RE: What can I use instead of headgear? Or fix?
Bilevel with Backup is what was used prior to the ASV being out there.
Bilevel with Backup (ST) is fixed pressure and fixed PS. The "Timed" backup comes into play when your breathing rate slows to below the setting. The Pressure Support, being fixed, doesn't always initiate a breath. This class of machine is trying to maintain set inhale and exhale pressures. This is the old way of treating CA. If you have some other respiratory conditions, like COPD etc. This may be a better choice.
The ResMed ASV maintains your breathing Minute Vent based on your lask 90 seconds by increasing the Pressure Support of your current breath to maintain your breathing volume. This variable PS can go much higher than the single fixed Pressure Support of the ST is typically set at, enough to maintain your Minute Vent numbers. This is a very different method of operating that the ST is NOT capable of.
This is why we push for the ASV. On the other hand, the ST is considerably cheaper for the DME and your Insurance.
07-08-2021, 10:33 PM
(This post was last modified: 07-08-2021, 10:35 PM by SarcasticDave94.
Edit Reason: PS added
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RE: What can I use instead of headgear? Or fix?
Yes, correct. The ST and ASV both have backup rates, but if you are in fact dealing with Central Apnea, the ASV is going to be by a large margin the better choice. That variable PS is very important. The ST cannot come close. In fact, while I've been using the ResMed AirCurve 10 ASV, the EPAP, PS, and IPAP will all have ranges to go all over the place and will tackle any apnea you throw at it and very effective as well. That is as long as you have pre-existing CA (or maybe idiopathic that needs the ASV), the ASV is then the best.
PS as Gideon said though, if you have other lung issues like COPD, ASV isn't ideal, that's why I have to replace mine as I have stage 1 COPD
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: What can I use instead of headgear? Or fix?
(07-08-2021, 03:15 PM)Zsolt Wrote: BiPAP with back up. BIPAP ST.
Other option is ASV.
What's the difference between CPAP with EPR and bipap?
RE: What can I use instead of headgear? Or fix?
A PAP's EPR is identical to a BPAP's Pressure Support except EPR reduces pressure on exhale and PS adds to the exhale pressure to get IPAP (inhale), and secondly PS has a larger range than EPR's 3.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: What can I use instead of headgear? Or fix?
(07-09-2021, 01:21 AM)SarcasticDave94 Wrote: A PAP's EPR is identical to a BPAP's Pressure Support except EPR reduces pressure on exhale and PS adds to the exhale pressure to get IPAP (inhale), and secondly PS has a larger range than EPR's 3.
So again I get to feel stupid again...
I don't understand how this works. The bipap increases pressure on exhale? Doesn't that make it less comfortable? And how does that cause me to inhale and prevent CAs?
RE: What can I use instead of headgear? Or fix?
No I don't think it's at all uncomfortable. Believe it or not, we're talking about a very small range of pressure in PSI. Yes you might need a small amount of time to get used to it, but not much.
Just remember again, if we're dealing with preventing CA, the best one to do that is an ASV. Your EPAP (exhale) pressure will auto range if in ASVAuto mode, this alone will take care of most obstructive events from OA, Obstructive Hypopnea, flow limits maybe not so much though. Pressure Support is added upon inhale and is a range itself. The ASV can change PS pretty fast if it senses CA and it will give a decent blow to your lungs.
Maybe this helps a bit, my longest used ASV settings were ASVAuto mode, EPAP 8-13, PS 3-15 so IPAP was 11-28 (by adding in EPAP to PS) All 3 of EPAP, PS, IPAP are ranges, each slides about under algorithm control. On this, EPAP is more or less what a CPAP is without EPR.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: What can I use instead of headgear? Or fix?
EPR also increases pressure on the exhale to get the inhale pressure identically to a BiLevel. The difference is only in the terms used.
CPAP by definition has only a single pressure. Auto only moves that single pressure around. So CPAP by definition does not have either an inhale or an exhale pressure, it only has pressure which is the current pressure. So during exhale a CPAP with EPR lowers that pressure by the amount of the EPR until you go to inhale and your CPAP increases pressure by the amount of the EPR. Replace the word CPAP with BiLevel and EPR with PS and you have just described how a BiLevel works. Both machines can have only one pressure at any point in time.
The names 9f the settings and the the math used is different because of the definition of the settings.
APAP uses min and max pressure
BiLevel uses min EPAP and Max IPAP
APAP uses EPR and BiLevel uses EPR.
If you call a CPAPs exhale pressure EPAP and start to inhale, EPR is added to that Exhale/EPAP pressure to reach the inhale pressure, the same as what happens on a BiLevel Now at the higher inhale pressure (either machine) you start to exhale and the pressure drops by either EPR or PS to the Exhale pressure.
I think of ResMed CPAPs as BiLevel machines because of the EPR.
BiLevel 101. EPAP or Exhale pressure is used to treat OA. PS (EPR) is used to treat hypopneas, RERAs, UARS, flow Limits, and snores
RE: What can I use instead of headgear? Or fix?
(07-09-2021, 03:00 AM)SarcasticDave94 Wrote: No I don't think it's at all uncomfortable. Believe it or not, we're talking about a very small range of pressure in PSI. Yes you might need a small amount of time to get used to it, but not much.
Just remember again, if we're dealing with preventing CA, the best one to do that is an ASV. Your EPAP (exhale) pressure will auto range if in ASVAuto mode, this alone will take care of most obstructive events from OA, Obstructive Hypopnea, flow limits maybe not so much though. Pressure Support is added upon inhale and is a range itself. The ASV can change PS pretty fast if it senses CA and it will give a decent blow to your lungs.
Maybe this helps a bit, my longest used ASV settings were ASVAuto mode, EPAP 8-13, PS 3-15 so IPAP was 11-28 (by adding in EPAP to PS) All 3 of EPAP, PS, IPAP are ranges, each slides about under algorithm control. On this, EPAP is more or less what a CPAP is without EPR.
So the BIPAP doesn't help with CAs? (And you write "if we're dealing with preventing CA, the best one to do that is an ASV" - preventing as opposed to what? I have the CAs and want to get rid of - or prevent - them....)
RE: What can I use instead of headgear? Or fix?
A ResMed ASV detects a a central Apnea on the breath it is happening and increases the PS on that same breath to maintain your minute volume and correct the apnea before it finishes.
RE: What can I use instead of headgear? Or fix?
(07-09-2021, 03:27 AM)Gideon Wrote: A ResMed ASV detects a a central Apnea on the breath it is happening and increases the PS on that same breath to maintain your minute volume and correct the apnea before it finishe So increasing the exhale pressure forces me to keep breathing?
When does it detect the apnea? When x seconds pass without my exhaling?
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