CPAP vs VPAP?!

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Some have commented that it is better for centrals and such.

Some seem to think that bilevel/VPAP is better for centrals, but I think that's generally not true. Sometimes, insurance wants to screw with you and makes you try bilevel for cental apnea. I think they're mostly trying to wear you down and make you give up before buying the much more expensive ASV.

However, centrals are sufficiently weird that it might work for some.

The "true" central apnea machines are "T" or "ST" mode bilevels and ASV machines, both of which are classified as "bilevel" for insurance and regulatory purposes, but they are more complicated than a "regular" bilevel/VPAP machine. There's some legitimate confusion since the "VPAP/bilevel/BiPAP" label is on all of them.

ASV is the "true" central apnea machine, and the "T" and "ST" mode machines are sort of half measures.

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The VPAP models allow greater flexibility in inhalation pressure vs. exhalation pressure and usually have a higher max pressure (25 cm vs. the AutoSet's 20 cm H2O)

I heard that too about Bilevels having higher pressure maximums. However, I also read that many/most users going from CPAP to BPAP actual use a lower pressure on inhaling because of the assistance with lower exhaling pressure. Yes/no?

BiPAP and VPAPs usually are capable of delivering up to 25 cm H2O of pressure, whereas CPAPs and APAPs usually are capable of delivering up to 20 cm H2O. But many (most?) BiPAP and VPAP users do NOT use pressures over 20 cm any way.

The connection between the titrated CPAP pressure and the titrated bi-level pressures is not completely straightforward.

For some people, the titrated IPAP will be about what the titrated CPAP pressure was, and the titrated EPAP may be several cm lower.

For some people, the titrated EPAP will be about what the titrated CPAP pressure was, and the titrated IPAP may be several cm higher.

For some people, the titrated CPAP pressure will be somewhere between the titrated EPAP and titrated IPAP.

In all three cases, however, breathing may feel more natural simply because of the the difference between IPAP and EPAP and the algorithms that control the change from IPAP to EPAP and back.