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CPAP versus Bilevel
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Alzwell Offline

Members

Posts: 16
Joined: Dec 2012

Machine: Resmed VPAP S Easy-Breathe
Mask Type: Full face mask
Mask Make & Model: Quattro FX FFM
Humidifier: Resmed H5i
CPAP Pressure: 14 inhale/9 exhale
CPAP Software: Not using software

Other Comments:

Sex: Female
Location: Utah

Post: #1
CPAP versus Bilevel
I have been on CPAP since November 27, 2012, and doing well. I also receive 2 liters of oxygen along with the CPAP. Most of my readings have been under the 5 per hour that is considered normal. The Pulmonary doctor ordered a bilevel sleep study for me, but sort of left it up to me to decide whether or not to go ahead with the study.Huh

It is such a hassle to go in for the study to be done, and I have made an appointment finally to go ahead and do it, but I keep wondering if it is necessary. He's the doctor--shouldn't he know whether or not I need this? The only reason I finally made the appointment was because the technician said after my original study that they might want to have me be on bilevel. He said that when we were discussing the fact that my oxygen levels were not quite up to where they want them to be.

I have learned more from this forum than from the doctors, and so I am asking you what you would do in this case. I just need some educated opinions before I go ahead and have this study done. By the way, my husband feels like if it "ain't broke, don't fix it!" Meaning if the CPAP is working, then why bother. Thinking-about

Thanks,
Gloria
02-16-2013 06:53 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #2
RE: CPAP versus Bilevel
Did you have trouble exhaling with your CPAP mask on during the sleep study? That's the usual reason for prescribing a bilevel machine.

I would call the offices of both the doctor and the sleep lab and find out just why this test is being ordered. If you can't get a reliable answer from both of them I would visit a different doctor and get a second opinion.

Sleepster
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
02-16-2013 07:17 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: CPAP versus Bilevel
(02-16-2013 06:53 PM)Alzwell Wrote:  The Pulmonary doctor ordered a bilevel sleep study for me, but sort of left it up to me to decide whether or not to go ahead with the study.Huh
it seem a bit vague to order a sleep study and leave you to decide
he ought to explain why the bilevel so you can make an informed decision

machines with EPR (exhalation pressure relief) feature can for some people make exhaling against pressure easier

for example if EPR set 3, inhale at 11 ... exhale at 8
on bilevel the difference between inhale and exhale pressure can be set higher
F&P Icon don,t have EPR feature. sensawake is not the same thing

Expiratory Pressure Relief (EPR)
http://www.apneaboard.com/wiki/index.php...ure_relief
02-17-2013 12:26 AM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: CPAP versus Bilevel
(02-16-2013 06:53 PM)Alzwell Wrote:  The only reason I finally made the appointment was because the technician said after my original study that they might want to have me be on bilevel. He said that when we were discussing the fact that my oxygen levels were not quite up to where they want them to be.

Hi Alzwell, welcome to the forum!

If your oxygen levels were not quite up to where they want them to be, and if in their experience they think Bi-level may be better for you, I suggest it would be a good idea to have the Bi-level titration done.

If you end up being prescribed a new class of machine (bi-level), then your insurance should cover it.

AND, of course, getting a new machine would be a fine opportuniy to ask for one of the machines on Archangle's list of recommended machines.

http://www.apneaboard.com/wiki/index.php...ne_Choices

As Archangle wrote:
"I consider any of the PRS1 or ResMed S9 bilevel machines to be acceptable, because all of them record full data, including airflow data.
"I do not recommend any other brands because they do not record full data, including airflow waveforms"

AHI does not tell the whole story on sleep quality. To fully optimize our treatment, it is also important (at least occasionally, and especially whenever starting a new medication, whether prescription or over-the-counter type) to look at the time waveforms of our sleep data, showing whether the lengths of the apneas were unusually long, whether they were predominantly obstructive or central type, whether there was Periodic Breathing or Cheyne-Stokes Respiration, or anything unusual which our doctor should appreciate being informed of and which he/she may want to have looked at further. Even if we have no unusual issues during a sleep study or now, we may develop one or more in future because of medications we may need to take because of some future change in our health needs.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 02-17-2013 06:30 AM by vsheline.)
02-17-2013 06:01 AM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #5
RE: CPAP versus Bilevel
My sleep specialist has always given me choices on how to procede with my treatment. At least the good one does. The bad doc stopped even telling me about changes he was making- he would tell the tech in front of me. I was getting the bums rush out of the office. Often we come to a place where we have to make the decision on how to procede because it's our quality of life. I was never able to get my AHI down to five in any modality- CPAP, AUTO, BiLevel. The good doc explained the ASV machine, told me they were expensive and left it up to me whether to have a sleep study with ASV. I felt ok, I didn't desaturate with an AHI average of 18.6/six months, but I didn't feel great. I was sleeping 10-12 hours a night, still having some daytime sleepiness, and was depressed. Hoping to do better I opted for trying the ASV and have never looked back. If I had settled for feeling ok I never would have know what it felt like to be properly treated. In my case I have mainly hypopneas due to meds I take. I still have a few- AHI 4-8/night over the last six months, but the ASV has cleaned up most of them.
Good luck in your decision.
02-18-2013 10:24 AM
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