does not think its a good idea for nasal pillows. That sucks because I wanted to try the swift fx for her with the bella loops. She also thinks my pressures are too high for it. Can anyone give me some masks recs based on all of this? Also I have updated my machine and I pray to god its not a brick, what software do I download if its not? Thank you all for reading and responding.

Give me a couple minutes and I will send you a private message about the software.
Your machine is NOT a brick. I have the same machine but in the slightly older model without the heated hose.
You have a super machine.

BTW...those pressures won't prohibit you from using a nasal pillow mask if you want to....I use higher and have great success.
I sometimes have seen my pressure line bumping 20... And yes, I can use the Bella Loops also.

Now the nose bleeds..I don't know...maybe it is just the drying of the nasal mucosa causing the bleeds. If that is the case a little more humidity should help.

what is the trigger that causes the doctor to consider switching to bipap? Is feeling uncomfortable with exhaling sufficient or is there some finding with the sleep data that points to bipap being a superior therapeutic choice for the patient?

I've used BiPAP fine up to 20 with nasal pillows. They won't cause nosebleeds if they fit correctly and you have enough humidity.

They need to seal very well at higher pressures to work, however. With BiPAP and changing pressures, that's even more true. Definitely can be used, just have to make sure it's the right pillows and it's dialed in right.

johnthomasmacdonald wrote:what is the trigger that causes the doctor to consider switching to bipap? Is feeling uncomfortable with exhaling sufficient or is there some finding with the sleep data that points to bipap being a superior therapeutic choice for the patient?

Very good question. I haven't seen any finding that points to bilevel therapy being superior in general to straight cpap therapy. Perhaps someone else has. I do know that for me -- while straight cpap can treat me fine, I personally like the more natural feel of bilevel's IPAP/EPAP changes. That feel is an "awake" comfort measure of course, but who knows... perhaps the separate inhale/exhale pressures keep me sleeping more restfully as well. Or maybe they don't matter once I'm asleep. I don't need bilevel (vs CPAP) but bilevel therapy is what I've chosen to use for many years now.

jnk posted a link to the American Academy of Sleep Medicine's practice parameters regarding Positive Airway Pressure.
viewtopic/t78730/viewtopic.php?p=715914#p715914

The link:
http://www.aasmnet.org/Resources/Practi ... essure.pdf

At the end of the PDF, there are two citations which may shed some light on whether cpap or bilevel is more effective treatment, in and of itself. I don't have access to medical journals, so I don't know if those studies touched at all on your question. The titles sounded as if they might. Those studies were done over ten years ago, however, and there have been changes -- particularly "comfort" improvements -- since then, in straight CPAP and in bilevel machines. And changes in mask designs. I strongly believe that mask comfort/discomfort can affect therapy efficacy with any machine... and I'm not talking about just whether the mask causes the person to not use his machine. A person could have 100% "compliance" and still not get restful sleep due to arousals from mask issues.

82. Reeves-Hoche MK, Hudgel DW, Meck R, Witteman R, Ross A, Zwillich CW.
Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med. Feb 1995;151(2 Pt 1):443-449.

91. Resta O, Guido P, Picca V, et al.
Prescription of nCPAP and nBIPAP in obstructive sleep apnoea syndrome: Italian experience in 105 subjects. A prospective two centre study. Respir Med. Jun 1998;92(6):820-827.

An old, but still interesting topic, about one doctor's non-mainstream approach in using bilevel instead of straight cpap for all (or most) patients. More recently, I think he has become a strong advocate of using ASV (adaptive servo ventilation) machines.
viewtopic/t26896/BILEVEL-PAP-Therapy-Pe ... urdle.html

There is another mask made that has the dark blue colored part called a ComfortGel Blue Nasal mask by Resperonics.
As to the pillows...perhaps the pressure is damaging the capillaries deep in your nostrals. Get with an ENT due to the danger of blood being pushed into your lungs and aspirating.
I also suggest you get a FF mask so that when you get sick, have allergies or other airway issues; you have a mask you can use the allows mouth breathing.

rested gal wrote:An old, but still interesting topic, about one doctor's non-mainstream approach in using bilevel instead of straight cpap for all (or most) patients. More recently, I think he has become a strong advocate of using ASV (adaptive servo ventilation) machines.
viewtopic/t26896/BILEVEL-PAP-Therapy-Pe ... urdle.html

Ahhh, the kinyesi thread.

Those were the good ol' days.

johnthomasmacdonald wrote: . . . trigger that causes the doctor to consider switching to bipap . . . ?

Often, I believe, in the context of OSA, it is when a patient with an AHI over 15 needs pressure above 15 cm and is very vocal about his or her inability to breathe out against the pressure. That way, a willing doc can "document" that CPAP is "ineffective" for that patient in order to get insurance to pony up for BPAP. I understand that sometimes "little white lies" have been employed in such processes, or similar processes--although, I, personally, of course, could never encourage, or ever condone, such a terrible thing! (http://respiratorytherapycave.blogspot. ... xygen.html)

Here is somebody's Medicare/insurance cheat sheet from somewhere last year for qualifying someone for BPAP, which includes conditions other than OSA in it, too: http://home2.coxhealth.com/homesupport/ ... -BIPAP.pdf (Pages 5 and 13 seem most relevant for OSA.)

deltadave wrote:. . . the good ol' days.

I miss them too. And I wasn't even there.

deltadave wrote:Ahhh, the kinyesi thread.

Those were the good ol' days.

LOL! yup.
Or rather I should say, ""ndiyo, naam" (via PM, of course!!)

Good links, jnk. Thank you.
That said (having been said ) this forum became all the richer and "good-er" when you arrived.

magnolia85 wrote:Ok, Im back to update. My sleep study went ok. I used a nasal mask for the first time and I fell in love with the extra freedom they provide. Too bad they do not make that particular mask anymore. It left a sore spot on my head for a few days. That's why the sleep tech said they stopped making that particular mask. I do not know the name of it but it had a dark blue gel around it. Anyway my pressure is 8-14 versus my old settings of 18 on the cpap. In the sleep study I found myself adjusting to the bipap quite well because I fell asleep so easily with i. I hope tonight goes smoothly. Lately, I have been getting these excessive nosebleeds that last over a half hour. I went to my doctor to get checked out. My doctor thinks they are caused by the cpap. So my DME does not think its a good idea for nasal pillows. That sucks because I wanted to try the swift fx for her with the bella loops. She also thinks my pressures are too high for it. Can anyone give me some masks recs based on all of this? Also I have updated my machine and I pray to god its not a brick, what software do I download if its not? Thank you all for reading and responding.

I have tried a lot of masks and the Resmed Mirage FX I have now, is by far the best and most comfortable mask I have ever tried. It seals very well, the whole design is allmost selfsealing with very little tension needed from the headgear. It's VERY quiet, theres hardly any noice at all when exhaling. The whole mask breaks down to only three parts and cleaning is very easy. I have the Swift FX in my drawer and loved it until I got the Mirage FX. Now the Swift FX is just too noicy and uncomfortable for me. You can check it out in my signature.