BIPAP: Should we all use it?

[Miko]

Just wondering if it is a good investment in getting a bipap machine to prevent any lung issues as a result of longterm CPAP use? To me, it only makes sense since your lungs are "stressed" by the extra exhalation they must endure while using CPAP or even C-FLEX?

[Guest]

your therapy pressure dictates a bipap. A bipap is just like cpap but it allows you to set different pressures for inhale and exhale.

if your pressure is low or under 15cm there is really no need for bipap.

[dsm]

Actually, A Resmed CPAP with EPR is a small Bilevel with max 3 cms seperating the inhale from exhale. My 'big' vpap 3 Bilevel is now set with that gap after I found my AHI was just too high when I had the gap wider - I did have it a 15/8 that was a gap of 7 cms.

Bilevels do offer great exhalation relief - I consider the real benefits for me, to be

- the minimising of aerophagia (that tends to be higher when I am on straight cpap or auto cpap.

- The reduction in mask leaks - on cpap, these are often triggered by that momentary increase in pressure when I sto inhaling & start exhaling - machine trying to pump 15 cms in & me trying to breathe better than 15 cms pressure out to overcome the machine. Mask seal is the weak point - the machine won't give up & when I exhale, neither will I.

DSM

[MandoJohnny]

getting a bipap machine to prevent any lung issues as a result of longterm CPAP use?

What lung issues? If you have seen any articles or studies that indicate "lung issues" due to exhalation stress on CPAP, I would really like to see them. I have not seen or heard of such a thing.

If this is just a theory, what lung conditions would you think might result from exhalation stress?

[mister_hose]

Actually, A Resmed CPAP with EPR is a small Bilevel with max 3 cms seperating the inhale from exhale.

[...]mask leaks - on cpap, these are often triggered by that momentary increase in pressure when I sto inhaling & start exhaling - machine trying to pump 15 cms in & me trying to breathe better than 15 cms pressure out to overcome the machine. Mask seal is the weak point

This is why I suspect that Respironics' C-Flex might be better than ResMed's EPR. I have C-Flex and never have had EPR, but your descriptions are interesting. The C-Flex's breath prediction techniques may be superior to EPR's, because after the first 30 seconds or so of breathing, C-Flex seems to "learn" my breathing cadence and it usually perfectly predicts exactly when to cut the pressure, leading to a smooth, natural inhale-to-exhale transition that I can't even "feel". Certainly no momentary mask leaks while I'm fighting the machine's pressure, before it "realizes" I'm exhaling and cuts the pressure!

Perhaps EPR is less sophisticated, then. I know C-Flex observes your recent breathing history to determine when to transition the pressures, and the prediction works very well indeed. Perhaps EPR does only realtime observation, and doesn't have a "history" that can let it make accurate predictions on exhale timing?

Just thinking out loud.

P.S.-- it's fun to mess with C-Flex's mind. Take long, slow, deep inhales for 15-20 breaths consistently, then halfway through your next inhale, suddenly exhale. It'll "fight" you for a split-second because it wasn't predicting you'd exhale then. Keep breathing shallowly like that, however, and it'll adjust and predict that, too. Fun.

[ladytonya]

I have a ResMed S8 with EPR and I haven't noticed any loss of pressure between breaths. My pressure is set at 9 cm and EPR is at 3. I have played with the EPR by breathing in and out both very fast and very slow. It always reacts quickly and changes with me. I have also tested it by exhaling and then holding my breath. It reduces pressure on the exhale and then when I don't inhale after probably 30 seconds it will automatically increase the pressure again. I am actually really enjoying the EPR function and I have only used this machine for 3 nights. Fron what I've read about the differenced between EPR and Cflex, I think I would prefer EPR anyway, but I've never used Cflex. I can say that in my opinion EPR feels great and I wouldn't want to stop using it even after just 3 nights.

[NightHawkeye]

Just wondering if it is a good investment in getting a bipap machine to prevent any lung issues as a result of longterm CPAP use?

Good question, Miko. A few others have posted similar questions, although few actually buy a BiPAP. I'm one of the few who did, and it turns out to have been a good investment for me (although not quite for the reasons I might have supposed).

Since I've used both CPAP and BiPAP, here are a few of my general thoughts.
- BiPAP takes a little more getting used. If you're prone to hyperventilation at all, this can be difficult. The same is true of C-flex. Some folks simply turn C-flex OFF.
- BiPAP is apparently useful for folks with high pressure requirements who have difficulty exhaling against the high pressure.
- BiPAP can help minimize aerophagia. This is where I get the benefit from BiPAP. If it weren't for aerophagia, I'd still be using my Remstar-auto, as my pressure isn't high enough to be uncomfortable. I'm actually more comfortable using APAP than BiPAP. Nevertheless, I get noticeable relief from aerophagia with BiPAP, and so I continue to use it.
- A very few folks change over from CPAP to BiPAP, even though they're doing OK on CPAP, because they enjoy the pressure relief BiPAP provides.

Hope this helps answer your question, Miko. This is all just my perspective, of course.

Regards,
Bill

[Sleepless in St. Louis]

To me, it only makes sense since your lungs are "stressed" by the extra exhalation they must endure while using CPAP or even C-FLEX?

During therapy, are the lungs being stressed or exercised as you breathe against pressure? Most muscles can be strengened when used a little right? I would imagine the same thing for the diaphram. I'm talking about heathy folks here, not ones with lung disease. Could be different for those people.

[Guest]

To me, it only makes sense since your lungs are "stressed" by the extra exhalation they must endure while using CPAP or even C-FLEX?

During therapy, are the lungs being stressed or exercised as you breathe against pressure? Most muscles can be strengened when used a little right? I would imagine the same thing for the diaphram. I'm talking about heathy folks here, not ones with lung disease. Could be different for those people.

Exactly, that's what I was referring to. Overtime, our muscles will become weak with age. If you suffer from asthma (many sleep apneacs do so I am told) or other cardio pulmonary ailments, even in their early stages will likely benefit from a BIPAP and even those wishing to prevent the onset because, I don't think we really don't know the longer-term effects of CPAP are.

I for one do suffere from Aerophagia and I have started to once again get into CPAP (CFLEX). I am looking for an AUTO BIPAP as my pressures fluctuate quite a bit throughout the night. I was looking at the BiPAP Auto with BiFlex: https://www.cpap.com/productpage/bipap-auto-biflex.html

[Miko]

Hope this helps answer your question, Miko. This is all just my perspective, of course.

Regards,
Bill

Thanks Bill, that's what I thought. BTW, which machine/model are you using?

[Sleepless in St. Louis]

I was looking at the BiPAP Auto with BiFlex: https://www.cpap.com/productpage/bipap-auto-biflex.html

Good choice. That machine is suppossed to be the "Cadilac" of xPap machines. Should probably be the standard (or a similar machine) for everone. No more of this machine switching etc. Give me the good stuff from the beginning.

[Miko]

Good choice. That machine is suppossed to be the "Cadilac" of xPap machines. Should probably be the standard (or a similar machine) for everone. No more of this machine switching etc. Give me the good stuff from the beginning.

Any idea how much noisier, if at all it is compared to the Resmed Auto w/CFLEX?

[Sleepless in St. Louis]

Someone else will be able to help with that. I've read that some people notice a bipap a little more because of the changes in pressure. My auto is so quiet I can't really hear it operating. I bet the auto is equally quiet.

[Goofproof]

Any idea how much noisier, if at all it is compared to the Resmed Auto w/CFLEX?

Resmed doesn't make a Auto / C Flex. It's only to be had in Remstar.

If fact Resmed's Auto doesn't even use EPR in the Auto Mode. . Not that I'd buy their products in the first place.

I just have two thoughts, about everyone get a Bi-PAP, even if they don't require one!

(1). The Government and Insurance, buys everyone one, regardless of need, Who, really pays for a machine that costs twice as much, and in most cases does little more good than APAP can. We all would, espessally the ones of us that work or have worked. If you had a headache, and the Dr. could give you a bottle of aspirin, or a IV Painkiller, both would do the job , but which is more effective.

(2) Is it possible that with a Bi-PAP making it so easy for us to breath out, that it will over time, cause our chest muscles to weaken early. "Use it or Loose it" syndrome. Jim

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, auto, APAP

[Guest]

Resmed doesn't make a Auto / C Flex. It's only to be had in Remstar.

Oops. a faux pas on my part; however, the link is for Respironics and that's what I was referring to.

If fact Resmed's Auto doesn't even use EPR in the Auto Mode. . Not that

I'd buy their products in the first place.

I just have two thoughts, about everyone get a Bi-PAP, even if they don't require one!

(1). The Government and Insurance, buys everyone one, regardless of need, Who, really pays for a machine that costs twice as much, and in most cases does little more good than APAP can. We all would, espessally the ones of us that work or have worked. If you had a headache, and the Dr. could give you a bottle of aspirin, or a IV Painkiller, both would do the job , but which is more effective.

(2) Is it possible that with a Bi-PAP making it so easy for us to breath out, that it will over time, cause our chest muscles to weaken early. "Use it or Loose it" syndrome. Jim

#2 makes no sense. Afterall, it is NOT natural for us to fight breathing out. It's not like our other muscles in the bodies like biceps, triceps,etc. By nature, we are to somewhat "stress them" but that cannot be said about our lungs and diaphram, at least not in the extent of forcing our lungs to expell air as oppose to expelling air lightly. That's is not what nature had intended for us and I believe in the longterm that can harm us CPAPers who don't use a BILEVEL one.