I have been on Auto CPAP machine for five years and although my AHI on CPAP is around 1.5 after use, yet, I never felt rested for 5 years. My recent PSG showed that I also suffered from Central Apneas and my doctor advised me to buy Respironics Bipap S/T. Apparently, for the reason, that Cpap does not address central apneas. My lungs, however, are functioning normally and I have no chest problem. Bipap S/T is apparently a ventilator. However, I intend to use it to rule out central apneas or atleast to provide me some more rest in the morning compared to cpap. I woud be very grateful, if very learned experts on this site could advise whether using Bipap in the S/T(Spontenaeous timed) mode will in any way be harmful to me, supposing that it does not address my centrl apnea or severe tiredness condition. I just want to give everything a try, considering the deplorable quality of life I suffer, due to my apnea condition and CPAP not effectively addressing my tiredness.
biap S/T
11 posts
• Page 1 of 1
Bipap S/T and central sleep apnea
Hi javaide! I have central sleep apnea and use the Bipap S/T. I've been using it for just over a year, but I'm not an expert in CSA or the mechanics of the machine. There are several people here who are very knowledgable in that regard.
On my tests a year ago, my AHI was 128. I do not know what it is now, but I do know that I feel much much better. I was falling asleep at work, in the car (passenger) and slept for hours at end at night - and napped on the weekends. I still don't have as much energy as I would like, but I have other health issues and take a fair bit of medication that can affect my energy levels.
The S/Ts fall into the ventilator category because of the "T" function. If you are breathing spontaneously, it is just like running a CPAP/autopap with some kind of pressure relief. But if your central apnea lasts too long, and you don't breath, say for 8 seconds, the machine tries to make you breathe.
As I said, I am not an expert, but if the IPAP and EPAP rates are set by your doctor, I don't see how it would hurt you. The machine isn't forcing you to breathe any differently than with the CPAP - except for those times your brain "forgets" to tell your body to inhale.
On my tests a year ago, my AHI was 128. I do not know what it is now, but I do know that I feel much much better. I was falling asleep at work, in the car (passenger) and slept for hours at end at night - and napped on the weekends. I still don't have as much energy as I would like, but I have other health issues and take a fair bit of medication that can affect my energy levels.
The S/Ts fall into the ventilator category because of the "T" function. If you are breathing spontaneously, it is just like running a CPAP/autopap with some kind of pressure relief. But if your central apnea lasts too long, and you don't breath, say for 8 seconds, the machine tries to make you breathe.
As I said, I am not an expert, but if the IPAP and EPAP rates are set by your doctor, I don't see how it would hurt you. The machine isn't forcing you to breathe any differently than with the CPAP - except for those times your brain "forgets" to tell your body to inhale.
_________________
| Mask: FlexiFit HC432 Full Face CPAP Mask with Headgear |
| Additional Comments: Started bipap Nov. 2005 |
Central Sleep Apnea
As already pointed out, the Bipap S/T qualifies as a ventilator because it can 'try' to get you breathing again if it senses you have not breathed within a particular time period.
A true ventilator will do your breathing for you (push air in & extract it at a set rate).
The Bipap S/T attempts to keep you breathing to a pattern by switching from its exhale pressure setting (epap) to its inhale pressure setting (ipap), in the expectation that this switch in pressure with set you off breathing properly again.
This machine can be set to run in S (spontaneous) mode and or T (timed) mode (that is S or T or ST modes).
1) In spontaneous mode it switches epap to ipap based on your breathing.
2) In timed mode, it switches epap to ipap at a fixed rate (say 15 breaths/min)
3) In spont/timed mode it will only do the epap/ipap switch if your breathing isn't occurring spontaeously within a timed period.
3 would be the preferred setting for someone who doesn't have some other respiratory disorder but does have occasional periods of 'centrals'.
The recommended minimum gap between epap and ipap pressures is usually 4 cms but the respiratory specialist may have reasons to vary these. I ran some tests using a VPAP III where I had epap=8 and ipap=15 and was getting very very high AHI numbers (over 50+) but when I changed the epap to 10 and ipap to 13, I was getting AHI numbers under 1.0. When I discussed this experiment with my respiratory specialist, his reaction was "what did you expect?" He suggested I go back to a difference of 4 or lower.
I use a Bilevel in S/T mode most of the time. Now that I run it at 10/13 I am very happy with the results. I use a Back-up Breathing Rate (bpm) of 6 (that is if I slow my breathing to less than 6 Breaths per Minute, the machine will do its epap/ipap switch.
An epap/ipap gap of 3 seems to be working ok for me but the issue really has to do with how much of a gap will work for you if you are having centrals.
Take a hypothetical case (unrealistic but useful to illustrate) of setting epap to 11 and ipap to 12. The gap is so small that even if the machines does its epap to ipap switch because it believes you are having a central, the gap may be too little pressure to trigger your breathing again & thus the central persists & is not treated. I would posit that the min gap on Bipap/Bilevel should be no less than 3 and no more than 5 unless a specialist has agreed otherwise. What he wants to avoid is setting the machine such that the supposed cure is worse than the condition.
Good luck with your machine. If you get a Bipap S/T, a few of us can offer further advice on the settings (I have one known as the Bipap S/T gray model).
DSM
A true ventilator will do your breathing for you (push air in & extract it at a set rate).
The Bipap S/T attempts to keep you breathing to a pattern by switching from its exhale pressure setting (epap) to its inhale pressure setting (ipap), in the expectation that this switch in pressure with set you off breathing properly again.
This machine can be set to run in S (spontaneous) mode and or T (timed) mode (that is S or T or ST modes).
1) In spontaneous mode it switches epap to ipap based on your breathing.
2) In timed mode, it switches epap to ipap at a fixed rate (say 15 breaths/min)
3) In spont/timed mode it will only do the epap/ipap switch if your breathing isn't occurring spontaeously within a timed period.
3 would be the preferred setting for someone who doesn't have some other respiratory disorder but does have occasional periods of 'centrals'.
The recommended minimum gap between epap and ipap pressures is usually 4 cms but the respiratory specialist may have reasons to vary these. I ran some tests using a VPAP III where I had epap=8 and ipap=15 and was getting very very high AHI numbers (over 50+) but when I changed the epap to 10 and ipap to 13, I was getting AHI numbers under 1.0. When I discussed this experiment with my respiratory specialist, his reaction was "what did you expect?" He suggested I go back to a difference of 4 or lower.
I use a Bilevel in S/T mode most of the time. Now that I run it at 10/13 I am very happy with the results. I use a Back-up Breathing Rate (bpm) of 6 (that is if I slow my breathing to less than 6 Breaths per Minute, the machine will do its epap/ipap switch.
An epap/ipap gap of 3 seems to be working ok for me but the issue really has to do with how much of a gap will work for you if you are having centrals.
Take a hypothetical case (unrealistic but useful to illustrate) of setting epap to 11 and ipap to 12. The gap is so small that even if the machines does its epap to ipap switch because it believes you are having a central, the gap may be too little pressure to trigger your breathing again & thus the central persists & is not treated. I would posit that the min gap on Bipap/Bilevel should be no less than 3 and no more than 5 unless a specialist has agreed otherwise. What he wants to avoid is setting the machine such that the supposed cure is worse than the condition.
Good luck with your machine. If you get a Bipap S/T, a few of us can offer further advice on the settings (I have one known as the Bipap S/T gray model).
DSM
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
The BiPAP S/T is not quite a ventilator, it is actually classified as ventilatory support. Basically, the difference in need is that obstructive sleep apnea is a collapse of the airway leading to a stoppage in breathing (or shallow breathing in the case of hypopneas). In a central apnea, there is another cause for your lack of breath. For someone with OSA, as long as you are on the proper pressure settings, the positive pressure should prevent apneas from occurring. A central apnea cannot be prevented by positive pressure and therefore traditional bipap/cpap therapy will not treat these events. An S/T device primarily functions as a traditional bipap and will cycle between inspiratory and expiratory pressures as the patient triggers it with their own breathing. When a central event occurs, there is no patient trigger and an S/T device is programmed to deliver what is known as a "backup breath" Basically, the unit is prescribed with a breath rate that will tell the device to trigger a breath in a specified amount of time if the patient does not trigger it before that.
A breath rate of 10 breaths/min will trigger a breath every 6 seconds, but if the patient spontaneously breathes before that 6 seconds is up, the the unit will be functioning as a traditional bipap.
A breath rate of 10 breaths/min will trigger a breath every 6 seconds, but if the patient spontaneously breathes before that 6 seconds is up, the the unit will be functioning as a traditional bipap.
[quote="REMmaster"]The BiPAP S/T is not quite a ventilator, it is actually classified as ventilatory support. Basically, the difference in need is that obstructive sleep apnea is a collapse of the airway leading to a stoppage in breathing (or shallow breathing in the case of hypopneas). In a central apnea, there is another cause for your lack of breath. For someone with OSA, as long as you are on the proper pressure settings, the positive pressure should prevent apneas from occurring. A central apnea cannot be prevented by positive pressure and therefore traditional bipap/cpap therapy will not treat these events. An S/T device primarily functions as a traditional bipap and will cycle between inspiratory and expiratory pressures as the patient triggers it with their own breathing. When a central event occurs, there is no patient trigger and an S/T device is programmed to deliver what is known as a "backup breath" Basically, the unit is prescribed with a breath rate that will tell the device to trigger a breath in a specified amount of time if the patient does not trigger it before that.
A breath rate of 10 breaths/min will trigger a breath every 6 seconds, but if the patient spontaneously breathes before that 6 seconds is up, the the unit will be functioning as a traditional bipap.
A breath rate of 10 breaths/min will trigger a breath every 6 seconds, but if the patient spontaneously breathes before that 6 seconds is up, the the unit will be functioning as a traditional bipap.
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
[quote="REMmaster"]The BiPAP S/T is not quite a ventilator, it is actually classified as ventilatory support.
_________________
| Mask: FlexiFit HC432 Full Face CPAP Mask with Headgear |
| Additional Comments: Started bipap Nov. 2005 |
Central Sleep Apnea
How much for a ResMed VPAP III with S/T mode?
What would the market value for a slightly used VPAP III (ST)
be these days? Isn't this old technology? I see that CPAP.COM
lists a new one for $3800.00. I was thinking that the Respironics
M series with Auto with BiFlex would be a much nicer machine.
The other point about the VPAP III when using ST mode.
If you put in a backup breathing rate of 14 bmp as recommended
by your Doctor, and then you can't actually keep up breathing
throughout the night at that rate, the Autoscan software will
give you a lower score on Spontaneous breaths in comparison
to a lower rate of say 12 bmp. My Spontaneous breath rate
is over 90% at a setting of 12, but my question is "Should it
be 100% for a normal, healthy, non-CentralApnea person?"
be these days? Isn't this old technology? I see that CPAP.COM
lists a new one for $3800.00. I was thinking that the Respironics
M series with Auto with BiFlex would be a much nicer machine.
The other point about the VPAP III when using ST mode.
If you put in a backup breathing rate of 14 bmp as recommended
by your Doctor, and then you can't actually keep up breathing
throughout the night at that rate, the Autoscan software will
give you a lower score on Spontaneous breaths in comparison
to a lower rate of say 12 bmp. My Spontaneous breath rate
is over 90% at a setting of 12, but my question is "Should it
be 100% for a normal, healthy, non-CentralApnea person?"
It has been so encouraging to go through such thorough dissemination of knowledge and contribution made by such well meaning gentlemen/ladies like Bella, DSM, RemMaster and Meister. Inspite of my best efforts I was not able to get these guidelines for the last five years and thanks to this forum,that I am beginning to get my answers. However, there is so much of wealth of information, that I being a lay man will take quite some time to decipher. I hope, all of you, well meaning men and women of God will always be available to help, once I have mulled over so many new thoughts and ideas given to my question on Bipap/St.
Re: How much for a ResMed VPAP III with S/T mode?
[quote="meister"]What would the market value for a slightly used VPAP III (ST)
be these days? Isn't this old technology? I see that CPAP.COM
lists a new one for $3800.00. I was thinking that the Respironics
M series with Auto with BiFlex would be a much nicer machine.
The other point about the VPAP III when using ST mode.
If you put in a backup breathing rate of 14 bmp as recommended
by your Doctor, and then you can't actually keep up breathing
throughout the night at that rate, the Autoscan software will
give you a lower score on Spontaneous breaths in comparison
to a lower rate of say 12 bmp. My Spontaneous breath rate
is over 90% at a setting of 12, but my question is "Should it
be 100% for a normal, healthy, non-CentralApnea person?"
be these days? Isn't this old technology? I see that CPAP.COM
lists a new one for $3800.00. I was thinking that the Respironics
M series with Auto with BiFlex would be a much nicer machine.
The other point about the VPAP III when using ST mode.
If you put in a backup breathing rate of 14 bmp as recommended
by your Doctor, and then you can't actually keep up breathing
throughout the night at that rate, the Autoscan software will
give you a lower score on Spontaneous breaths in comparison
to a lower rate of say 12 bmp. My Spontaneous breath rate
is over 90% at a setting of 12, but my question is "Should it
be 100% for a normal, healthy, non-CentralApnea person?"
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
Re: biap S/T
[quote="javaide"]I have been on Auto CPAP machine for five years and although my AHI on CPAP is around 1.5 after use, yet, I never felt rested for 5 years. My recent PSG showed that I also suffered from Central Apneas and my doctor advised me to buy Respironics Bipap S/T. Apparently, for the reason, that Cpap does not address central apneas. My lungs, however, are functioning normally and I have no chest problem. Bipap S/T is apparently a ventilator. However, I intend to use it to rule out central apneas or atleast to provide me some more rest in the morning compared to cpap. I woud be very grateful, if very learned experts on this site could advise whether using Bipap in the S/T(Spontenaeous timed) mode will in any way be harmful to me, supposing that it does not address my centrl apnea or severe tiredness condition. I just want to give everything a try, considering the deplorable quality of life I suffer, due to my apnea condition and CPAP not effectively addressing my tiredness.
xPAP and Quattro std mask (plus a pad-a-cheek anti-leak strap)
11 posts
• Page 1 of 1