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APAP to Bi-Level for UARS?
#1
APAP to Bi-Level for UARS?
Hello Everyone, I would like to know some of your experiences going from CPAP/APAP to Bi-Level machines for UARS.

I've been using an APAP for the past year or so. I could only use it at a maximum of 10.5 - 11 cm H2O previously, otherwise I would get aerophagia and abdominal bloating. At that pressure, I could breathe a lot better at night, but it didn't improve my sleep quality/fatigue levels by much. Recently, I have tried increasing my pressure and have found that I am now able to tolerate higher pressures, and I immediately noticed an improvement in my sleep. Exciting!

But the higher pressure does make it more difficult to exhale, and I have heard a lot that bi-level machines are usually better for UARS patients. Since I am seeing positive results with increased pressures, I am strongly considering buying a bi-level machine so that I can use higher inhalation pressures with lower exhalation pressures for better treatment and comfort. Also, my APAP is quite old and makes a lot of noise, especially at higher pressures, which also make me want a new machine.

Has anyone gone from APAP to Bi-Level? Could you share your experiences? Was it a significant improvement?

And as for bi-level machines for UARS, I have seen the Aircurve 10 V auto recommended a lot more than the Dreamstation BiPAP. Why is that? Is it really better for UARS?

Thanks very much!
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#2
RE: APAP to Bi-Level for UARS?
(05-25-2020, 03:19 PM)jdip Wrote: Since I am seeing positive results with increased pressures, I am strongly considering buying a bi-level machine so that I can use higher inhalation pressures with lower exhalation pressures for better treatment and comfort.

...

And as for bi-level machines for UARS, I have seen the Aircurve 10 V auto recommended a lot more than the Dreamstation BiPAP. Why is that? Is it really better for UARS?

That makes perfect sense.

You can search the forums for more, but Resmed machines are generally preferred here because the algorithms are more responsive.

Definitely get a VAuto.
Caveats: I'm just a patient, with no medical training.
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#3
RE: APAP to Bi-Level for UARS?
Many members have moved from CPAP to bilevel with great results With bilevel, the exhale pressure only needs to be high enough to resolve obstructive apnea, we then use pressure support (the difference between inhale and exhale pressure) to treat hypopnea and flow limitation common in UARS. I can assure you the difference is amazing. Look for a Resmed Aircurve 10 Vauto as preferred.
Sleeprider
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#4
RE: APAP to Bi-Level for UARS?
Thank you for your replies slowriter and Sleeprider.

I have been definitely been leaning towards the V Auto with what I have been reading (I read around 50 pages of threads in the past two days). I have only seen one person (they are on reddit) that prefers the Dreamstation BiPAP because it automatically adjusts trigger and cycle settings. I understand that these need to be set manually on the V Auto - is it easy to dial in the trigger and cycle values to find one's optimal setting?

Algorithms aside, I have seen that Philips machines flag RERAs whereas Resmed ones do not. Am I correct in not putting much stock in the value of that feature, seeing as an EEG is required to accurately identify RERAs? My current machine flags RERAs as well and I have found it to be mostly useless.
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#5
RE: APAP to Bi-Level for UARS?
From the feedback here on AB, it seems pretty easy to determine what cycle and trigger settings will be good for you on a VAuto.
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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.
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#6
RE: APAP to Bi-Level for UARS?
(05-26-2020, 11:58 AM)SarcasticDave94 Wrote: From the feedback here on AB, it seems pretty easy to determine what cycle and trigger settings will be good for you on a VAuto.

I agree. And in many/most cases, the defaults are perfectly fine.
Caveats: I'm just a patient, with no medical training.
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#7
RE: APAP to Bi-Level for UARS?
(05-26-2020, 11:48 AM)jdip Wrote: Algorithms aside, I have seen that Philips machines flag RERAs whereas Resmed ones do not. Am I correct in not putting much stock in the value of that feature, seeing as an EEG is required to accurately identify RERAs? My current machine flags RERAs as well and I have found it to be mostly useless.

I put zero stock in machine RERA tracking.

The FL graph and numbers can give you precise places to look for evidence of RERAs in the flow rate graph, and as a general rule, the lower that activity is, the less likely you are to have RERAs.
Caveats: I'm just a patient, with no medical training.
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#8
RE: APAP to Bi-Level for UARS?
It's only been a week since I switched but I am feeling much better already. My BP has come down, no brain fog in the morning, energy throughout the entire day! This was my best night score-wise in awhile & I felt great to match the numbers. I was originally on a Dreamstation Apap it did okay but the Resmed aircurve 10 is way better for me.


[Image: may-23-2020-full-night.png]
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#9
RE: APAP to Bi-Level for UARS?
FYI ResMed AirCurve 10 is a model line with many machines, with each model designed to treat different conditions. The recommended model for OSA in the absence of other issues in the VAuto, specifically the ResMed AirCurve 10 VAuto that redlegs has.
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#10
RE: APAP to Bi-Level for UARS?
Thanks everyone for all of your input, I really appreciate it! You guys are wonderful and have helped me a lot. I'm pretty much sold on the V Auto and I'm thinking about ordering it today.

Quote:SarcasticDave94
From the feedback here on AB, it seems pretty easy to determine what cycle and trigger settings will be good for you on a VAuto.

Quote:slowriter
SarcasticDave94
From the feedback here on AB, it seems pretty easy to determine what cycle and trigger settings will be good for you on a VAuto.

I agree. And in many/most cases, the defaults are perfectly fine.

Thanks guys, sounds good!

Quote:slowriter
Algorithms aside, I have seen that Philips machines flag RERAs whereas Resmed ones do not. Am I correct in not putting much stock in the value of that feature, seeing as an EEG is required to accurately identify RERAs? My current machine flags RERAs as well and I have found it to be mostly useless.

I put zero stock in machine RERA tracking.

The FL graph and numbers can give you precise places to look for evidence of RERAs in the flow rate graph, and as a general rule, the lower that activity is, the less likely you are to have RERAs.

That is what I suspected, thanks for confirming.

Quote:redlegs
It's only been a week since I switched but I am feeling much better already. My BP has come down, no brain fog in the morning, energy throughout the entire day! This was my best night score-wise in awhile & I felt great to match the numbers. I was originally on a Dreamstation Apap it did okay but the Resmed aircurve 10 is way better for me.

That is incredible and exciting to hear. I am very happy for you and hoping for a similar improvement for myself. Do you also have UARS? And have your AHI/FL numbers come down since switching to Bi-level?

Quote:bonjour
FYI ResMed AirCurve 10 is a model line with many machines, with each model designed to treat different conditions. The recommended model for OSA in the absence of other issues in the VAuto, specifically the ResMed AirCurve 10 VAuto that redlegs has.

Thanks for looking out.  I'll be sure to get the V Auto.
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