Switching to BiPAP Therapy

[nearenough]

Hi all,

I have a BiPAPtitration scheduled and I'm trying to educate myself in advance of the titration.  I get the mechanics of BiPAP with differing IPAP and EPAP pressures (I'm on an APAP with 3cm EPR...).  I'm really more curious about what kinds of things I need to be aware of when (if?) switching to a BiPAP machine.  Many contributors here have been extremely helpful in getting my APAP dialed in and answering questions.  I'd like to be aware of the things the lab or your doctor don't tell you so I can optimize my therapy as I start a new chapter in treatment.  For example, my original prescription was for APAP 4-16cmH20 which was far too broad and caused all kinds of therapy-induced CA's.  My hope is that I can have a good game plan in mind when starting on a BiPAP device.  What are your suggestions, 'gotchas', tips, etc.?

Thanks!

[Sleeprider]

Understand the titration protocol for bilevel is basically a methodical trial and error application of pressure and pressure support starting at low pressure and using a logical decision tree on the next step until events and sleep quality meets the criteria for a successful titration. The clinical study is not nearly as useful as your long-term experience will be. It is mainly performed to justify the bilevel in terms of medical necessity and efficacy. We have very little control of how a titration is conducted and even the technician is limited in how they can conduct the test and change the variables. In general they won't discuss the details of the test, but if you can express your goals conversationally, that might have an effect on how they conduct some of the discretionary decisions.