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CPAP or BiPAP?
What's the difference between a CPAP and a BiPap machine? I have a BiPap.
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Replies to This Discussion
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Permalink Reply by Mary Z on
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Sheila, a CPAP delivers one continuous pressure while a BiLevel machine delivers one pressure for inhalation and another for exhalation.
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Permalink Reply by Sheila Ellis on
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Thanks!
Mary Z said:
Sheila, a CPAP delivers one continuous pressure while a BiLevel machine delivers one pressure for inhalation and another for exhalation.
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Permalink Reply by Gil Ben-Dov on
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Hi Sheila. Mary is absolutely correct. Hopefully the following adds a little more color commentary and is useful.
The maximum difference between inhalation pressure and exhalation pressure (called "pressure support") defines which category a device belongs in. With a CPAP device, the maximum allowable pressure suppport is 3 cm H20 (accomplished using exhalation pressure relief ("EPR") which provides a slightly lower pressure against your exhalation), while our bi-level devices can deliver pressure support of up to 37 cm. In both cases the devices can be set to provide pressure support which is lower than the maximum values cited above.
From a clinical perspective, CPAP devices (including Autoset models) are principally used to treat OSA (obstructive sleep apnea), while bilevel devices can also treat OSA, their additional features allow them to be prescribed for CSA (central sleep apnea), certain neuromuscular diseases, obesity hypoventilation syndrome, and COPD.
I hope this is helpful information. I'm working on a response to Fred in this forum which goes into more detail about the differences between the array of bilevel models and hope to have that published later this week.
Gil Ben-Dov
ResMed, VP Social Media Strategy
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After failing AutoPAP, I am currently trying out BiPAP. I started with great anticipation, but unfortunately, it has not panned out. In fact, I feel MUCH worse than I ever did with AutoPAP. I am really at a loss since BiPAP came highly recommended as a treatment for UARS (Upper Airway Resistance Syndrome). I wake up numerous times during the night, and in the morning, I have the worst kind of hangover. The problem is, instead of adapting to YOUR breathing rhythm, the machine forces YOU to adapt to ITS rhythm. I find this very disturbing - before I've finished exhaling, it's already cranking up the pressure for inhalation. I frankly don't know what to do - should I redouble my efforts or should I scrap BiPAP?
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Permalink Reply by Somnonaut on
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Gil Ben-Dov,
The Pressure Support (PS) is not truly changed therapeutically using EPR. So why do you mention that CPAP can have +-3cm/H20? CPAP has very low tolerance for pressure swings, that is why it is called Continuous. EPR only alters the pressure for a short duration during exhalation, to create the perception of breathing out against lower pressure, but the actual pressure within the airway does return (within the 100msec or so window of "pressure relief") to the Rx pressure (within the manufacturer machine tolerances.) So, I would not include EPR in describing CPAP except as a comfort feature. I would not describe CPAP as allowing a swing of 3 cm/H20 in a patient's Rx either.
Just my opinion.
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Permalink Reply by Banyon on
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Reply by Danny Heller
After failing AutoPAP, I am currently trying out BiPAP. I started with great anticipation, but unfortunately, it has not panned out. In fact, I feel MUCH worse than I ever did with AutoPAP. I am really at a loss since BiPAP came highly recommended as a treatment for UARS (Upper Airway Resistance Syndrome). I wake up numerous times during the night, and in the morning, I have the worst kind of hangover. The problem is, instead of adapting to YOUR breathing rhythm, the machine forces YOU to adapt to ITS rhythm. I find this very disturbing - before I've finished exhaling, it's already cranking up the pressure for inhalation. I frankly don't know what to do - should I redouble my efforts or should I scrap BiPAP?What was your diagnosis? What are your prescribed pressuring settings? Exactly which mask are you using? Exactly which machine do you have?
Do you have the software so you can see what is going on at night? If so, what type and how many events are you having, what time of night, what does the leak line look like, what does the pressure line look like?
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There are settings in the clinical menu that can be adjusted for inhalation and exhalation relief and other things that I don't know anything about. My Resmed S9 VPAP has them but they haven't been adjusted yet. I've only had the machine 6 weeks though.
I hope to learn more about these and other settings and reports. Maybe Gil Ben-Dove can help us out. For example, my RT doesn't know the difference between % spontaneous cycled breaths vs % spontaneous triggered breaths. Hmmm.
About BiPAP helping centrals. I don't know about that. I have more centrals than obstructives on BiPap although they seem to happen when there are mask leaks at the same time. It's hard to know if they are centrals or leaks. I feel better most days so I suspect they aren't true centrals. It would be nice if the machine could differentiate between leaks and centrals better.
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Danny, I would talk to your doc or DME about getting the rise time, or TiMin and TiMax changed. I experienced the same problem on BiPap. I felt like I couldn't finish my inhalation before it switched to exhalation. Rasing the Ti Max to 3 seconds and the Ti Min to .3 seconds solved my problem. Don't know that this will help you, but good luck.
That's why I perfer straight CPAP- no pressure changes, but I don't have UARS.
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Hi Danny. Wow! I'm so sorry to hear you're having such trouble with the BiPap. I initially couldn't get use to it either. I guess I forced myself because I had sleep apnea for years without knowing it. I finally ended up in the hospital last December with a blood oxygen level of 84. Hence, a sleep study was ordered and here I am. While I remain a novice on this subject I would try talking to your sleep care doctor and/or the technician who administered your sleep study and recommended the BiPap. Good luck and keep me posted!
Danny Heller said:
After failing AutoPAP, I am currently trying out BiPAP. I started with great anticipation, but unfortunately, it has not panned out. In fact, I feel MUCH worse than I ever did with AutoPAP. I am really at a loss since BiPAP came highly recommended as a treatment for UARS (Upper Airway Resistance Syndrome). I wake up numerous times during the night, and in the morning, I have the worst kind of hangover. The problem is, instead of adapting to YOUR breathing rhythm, the machine forces YOU to adapt to ITS rhythm. I find this very disturbing - before I've finished exhaling, it's already cranking up the pressure for inhalation. I frankly don't know what to do - should I redouble my efforts or should I scrap BiPAP?
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Banyon, I was diagnosed with "mild" sleep apnea (but in no way is my misery level "mild"!) and UARS, which is the more significant fact here, because it is what causes the bulk of my arousals. I don't have access to the machine data, but I know my pressure settings are 9cm for inhalation and 5 cm for exhalation. I am using a nasal pillows mask (Swift FX, I believe). I couldn't stand a nasal mask - it chewed my face up and made it impossible to sleep on either side.
Mary, thanks for the tip. Glad to hear my problem is not unique.
Sheila, thanks for your info. Are you being helped by BiPAP?
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Yes, very much. I feel so much better during the day, I'm off oxygen and of course my blood oxygen level is a healthy 96 (according to my last appointment in June). Hopefully your search for the equipment that's perfect for you will be in the immediate future. Stay positive!
Danny Heller said:
Banyon, I was diagnosed with "mild" sleep apnea (but in no way is my misery level "mild"!) and UARS, which is the more significant fact here, because it is what causes the bulk of my arousals. I don't have access to the machine data, but I know my pressure settings are 9cm for inhalation and 5 cm for exhalation. I am using a nasal pillows mask (Swift FX, I believe). I couldn't stand a nasal mask - it chewed my face up and made it impossible to sleep on either side.
Mary, thanks for the tip. Glad to hear my problem is not unique.
Sheila, thanks for your info. Are you being helped by BiPAP?
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Thanks, Sheila, for giving me hope for a better (and better-rested) future!
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