APAP or BiPAP?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
merhaba12
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APAP or BiPAP?

Post by merhaba12 » Thu May 30, 2013 9:23 pm

My son (age 31) was recently diagnosed with sleep apnea by having an overnight sleep study at the hospital. Unfortunately, he only slept around 5 hours so they couldn't do a titration study. His pulmonologist rx'd a PR 560 with settings 6-20. After 12 days of use, my son's 95% pressure is 16.9. His average AHI is 6.9. He says he wakes up at night because of the high pressure. He is a mouth breather and a horrible snorer so he uses an Amara Full Face mask. He has the leaks under control.

I don't know anything about BiPaps. Are they for people who need higher pressures?

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chunkyfrog
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Re: APAP or BiPAP?

Post by chunkyfrog » Thu May 30, 2013 9:34 pm

Can you post some of his data?
6-20 sounds like a wide range, and some changes may be in order.
Bipaps are capable of >20cm pressures, and more than 3cm reduction for easier exhalation.

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merhaba12
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Re: APAP or BiPAP?

Post by merhaba12 » Thu May 30, 2013 9:51 pm

I'll ask him. He emailed me 2 nights of data but the print is very small! He's new at this, but I'll see what he will do.
Thank you for your input. If I understand it correctly, unless he needs a pressure >20cm, he doesn't need a BPAP.

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Pugsy
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Re: APAP or BiPAP?

Post by Pugsy » Thu May 30, 2013 9:56 pm

Yes, BiPaps/bilevel pressure machines offer more comfort when exhaling against higher pressures.
2 separate pressures...1 for inhale (IPAP) and another for exhale (EPAP)...the difference between EPAP and IPAP is what offers the comfort.

There may be something that can be do with his existing machine that could stabilize his pressures and reduce the chance of the higher pressures causing awakenings.

Can you get us a few software reports to look at to see what is going on?
It's possible that with a more optimal minimum pressure setting that the maximum may not go so high.
See this thread for example of what I mean.
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

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jdm2857
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Re: APAP or BiPAP?

Post by jdm2857 » Thu May 30, 2013 9:58 pm

BiPap machines have two pressure settings -- one for inhalation, and a reduced pressure for exhalation.
This can make using high pressures more comfortable.

Many CPAP machines have exhalation relief -- ResMed calls it EPR while Respironics call it either A-Flex or C-Flex.
These make exhalation more comfortable but are more limited in functionality that a BiPap.

Edit: Arrgh! Out-pugged again!
jeff

merhaba12
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Re: APAP or BiPAP?

Post by merhaba12 » Thu May 30, 2013 10:22 pm

Thank you for your replies, He has to go back to his dr in a couple of weeks to go over his data. It will be interesting to see how knowledgeable (or not) his dr is. In the meantime, my son doesn't want me to help tweak his pressures. Using personal experience with curing my snoring by raising my bottom pressure, I would love to tell him to raise his bottom pressure from 6 to perhaps 10. I would still like to post some of his graphs for your interpretations! I think he is going to work on getting me the graphs this weekend.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Mirage™ FX Nasal CPAP Mask with Headgear
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Philips Respironics