POLL - CPAP vs. all other PAPs

[SuperSleeper]

I know this statement makes no sense, but maybe we're the odd ones. We started talking about battery backups and the next thing you know, somebody in the group has reverse engineered, peer reviewed and built a dang prototype of a manufacturer's power supply ......

The geek quotient on this board is pleasingly high.

Yep, and that thread is an amazing one to follow.

[OMyMyOHellYes]

Poll is complete - looks like:

82% on CPAP/APAP
18% on Bi/VPAP

Poll is no doubt skewed due to a non-=standard population on this list - I would guess that the percentage of Bi/VPAP here is maybe twice the general population of appliance users?

[shawn42]

[link to commercial DME blog article on Supplier #10's website removed] would have me believe that Auto-BiPAPs are a category of their own. Did you intend for them to be included under VPAP or BPAP or APAP? I'm confused where I fall here.

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[OMyMyOHellYes]

This question started when Mongo threw into a thread that his S-8 was a 24V system. Well, yes, ResMed had started using 24 for their Bi/VPAP machines back then, but my point was it was a really small portion of the universe and that they didn't really go in for a non-standard 24 V standard until the S-9s.

So, to answer your question, if the machine says BiPAP or ASV or Auto Servo or VPAP anywhere it is in the BiPAP/VPAP group which probably make up 10-15% of the world - auto machines are really considered CPAPs as lumped together by the medical/insurance/government cabal and probably make up 85-90%. You are really talking features, not major functionality differences that would exist between say someone needing to treat central vs. obstructive apneas.

The purpose here was to have an anecdotal, wild assed guess as to what ratio of the two kinds of machines there are in use. It has no realistic statistical validity. I just wanted to be somewhere on the paper when I try to conceptualize the split in the PAP community. 8:1 or 9:1 or somewhere in between I think would be reasonable.

OMMOHY

[shawn42]

Somehow you've managed to say a lot, but still leave me pretty confused =) I'll blame myself this time.

I think I'm just gonna start saying ABPAP. If one distinguishes an APAP from a CPAP, then I feel it's reasonable to distinguish an ABPAP from a BPAP. I don't know where to draw the line between what's considered a feature vs a function. They sound like the same thing, to me, when it comes to these machines.

[OMyMyOHellYes]

CPAP/APAP vs. BiPAP/VPAP - They LOOK the same, but do different things. A quick and dirty way to differentiate is to ask "what is the max pressure the machine will go to?" CPAP/APAP go only up to 20 cmH2O. BiPAP/VPAP go higher. Also, inhalation pressure is higher than exhalation pressure. Admittedly, "flex" comfort feature of 1-3 cm reduction found on some units blurs that line, but for biPAP the pressure differential is bigger and can actually assist in breathing.

CPAP/APAP purpose: holds your throat open so you can breathe on your own. They are not respiratory assist devices. They don't "help" you breathe.

BiPAP/VPAP purpose: are respiratory assist devices that actually help you breathe.

A brief explanation of the insurance billing codes (HSPCS) found on a supplier's site (click da pic):

[attachment=2603]

E0601 is CPAP/APAP; non-invasive
E0470 is a BiPap (I think); non-invasive
E0471 is an adaptive servo machine (I think); non-invasive
E0472 uses a trach tube; invasive - not what we would normally consider when talking about these kinds of machines.

OMMOHY

[justMongo]

As for ResMed going to 24 V on their S8 bilevel machine (VPAP), I would suggest that the wider split between IPAP and EPAP requires a more responsive blower motor; and 24 V makes that easier.^*

* The blower may have to raise pressure by perhaps 6 cm in 300 msec.