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Dreamstation BiPap vs AutoBiPap
Hi all. Been a lurker here for a while, trying to learn what I can while going through the study process. Basic question is I have been diagnosed with severe apnea and a BiPap has been selected. They tell me I'll be locked into this machine for the next 5 years and that the std BiPap is what I need. I have been pushing for auto for the flexibility going forward. Do I cave and go with the regular BiPap or stick to guns for the Auto? I do not have a copy of my results yet, though I requested them over a week ago...Really want to get the machine and start the process. Falling alseep at work every day. Thank goodness I am the boss! :^)
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Who is saying what machine was selected? Doc? or DME?
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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Well, still somewhat new to all of this but well educated and well read in the topic. If you wete just diagnosed, it seems odd they would perscribe a bipap to start. Perhaps your doc has a specific reason, but generally a cpap is the first step. The auto feature is pretty awesome, i did mot statt with an auto but after the switch all is much better. Bipaps ate much more expensive, so off that would be the starting point.
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Sleep Center Doc recommended the BiPap. I assume it was because they had to use pretty high pressure for me. The whole process has been less than transparent. Have never met the doc. I go in, a tech wired me up etc. and made adjustments through the night and booted me out in the morning. Three weeks later I am calling to find out what the results were and am told I need a BiPap machine and they are submitting to insurance. Was like pulling teeth just to get a model number out of someone. Going to beg again today to get hold of the results of the two studies they did leading up to this.
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As you probably know, the Respironics BiPAP Pro uses fixed EPAP and IPAP pressures through the night. All auto bilevel machines can be configured this way, so there is nothing given-up by using auto except the option to have a variable pressure through the night. The two major auto bilevel machines perform differently, and it might be helpful to understand those differences.

The Philips Respironics auto BiPAP in auto mode allows the clinician to select a minimum EPAP, a maximum IPAP and minimum and maximum pressure support. so technically, this machine may deliver zero to 8 cm pressure support to an EPAP that varies to resolve obstructive apnea, and IPAP that varies for hypopnea and flow limitation. It tends to be a bit less active in changing pressure than the Resmed.

The Resmed Aircurve 10 Auto uses a fixed pressure support, with EPAP min and IPAP max. So there is always the same pressure support as therapy pressure increases or decreases to treat apnea and other events. The Aircurve 10 S is the fixed bilevel and works the same as Respironics BiPAP Pro.

One last technicality. The term BiPAP is a registered trademark for Respironics, and VPAP or Aircurve is for Resmed bilevel machines. as far as preference, it's in my profile. I have both a Philips Respironics System One 60 series BiPAP Auto, and Resmed Aircurve 10 Auto. The PRS1 is the standby. I have operated the machines in fixed mode, but get better results with variable pressure through the night. Only an arrogant sleep doctor could conclude you never shift position or have fixed needs through the night rather than periods when lower pressures are sufficient. The test is designed to identify your needs but those needs will change as you have changes in health, age and even through the night. As your pressure needs change over you lifetime, this would seem to be designed to keep you coming back for more sleep studies. An auto machine is arguably a comfort issue, but the price differential is not really that great.
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Hi KingDaddyPants,
WELCOME! to the forum.!
Good luck to you as you start your CPAP journey.
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Thanks for the feedback. I was not aware of everything you just shared and will have to get a little more schooled on what it all means. I concur with your assessment that the present direction seems designed to milk the insurance rather than serve current needs while preparing for the future. For the moment I have agreed to go with the fixed machine because I have to get something going before I just fall asleep and pile on the pounds forever. It would be an unfair loss to humanity if that were to happen prematurely!Big Grin

Again, thanks for the response. I'm an engineering guy so will certainly dig in to the numbers and what they all mean, but at present am just skimming the surface. The doc prescribed 17/13 as my levels, by the way. I finally managed to pry that out of someone anyway. The two study test results are "in the mail". We shall see.
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Good Evening;

Something that has not been mentioned yet is the fact that there is only one DME code for BiPAP reimbursement by insurance companies (at least in the USA).

In other words, whether you get an auto BiPAP machine or a fixed level BiPAP machine, you and your insurance company will pay the same amount for the machine.

As has been mentioned previously, the auto BiPAP machines can be set to perform as fixed level BiPAP machines as well as in automatic mode. I have the Dreamstation Auto BiPAP, and I am finding that the auto setting is much more comfortable for me, which enables me to sleep longer at a single stretch. I am now just starting to see 7 and 8 hours without waking, versus no more then 4 hours without waking when set on fixed BiPAP.

Both the current Respironics and the ResMed machines have their strengths and weaknesses. I think it truly comes down to personal preference. I am using the Respironics machine because my wife has the previous model Auto BiPAP (Respironics System One), and it has been giving us excellent service, performing flawlessly for years.

When my wife got her machine a few years ago, I had to stand my ground to get the auto BiPAP for her, and I had to once again stand my ground when I got my own machine. Our sleep doc is anti auto-level, and prefers his patients to have fixed pressures (although he cannot cite any research to support his stance).

If I was in your situation, I would look at both machines carefully, and choose which one you think would work best for you, and then stick by my guns to get the automatic BiPAP of your choice.

Remember, in the final analysis, you are the only one to have to live with the choice, not your sleep doctor, and not your DME.
(getting off soap box)......

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