(04-24-2013, 08:22 PM)Sleepster Wrote: His pressure is 17/11. Not sure why they're prescribing an auto BiPAP instead of an APAP.
Because of the differential in IPAP vs. EPAP (pressure support). With a normal APAP, (with A-Flex or EPR) the pressure relief setting can only lower the exhalation pressure by 3 cmH2O, max. At a high pressure of 17, he could only get an exhalation pressure of 14 using Flex or EPR technology. With a bi-level, the inhalation pressure can be adjusted to a much lower level (in this case 11 cmH20), making the higher pressure much more tolerable.
If (and I stress if
) he can tolerate breathing out against a pressure of 14, then the APAP might work with the A-Flex/EPR set at the 3 cmH2O high setting. However, if his pressure needs increase during the night (say up to 20, then he'd be breathing out against a pressure of 17 (pretty darn high). In that case, it would be better to go with an Auto-BiPAP (to adjust pressure automatically) or a less expensive straight BiPAP (bi-level). Also, if you go with a standard APAP, realize that the pressure will only go up to 20 cmH20, and he may need more than this to punch through stubborn obstructive events. That's a real possibility, considering his prescribed pressure is already at 17.
If it were me and I could afford it, at that pressure level need, I'd go with an Auto-BiPAP if possible. That way you automatically adjust to the changing needs, extend the upper pressure limit (I think most Auto-BiPAPs go up to 25 cmH2o).. plus you've got a much higher IPAP/EPAP range when needed (much greater than the simple 3 cmH20 range offered by Flex or EPR technology on a standard APAP or CPAP).
The DS750 looks like the best option to me. And Zonk is right, the ResMed VPAP Auto 25 unit they are offering is likely not the newer S9 VPAP Auto, although it might be worth getting some clarification on that, because if it is an S9 VPAP Auto, that's a pretty good price.
Here's pics of the ResMed VPAP Auto 25 vs. ResMed S9 VPAP Auto, for comparison purposes: