Regular BiPAP vs Auto BiPAP

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Regular BiPAP vs Auto BiPAP

Postby ad111 » Fri Jan 04, 2013 1:48 pm

Any thoughts/experiences on straight BiPAP vs Auto BiPAP? When I was first diagnosed with OSA 5 years ago, I tried CPAP for about 6 months and couldn't tolerate it, was miserable. I switched to an Oral Appliance, which has limited effectiveness but definitely has helped. I am now coming around to researching the current state of the art on PAP, and thought that an Auto BiPAP machine might help me best to tolerate the pressure.

I had a sleep study and the doctor prescribed BiPAP. After some research, I wanted the ResMed S9 VPAP Auto, an Auto BiPAP machine. My DME said insurance wouldn't cover it unless the prescription specifically indicated "S9". So I got my doctor to add that, but then the DME said the prescription had to say "Auto BiPAP". After some back and forth with my doctor, he just won't prescribe an Auto BiPAP machine, says he doesn't think that I need it, and considers Auto BiPAPs potentially "dangerous".

However, it seems to me that if properly programmed, Auto BiPAP's can be quite beneficial for delivering effective treatment at the lowest pressure possible. I don't want to give up on getting the Auto BiPAP, as this is not a matter of wanting a "nice to have" feature. This is a condition that profoundly degraded my quality of life, and if a more advanced machine will give me a better shot at living better, then I want the best available.

Is it unreasonable for me to insist on the Auto BiPAP? I'll pay for it myself if I have to, but it's a problem if my doctor is not supportive of the technology. I would greatly appreciate any advise and/or comments.
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Re: Regular BiPAP vs Auto BiPAP

Postby Xney » Fri Jan 04, 2013 3:11 pm

I've used BiPAPs in regular mode and auto. I think the benefits are much the same as with CPAP vs. APAP: if your pressure needs change based on position or some nights, it can be great because you can usually use lower pressure. Some people like auto better, or get better sleep on auto. Some sleep better on straight pressure.

With CPAP machines, the auto option is really not much of a difference in price, so it makes sense to get it. That may not be true with a bipap.

I'm not sure what could possibly be "dangerous" about an auto bipap. You have most of the same issues with auto CPAPs, and many, many people use those.

I would say, though, that I wouldn't get too involved in getting the "best" machine as an auto. Most of the time, a basic bipap will do just fine. The auto part mainly copes with pressure need changes through the night. If you have enough pressure set, you don't need more pressure, so no need for auto - for most people.

Personally, I had an auto bipap before my ASV, and the flexibility in trying stuff was very nice to have. I liked the auto mode, but I also watched my data very, very closely. If I wasn't a data hawk, I would probably use a set pressure. In my case, I had a lot of issues with xPAP therapy so the flexibility was important, but I can't imagine that being the case for most people. :)

I'm not sure why your DME is saying you have to have a prescription for "auto bipap". It's usually the same insurance code for any bipap. They can set it up for straight bipap, and maybe you can pay the difference in price. Then you could start with straight bipap, and have the option to try auto if you need.

Just one user's opinion. :)
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Re: Regular BiPAP vs Auto BiPAP

Postby need_air_at_night » Sat Jan 05, 2013 1:59 am

I use auto Bipap and it adjusts automatcily to apnea hypoapnea's I suffer from shallow breathing at night so it corrects itself. It feels like a positive pressure SCBA that we used in the Navy. It also has a way for it to ajust to altatude automaticly as well I live almost at sea level but when I do travil to other places it ajusts to the altitude of were I am at. My doctor one of the founders of modern sleep medicien prescribed it for me. why your GP would say a auto is hazardus is neyond me. But then again I never went to medical school.
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Re: Regular BiPAP vs Auto BiPAP

Postby WmEDSullivan » Sun Nov 17, 2013 3:26 pm

Highlight AutoSv vs Bipap S/T
I had a Respironics BiPAP S/T for 5+ yrs, which broke down in Aug.
My sleep test showed I had Central S.A. and that the S/T unit worked very well.

My new DME took my Dr. Prescription of "13bpm" since the tests showed I had 51 Apneas per Hr
for 50 Sec each.. BAD.. The Night tests showed no Apneas @ 13.. but any increase causes Havoc.

The DME, delivered a BiPAP AutoSV unit.. which does balance C0@ vs O2
The Auto SV is a "Back up".. so if my Original breath doesn't register after 4 sec (20bpm); it kicks into
RR= 18-28 bpm.. Whoops my AutoSV does look for the 13 setting; can't find it in 4 Sec, & the Help desk didn't
understand what the backup was doing.. Felt their Setting of "13" was good, yet my SD card validated
It never locked into "13" and the Backup Setting' amounts to fast shallow breathing.. (Not Good)
I'd be happy with Breath Backup set @ 10 or 12; ... 5 or 6 seconds., not below 3 seconds breathing
An Emergency call to Resp. Emergency help Rep last night explained how AutoSV works.. I need a ReSet.

PS, I uncovered the Tech double-click Codes which the DME's use for settings.. they hide that; since they're
concerned patients will kill themselves.. Actually in my case they're setting arousal levels, which the Heart
senses Adrenalin need, which is driving my Blood Pressure up to 169/94. ...I can't allow that! ...
Why one Member here, said his Doctor was adamant about which machine & what settings are Required!
PS: At least my backup shows I'm @ only 6 apneas now vs my original 50+
Six(6) is still too many per the UCLA & other R&D showing injury to Brain Matter Clogging, & Kidneys.

Phillips needs to better train & Alert DME Help Desks when the SD Data doesn't not matching bpm settings

This is a Long response But we need to Alert the Apnea Users to how New Systems are Good & Not-So-Good
I found A new Nerve Voltage Biometer to ID why REM pulses might trigger Apneas @ night-Time Only
Bill Sullivan Formerly dba Tesla Inc Consulting
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Re: Regular BiPAP vs Auto BiPAP

Postby robysue » Sun Nov 17, 2013 3:57 pm

Note for any newbies reading this thread:

Plain old BiPAPs and BiPAP Autos are NOT the same kind of machine as BiPAP S/T and BiPAP AutoSV and BiPAP AutoSV Advanced machines.

Plain old BiPAPs and BiPAP Autos (which the original post in this thread was about) are really nothing but a bi-level CPAP machine---they have one pressure for inhalation (IPAP) and one for exhalation (EPAP). And they pretty much treat OSA and that's it. For some people with (minor) problems with central apneas, the switch from CPAP/APAP to BiPAP/BiPAP Auto is enough to allow their problem to resolve. But for a person who has a real and persistent problem with central apnea (i.e. a diagnosis of Central Sleep Apnea or Complex Sleep Apnea), the switch to a plain old BiPAP or BiPAP Auto usually won't fully resolve the problem.

People with Central Sleep Apnea and Complex Sleep Apnea will usually wind up being moved to a BiPAP S/T or a BiPAP AutoSV or a BiPAP AutoSV Advanced machine after CPAP/APAP and BiPAP/BiPAP Auto fail to resolve their problems. The BiPAP S/T, BiPAP AutoSV, and BiPAP AutoSV Advanced machines can all trigger patient inhalations by acting as a noninvasive ventilator.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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