[Equipment] Bipap with no ventilation advice

[dragonboyc]

Hi, 

I have been advised that I need an auto Bipap machine due to my severe apnea. I am also told that I should avoid a ventilator as you don't want to get used to ventilation if you don't need it. 

Philips has Bipaps with no ventilation but with the recall no one is selling them (and there is no dreamstation 2 bipap that I know of). The Resmed AirCurve VAuto is very nice but it has ventilation that you cannot turn off. 

The Resmed Lumis has ventilation that you can turn off but it is a bit above my budget (also I was told that if I buy a machine with features that I don't need then that's just a waste).

Anyone has any advice? Keen to hear what people's thought are.

Thanks in advance!!!

P.S. I don't have central so that is why they say I don't need a ventilator.

[Gideon]

IMHO the distinction I think is being made is that of a backup rate, the ability to start a breath when you don't.

Classes of machines
CPAP/APAP
BiLevel without backup (S, VAuto)
BiLevel with backup (T, ST, AVAPS, ASV)
Ventilator (even more advanced)

Based on your description it is the VAuto that you want.

ALL of the above machines provide ventilation assistance, even the most basic CPAP, they ALL improve your breathing, even the CPAP.

Post a copy of your OSCAR daily charts and your sleep studies, redacted of personal info, and we can and will provide more specific advice.

[dragonboyc]

Thanks Gideon. I have attached 2 daily Oscar charts - one when I was trialing the Respironics System One Bipap Auto and the other using the Resmed Aircurve VAuto (does the V stand for variable or ventilator anyway?).

What the comments were:

1) Resmed always show lower AHI - not sure why
2) The Resmed has a ventilation setting that can be minimised but not turned off - if you want to turn it off you go higher class and buy the Lumis and then you may be able to turn it off
3) The Resmed is a ventilator as even the Oscar report classed it as VPAP auto whilst the Respironics is just a BiLevel Auto as identified by Oscar (I was told the difference is the ventilation setting ...)

I am very confused and conflicted so would appreciate any advice given.

After talking to my family also - their comment was that since I have been using the dreamstation for years why don't I just keep using that until things settle down (and maybe get a Dreamstation 2 Bipap if and when it comes out) ... I was thinking about getting a new machine due to the whole foam issue and given my high pressure if I get a machine it is better to be a bipap. 

Should I stick with just a cpap and wait until things calm down a bit? 

   

   

[SarcasticDave94]

I'd get the VAuto. It is not a ventilator like those advising you are using the word. They are misusing the word ventilator.

A ResMed ventilator can be ASV as it stands for Adaptive Servo Ventilator; it treats Central Apnea. And also in the US is an ST-A, Stellar, and Astral. These are true ventilators, they treat Apnea when you also have lung diseases.

As Gideon mentions, they're probably calling a BPAP with backup rate a ventilator. It's somewhat true, it seems those advising are somewhat confused themselves.

Using any CPAP level machine will not make you addicted.

[staceyburke]

I would say the ResMed is giving you better therapy. It sure did with me moving from a dreamstation bipap to the VAUTO. It does not have ventilation. 

From ResMed web site

Key features

• •
  Comfortable. Climate Control automatically delivers therapy at the most comfortable temperature and humidity levels, with no settings to change or complicated menus to navigate. 
  
• •
  Dependable. Vsync continuous leak management enables reliable delivery of therapy pressure while maintaining patient–device synchrony.
  
• •
  Easy-Breathe. Easy-Breathe pressure waveform mimics the wave shape of normal breathing and replicates it for your patients’ breathing comfort.
  

• •
  Customizable. TiControl™ lets you set limits on patient’s ideal inspiratory time to encourage spontaneous breathing.
  
• •
  Adaptable. The AirCurve 10 VAuto is compatible with up to 15 L/min of supplemental oxygen in S and CPAP mode and 4 L/min in VAuto mode.
  
• •
  Remote-ready. Cloud-based AirView™ patient management system lets you access nightly data, troubleshoot and change device settings remotely.
  

[dragonboyc]

I am also attaching 2 days when I was using my dreamstation CPAP before I started trialing BiPAP. Thanks so much again!!

   

   

[staceyburke]

I’m sorry but I don’t understand- your numbers are much better with the ResMed, why are you questioning the therapy? Do you FEEL better on the ResMed or Phillips?

[Gideon]

Based on your charts I would get the VAuto.
I honestly don't know what the "V" stands for.

[dragonboyc]

Hi Dave,

Really thanks for this. I told the person that told me it is a ventilator and he said that the trigger and cycle settings prove that it is a ventilator. In Philips only the ventilators have those settings - the Bipap auto does not. 

What's you thought? I am sooo confused and don't know what to think

Herbert

   

[dragonboyc]

Hi @StaceyBurke,

To be frank I feel better on the vauto - but I was told it is a ventilator and ventilators are bad for you unless you have central apnea and I am getting better results because it is a ventilator (they say the trigger and cycle settings prove it is a ventilator as they only exist in philips ventilators - not bipap ...).

They say with the lumis you can switch it off and they think the settings should be switched off.