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+--- Thread: Bought a BiPAP instead of APAP (/Thread-Bought-a-BiPAP-instead-of-APAP)
Bought a BiPAP instead of APAP - JesseLee - 03-02-2018
My wife was diagnosed with mild OSA a little over a month ago. Insurance is dragging their feet and DME is slow as well. That said, I got on Craigslist and bought a brand new DSX600T11. Dreamstation BiPAP Pro. Seller didn't know the details on it but told me it was an auto, which it is not. I bought it anyway for 150 bucks. It's brand new. 0.2 hrs on the blower.
My plan was to get her on an APAP and start her 7-15, with flex 2, hose 4, humidifier 2 or 3. Now that I've got this bilevel machine, I'm wanting advice from you all.
She is excited to get therapy started soon, and I am open for any suggestions you all give to me as always. Thanks!
Jesse Lee
RE: Bought a BiPAP instead of APAP - Sleeprider - 03-02-2018
We can help you get her titrated and adjusted to the DSX600T11, which is a fixed pressure BiPAP Pro with humidifier and heated tube. The BiPAP can ultimately provide as-good or better treatment than the Dreamstation Auto CPAP, but you're going to have to work at getting the settings. If I was staring a new user on BiPAP-S, I would start at EPAP 6, IPAP 10 and observe the results. If OA are present, increase EPAP pressure until the OA is controlled. If CA is present above 2-3 CAI, then reduce the pressure support (the difference between IPAP-EPAP). We can help.
Be sure to create a separate log-in for Sleepyhead for her profile. Before using the machine purge all data from the SD card and the machine user data. A clinical manual is available from the Setup Manuals link at the top of the page.
Just a quick alternative thought. Post your sleep chart and Statistic summary, and we can probably come up with valid settings for you on the BiPAP, then you can give her the APAP.
RE: Bought a BiPAP instead of APAP - Sleeprider - 03-02-2018
Here is a titration protocol for BiPAP-S used by clinics. As you can see it starts at EPAP 4 and IPAP 8 and follows the flow-chart procedure. If you want to go by the book, this is a conservative start, and allows her to use the lowest pressure possible. It may take a little longer to reach the correct therapeutic pressure, but patience is a virtue. For self-titration, ignore the reduce pressure for CA events, and only reduce pressure support by reducing IPAP, n as suggested above.
RE: Bought a BiPAP instead of APAP - JesseLee - 03-02-2018
Thank you SR. Will do exactly that.
Jesse
RE: Bought a BiPAP instead of APAP - JesseLee - 03-02-2018
I decided to switch out machines. I'm going to use the BiPAP and she the Auto. She decided to wait until tomorrow night to get started as she doesn't work Sunday and Monday. My computer is not with me now. I'm going to post SH charts Sunday.
My AHI is 1 most nights and at most 3. My 90% pressure is around 11 usually. I sleep well and feel great. I've setup the bilevel 11 IPAP and 7 EPAP. I don't have CA or mixed. OA and hypopnea. Sound ok?
RE: Bought a BiPAP instead of APAP - JesseLee - 03-02-2018
Correction, I have the machine set at 11 IPAP AND 9 EPAP. My flex was set at 2 so I adjusted for a 2 cm difference. And to clarify, I don't have CA or mixed, I have OA and hypopnea.
RE: Bought a BiPAP instead of APAP - jaswilliams - 03-03-2018
Epap of 9 might be a bit low for you what us your 95% pressure ? And any flex settings ?
RE: Bought a BiPAP instead of APAP - JesseLee - 03-03-2018
My EPR was set at 2. 90% was around 11. I used the BiPAP last night and it felt very much the same as my Auto. I didn't sleep well, but that was because I worked a lot later than usual and my routine was very disturbed. I did get in 6.5 hours and AHI was 1.3. I'm not complaining. I'm still wondering if my settings are roughly close.
RE: Bought a BiPAP instead of APAP - Sleeprider - 03-03-2018
All we really need to do is treat OA with EPAP and use IPAP to treat hypopnea, flow limits and snores. It usually works at lower pressures than most people think. I believe your decision to start at EPAP 9 is pretty well founded. I would go with IPAP 12 because I think you will find PS 3 to be very comfortable and more effective...don't look now at who is writing this and uses that as a starting pressure on Vauto. I believe once we dial you in from this pressure, you will achieve better therapy than you had with the APAP. This is the decision I had hoped you would make, and that's why I suggested it above. I think your wife will do better with an auto titrating machine to start, and your therapy will not be difficult to dial in on BiPAP.
One last reminder, you need to create separate profiles in Sleepyhead and you can take your card to the BiPAP after you purge the user data in the machine. You do not have to erase your SD card to use it in the new BiPAP. Sleepyhead will show you your previous therapy and new BiPAP therapy without any breaks or problems. Erase your user data from the auto CPAP and the SD card you put in it, then be sure to always switch users as needed in Sleepyhead to import the data.
If you will post some data rather than talking about it, we could also do more than talk about it.
RE: Bought a BiPAP instead of APAP - JesseLee - 03-03-2018
Thank you for the advice about switching SD card over to BiLevel. I was uncertain about that because the thought had crossed my mind. The lady will be fine I believe. She's receptive to therapy and is excited to begin. I'm going to use my new spares to get her equipped. We have to travel this afternoon and I don't know if I will be able to, but I will try to post sleepyhead charts and stats for me. If not today, then tomorrow for sure. I will follow your advice tonight and raise IPAP to 12. Will also make a profile for her in Sleepyhead. Hopefully her insurance will have everything they need to get her setup soon. I believe our DME only offers the Dreamstation Auto, so she will not have any issues with machine transition.
Jesse