Auto bipap per doctor ---but which is "best" unit?

dllfo · Post by **dllfo** » Sun May 07, 2006 5:08 pm

I am new to the forum and Cpap/Bipap. I am supposed to get an auto bipap, but have NO clue as to which one to try for.

Or maybe I don't get a choice? Tricare is my insurance. For example:
Tricare got me a large Nebulizer, 110 volt. It worked ok, within limited para-
meters. I wanted more flexibility, so I bought myself an Omron NE -U22 unit, which much smaller and easier to use. Uses 2 AA batteries and fits in my shirt pocket. I can even use it as I drive if I need to.

So I think I would want a small auto bipap, if there is one...I am not sure I will care about the codes for awhile. I understand I won't be using it as I drive, etc. Operating on 12 volts would be nice.

I also would like to get the "best" mask. Again, if there is such a thing.
Bu best I think I mean comfortable, usable and with the capability of fitting
several Bipap machines. If they get me an auto bipap that doesn't meet my needs and I buy a different unit, it would need a mask.

This is all new to me and I may be asking the impossible, but I am hoping
to be knowledgeable enough to know which equipment to ask for before I
have to pay for it myself.

Any help appreciated...thanks...Dave

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Sun May 07, 2006 5:30 pm

dllfo, I can't answer your question on bipaps, hopefully somebody will come along to answer that part of your question. As far as masks go, they are a very individual thing, and nobody can tell you what mask is right for you. The best thing is to try on as many masks as you can when you meet with your DME and see which one works best for you. The 3 main kinds of masks are Nasal Mask, Nasal Pillow, and Full Face Mask. Read the forum and look at https://www.cpap.com to get an idea of the masks and machines that are available.

dsm · Post by **dsm** » Sun May 07, 2006 6:35 pm

For an AUTO BiPap the choice is simple. AFAIK there is only the one. The Remstar AUTO Bipap.

For straight BiLevel good choices include (S/T models are not included below)

Respironics Bipap Pro 2
Resmed VPAP III
Puritan Bennett KnightStar PB330

If however you require a full face mask, and want to buy a Respironics Bipap Pro 2 or Bipap S, try it before you pay. These machines especially when run at high CMS, can have difficulty controlling IPAP/EPAP flipping when used with F/F masks or other masks with similar high fixed-leak rates (the little air holes that let excess air & co2 out).

Good luck

DSM

NightHawkeye · Post by **NightHawkeye** » Sun May 07, 2006 6:39 pm

dllfo wrote:I am supposed to get an auto bipap, but have NO clue as to which one to try for.

Or maybe I don't get a choice?

That is correct. There is only one auto-BiPAP made. It is manufactured by Respironics. Here's a link to it:
https://www.cpap.com/productpage/bipap- ... ifier.html

Make sure you get the heated humidifier, and also the software so that you can monitor your progress.

Welcome, Dave. The BiPAP-auto is a good machine. You should do well with it.

As for masks, that is largely individual preference, and many have to try a few before they find one that is compatible. Look through some of the posts and you'll quickly see some of the more popular types. The Ultra Mirage full face and nasal masks are both good. I like the Swift, and also the ComfortLite 2, although both are quirky in their own ways.

Best of luck with your treatment, Dave.

Regards,
Bill

mdkohm · Post by **mdkohm** » Sun May 07, 2006 9:33 pm

Let me make sure I understand.

I am supposed to be on Auto with Bi-level or expiratory relief. I have the S8 Vantage which is set on Auto 6 - 16. Does that mean that this machine does not do both Auto and EPR at the same time? Does it only do EPR when set to CPAP?

I have only used the machine for about 40 hours (new to treatment) and I think it is waking me up at higher pressure due to trouble exhaling. I don't think the DME knew what he was doing?

Let me know if I am incorrect in my statements above.

Guest-DSM · Post by **Guest-DSM** » Sun May 07, 2006 9:48 pm

"I am supposed to be on Auto with Bi-level or expiratory relief. I have the S8 Vantage which is set on Auto 6 - 16. Does that mean that this machine does not do both Auto and EPR at the same time? Does it only do EPR when set to CPAP?"

S8 Vantage can do AUTO where it is set to a min pressure & a max pressure & machine attempts to find optimum CMS for your sleep state.

BiLevel relief does describe what EPR is but the S8 Vantage can only activate EPR when in CPAP mode.

EPR can switch inhale & exhale pressure by 1, 2 and 3 CMS for the duration of the breathing cycle. By contrast, c-flex & bi-flex will provide a short burst of exhale relief at the very start of the Exhalation cycle (varying this effect with settings of 0, 1, 2 & 3).

When in EPR CPAP mode then, an S8 Vantage can act like a limited function BiLevel machine (with settings of 1,2 or 3 CMS between 'IPAP' & 'EPAP').

Cheers

DSM

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Sun May 07, 2006 9:55 pm

The S8 Vangate is not a bipap, it is an autopap. An autopap changes pressure as needed, but there is no exhalation relief when in auto mode. Also, the maximum exhalation relief is 3cmh20. Bipap can be set to an inhalation pressure and an exhalation pressure, and there is no limit on the difference. The auto feature means it can adjust to your needs and give you lower pressures for part of the night, and then adjusts the pressure to your needs, so you don't have to be on a high pressure the entire night.

mdkohm · Post by **mdkohm** » Sun May 07, 2006 10:01 pm

Thanks Sleepy Dog.

I think the DME assumed (as did I - but what do I know) that the EPR would also function in Auto mode.

It sounds like I need to call them in the morning. This could explain some of my problems with getting used to my treatment.

rested gal · Post by **rested gal** » Mon May 08, 2006 4:08 am

mdlkohm, if you want a machine that can give the precise "no limit to the difference" settings of separate pressures for inhaling and exhaling like Sleepy Dog Lover mentioned -- AND have a machine that can also vary the pressure as needed throughout the night, you might want to ask for a Respironics BiPAP Auto with BiFlex.

It's a true combo machine that can work like a bilevel (separate IPAP/EPAP pressures) to give exact pressure relief for each exhalation while at the same time function as an autopap to use whatever varying pressure you need.

mdkohm · Post by **mdkohm** » Mon May 08, 2006 6:05 am

Thank you all for the information. What concerns me is that my doctor had ordered a machine set on Auto from 6 - 16 with either C-FLEX or EPR set to 3.

It looks like the doctor didn't know that you can't have Auto and EPR at the same time.

And the DME didn't know that he wasn't giving me what was prescribed.

It makes me mad that I only stumbled upon this information in this forum by accident. I have been struggling with claustrophobia and wake up several times at night feeling like I am unable to exhale (probably against the higher pressures my machine reaches during the night).

I ASSUMED that I already had both Auto and EPR, so I would have to either lean to deal with it, or give up completely. If it wasn't for this information found here I would not have known that my machine is not giving me the relief on exhale that I was prescribed.

You may ask how I didn't know that this wasn't working. Honestly the whole thing feels so foreign that I really didn't know. I am still working on wearing the machine and falling asleep without thinking "I have a machine hooked to my head....breath...breath...breath" - LOL

NightHawkeye · Post by **NightHawkeye** » Mon May 08, 2006 7:06 am

Please don't take my comments the wrong way. It's obvious that you're seriously interesting in optimizing your treatment, so it may be important to you to understand how the "system" currently works.

mdkohm wrote:It looks like the doctor didn't know that you can't have Auto and EPR at the same time.

In general, physicians are highly ignorant of equipment capabilities. Just spend a little time reading through the posts and you'll gain an appreciation of how woefully uninformed they really are.

mdkohm wrote:And the DME didn't know that he wasn't giving me what was prescribed.

This may or may not have been true. Some folks put DME's in the same class as used car salesmen. Just remember that their primary mission is to make money. Very few accounts of DME's being altruistic have surfaced here, whereas many accounts of DME's lying to patients have been described.

The adage "Caveat Emptor" is directly applicable to all things xPAP related.

No need to get mad about it though. It's just the way things are. Being successful with xPAP treatment, unfortunately, means dealing with this stuff. Learn as much as you can and deal with your DME and physician as you would any other business. (Both are in the business of making money, after all.) Treat it as you would buying an automobile and you'll be just fine. Do your research, don't believe empty promises, make 'em stand behind the claims they toss out.

Regards,
Bill

sthnreb · Post by **sthnreb** » Mon May 08, 2006 9:07 am

AMEN!

mdkohm · Post by **mdkohm** » Mon May 08, 2006 9:15 am

I spoke to DME and they are going to switch out my ResMed Vantage for the Remstar Auto Bi-Flex. Is that a pretty good machine?

Now what do I do with the $200 software (AutoScan 5.7) and reader I just bought on Friday?

Anyone want to trade AutoScan for Encore Pro? I really can't afford to spend another $150 on new software. Jeez, trying to get involved with your treatment can get costly.

Thanks for all the great help.

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Mon May 08, 2006 9:26 am

Thats a great machine. I believe that is the only auto bipap out there.

Where did you buy the software from, and did you open it yet? If you haven't opened it, I would talk to the people you bought it from, you may be able to get your money back. Of course, there may be a restocking fee.

Wulfman · Post by **Wulfman** » Mon May 08, 2006 10:07 am

mdkohm wrote:Jeez, trying to get involved with your treatment can get costly.

Yup! But so are the alternatives.

Just look at it as tuition paid for a "correspondence course" at an institution of higher education.

Best wishes,

Den

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Auto bipap per doctor ---but which is "best" unit?

Auto bipap per doctor ---but which is "best" unit?

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