Sleep Study Question-Regular Auto/Bipap

[bluemom51]

I'm having a sleep study in about 3-4 weeks since I'm having a few problems and have mild heart issues, and it's been a long time since the last one.

When they do a basic sleep study ordered by the doctor, do they automatically try to determine if you now need a bipap, or do you have to have the doctor specifically order a sleep study or instructions for that?

I think I just need a basic auto machine - numbers not wonderful, but AHIs have ranged from about 4-8 average the last few years.  Mostly obstructive with only 2-3 central.  I don't think I would need an ASV, but I just wondered how they determined if you now needed a bipap machine or not?

Thanks for any help with this.

[Sleeprider]

In the past, you have posted charts and I have recommended higher pressure because you have persistent obstructive event problems. For example: http://www.apneaboard.com/forums/Thread-...Is-this-it

You have apparently kept your minimum pressure of 9, and are now going to have another sleep study. I think the study will find a need for higher minimum pressure, and may find you need pressure high enough that you will benefit from bilevel. The Philips Respironics Dreamstation Auto is simply incapable of increasing pressure from a minimum of 9.0 to what you need to treat your obstructive apnea. I think you may end up with a higher pressure from this titration, and that bilevel will make it more comfortable. On the other hand, you might have considered making the changes suggested in your past threads to make Auto CPAP work. Good luck!

[bluemom51]

On the ResMed 9 that I am currently using, I followed the advice and increased the base level to 10.5, and reduced the EPR from 3 to 1 - that improved things to AHIs averaging 3-4, so much better there (and it feels really comfortable pressure-wise).  Just struggling to switch to a F&P Nasal Mask without major rainout despite trying all the usual solutions.  And the ResMed 9 is on its last legs - just trying to make it last through the sleep study.  Don't want to buy another basic auto machine if they say I need a bipap.

Based on recommendations specifically (prior to the scary events), I had increased the base pressure on the DreamStation while trying for a few nights to 12.  It's possible that I need to go higher than that. It looks like my average pressure is around 12-14 and I have the upper limit set to 17.  The 12 felt a bit strong to me but I left it that.

Sorry I am trying so many masks and switching machines back and forth that I have not updated my profile data.

Sadly I may for whatever reason, be a ResMed algorithm person and the DreamStation may just be wrong for me, and I may need to sell it or donate it, and move on.  After the sleep study, I will be getting a ResMed auto or bipap, depending what they find out.  Just looking at the DreamStation now gives me a panic attack.....

But, yes, I always try the suggested adjustments that are reasonable and safe, which almost everything has been.

[Sleeprider]

Thanks for that Bluemom. I never heard the follow-up. If the sleep study finds bilevel is warranted, then you're going to be much happier. I used CPAP for many years before moving to bilevel therapy, and would never look back. My event rate is much lower, and comfort much higher. You're not far from my pressure range, and I hope you find a solution that makes your comfort and sleep much better. No doubt in my mind that the Resmed Autoset or Aircurve 10 Auto is so much more effective and comfortable. As my signature says, I can go a couple miles and pass the Philips Respironics headquarters and manufacturing facilities. I wish I was a fan of the local product, but I'm not.

[bluemom51]

Thank you, Sleeprider.  You made me feel "not crazy" that I was finding basic differences between the 2 brands and that it was obviously upsetting my brain.  Also, now I am looking forward to the sleep study that I had put off for a while, and getting updated data about what machine I need, pressures, heart issues at night, etc.  You made my day!