Need help choosing a BiPAP machine

[slarai]

My doctor is recommending I try a BiPAP machine rather than the standard CPAP machine I've been using for several months now (Resmed Airsense CPAP), and I'm just looking for guidance on choosing a BiPAP machine. The current ResMed Airsense CPAP machine I have has no data recording capability, so I'd definitely like to find a BiPAP machine with this capability.  I read that "All the ResMed S9/A10 or Philips REspironics PRS1/Dreamstation bilevel/BiPAP/VPAP/ASV/AVAPS machines provide efficacy data that can be displayed by Resmed's ResScan, Philip's Encore and #Sleepyhead." 

So, do ALL BiPAP machines have equivalent data recording capability, or are some better than others? (and are there any that aren't compatible with Sleepyhead software at this time?)

I've also heard that BiPAP machines can vary in how well they sense breathing patterns and adjust pressures. For example, during my BiPAP titration study, I felt that the machine wasn't detecting when I was inhaling well and would just keep it on the lower pressure setting - perhaps due to breathing too shallowly? In that case, I guess I'm also looking for advice on what BiPAP machines are most sensitive in people who tend to breathe more shallowly.  Thanks for any advice!

[Walla Walla]

ResMed Aircurve 10 autov is probably the best. I have a dreamstation Auto Bipap which is also good.

[Gideon]

(best choice) indicates a full data capable machine that has Sleepyhead software capability and an Auto Mode.  These are in general the best available machines

Always specify the exact machine you wish, This removes all ambiguities and prevents substitutions.
DAW (Dispense as Written) prevents substitutions.
Current acceptable in Production Machines (ResMed and Philips Respironics, the 2 most popular manufactures)

• ResMed AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier (37211) (E0601, E0562) (best choice) (Fixed CPAP, BiLevel S, VAuto (Auto-BiLevel))
  
  
• Philips Respironics DreamStation BiPAP Auto Machine (DSX700x11) (Not all DreamStation Models, Check SN on bottom) (Fixed CPAP, Fixed BiPAP, Auto BiPAP) (best choice)
  
  
  
  
  

[slarai]

Thanks for the advice. Another question - do most of the best BiPAP machines also have the APAP feature as well? My doctor essentially doesn't believe in APAP machines, saying they're not sensitive enough and doesn't prescribe them for any of his patients (and he's supposedly one of the best sleep med docs in Houston), so I don't know if he'd prescribe one of the machines in the previous post since they appear to have that auto feature. But just wondering what the alternatives are for a good BiPAP without the auto feature (if that exists)? I'm very confused.

I'd actually prefer having the 'auto' capability as that makes more sense to me than having a set pressure all the time. Someone else had posted that the Resmed airsence Autoset for Her machine has the most sensitive algorithms (and better for women somehow), but that's not a BiPAP machine. Does anyone know how the sensitivity of the auto algorithms on these machines (below) compares with that of the Resmed airsence Autoset for Her?

• ResMed AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier (37211) (E0601, E0562)
  
  
  
• Philips Respironics DreamStation BiPAP Auto Machine 
  

[Walla Walla]

You want to get a Auto BIPAP. They can be set for CPAP or fix BIPAP or Auto BIPAP. They don't have Auto CPAP though. You can set up a BIPAP to run like a Auto CPAP.

[Gideon]

Why is your Dr looking at BiPAP for you?
I'm sure there is a reason.

[Sleeprider]

You have posted a lot of different threads, and it's getting confusing. If you would leave your history in one thread, you'd get better results from us. You have said you have aerophagia and hypopnea, and asked in multiple threads, what CPAP to get and what BiPAP to get, and you have never actually posted any data or charts. So we can continue to play this hide and seek game of how to help you, or you could choose a single thread and give us some real information.

Either the Philips BiPAP Auto or Resmed Aircurve 10 Auto can give you comparable treatment. The Resmed lets you set the trigger sensitivity and some inspiratory timing to ensure faster switching from EPAP to IPAP and longer or shorter IPAP as needed. The Philips has variable pressure support that can keep pressure lower and provide a boost in IPAP for hypopnea. Either might work, but we won't know how to help you until you help us with better information.

[slarai]

I'm having a lot of issues with air swallowing, mouth leakage, and continued bruxism (which was expected to decrease significantly since it seems to be apnea-related but hasn't for some reason). He thinks a BiPAP machine would at least help with the air swallowing and mouth leakage, assuming these are both due to the expiratory pressure being too high for me to tolerate. We're not sure if the continued bruxism (and severe chronic jaw pain!!) could be a by-product of the air swallowing as well, so maybe could help with that? Not sure. 

An auto machine makes so much more sense to me than using a set pressure all night though. So, how are the 'auto' algorithms in an 'auto BiPAP' different from the 'auto' algorithms in an Auto CPAP? Are the algorithms more sensitive, for example, in an auto CPAP than an auto BiPAP? Sorry for all the questions - I've been using a standard CPAP for 5 months now with absolutely no improvement in symptom relief and just trying to take more control over my treatment (and trying not to get too frustrated!!)  Thanks!

[slarai]

Hi - sorry for posting questions on several threads in the last few months. It seemed to make sense to post different questions on different threads, but maybe that's not the best way to go about it. Part of my frustration is that I have no data or charts that I can provide since the machine I was given is a 'brick' - one reason I want to make sure the next machine I get (either BiPAP or Auto-BiPAP) is data-capable. The only info for my case that I can provide is that my sleep study showed an AHI of 41, mostly hypopneas, with no oxygen desaturation. An esophageal pressure catheter was used in the study that showed significant respiratory effort. I was started on the ResMed Airsense CPAP 5 months ago but have aerophagia/mouth leakage/continued severe bruxism/continued daytime sleepiness. My doctor has been playing around with different pressures ranging from 8-12, but I haven't noticed any difference in symptoms, and aerophagia/leakage of course only gets worse with increases in pressure. That's why he's considering a BiPAP, although I'd prefer an auto CPAP/BiPAP because staying at a single pressure setting all night doesn't seem to make sense to me (but he doesn't believe the algorithms in the 'auto' machines are sensitive enough). I'm just trying to get better informed on the different types of auto-BiPAPs/ Auto-CPAP machines available and how the algorithms differ, etc., to be better prepared for my follow-up from a recent Bi-PAP titration study.  I appreciate all the replies and help from this forum!

[Sleeprider]

A high level of hypopnea and the other findings of your study suggest UARS which would more likely respond to bilevel treatment. An auto bilevel is clearly the best choice since it has greater versatility. All of the bilevels provide data. Philips Respironics will report RERA which may be an advantage, and it also can vary the pressure support (difference between IPAP-EPAP). Both Philips and Resmed are highly adjustable and whatever you end up with is fine. I would try to avoid the BiPAP S / VPAP S which are not capable of auto titration.

Your doctor's rationale sounds good, and I would just encourage him to specify "auto" rather than a single fixed bilevel prescription. I have both a Philips and a Resmed bilevel and both have pros and cons, but both are also more likely to succeed in your case than simple CPAP. Make sure the prescription specifies auto. Let your doctor know, we should have learned our lesson about fixed pressure the first time.