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Sleep doc only wants CPAP, not APAP
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tedburnsIII Offline


Posts: 196
Joined: Mar 2015

Machine: 3B RESmart APAP
Mask Type: Nasal mask
Mask Make & Model: Wisp nasal; ResMed FX nasal
Humidifier: came with unit-I vary it, currently set at '3', '5' is max
CPAP Pressure: 10 cm CPAP
CPAP Software: Other Software

Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

Sex: Male
Location: San Diego

Post: #21
RE: Sleep doc only wants CPAP, not APAP
For those interested in how sleep technologists recommend an optimal or other fixed pressure, click on this link:
06-04-2015 02:34 PM
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PaytonA Offline
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Posts: 2,956
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #22
RE: Sleep doc only wants CPAP, not APAP
(06-04-2015 11:31 AM)Sleeprider Wrote:  Payton, the pressure reduction in EPAP allows more air to be exhaled by some people than exhalation against pressure. The tidal volume can be influenced by setting the pressure support. In fact, if set too high it can induce centrals by purging too much CO2. This link explains how tidal volume can be targeted by pressure support: Bilevel therapy is commonly used in COPD, chronic obstructive, asthma, and other patients to improve volume and ease breathing, but the same principles apply to pretty much anyone. In my own case, my tidal volume on APAP at 11-14 averages in the mid to upper 540 to 610 mL range. With BiPAP Min EPAP 8.0 Max IPAP 18.0 PS 5.0-8.0 (cmH2O), the tidal volume average 630 to 680.

Maybe this is just my misunderstanding but this link points to setup for a BiPAP AVAPS not a simple BiPAP or BiPAP auto. Different animal entirely.

Your comparison of tidal volume with more pressure relief on exhalation has more potentially changed than just the pressure support.

(06-04-2015 11:31 AM)Sleeprider Wrote:  You can pretty accurately target tidal volume with BiPAP settings and have much more influence on overall blood oxygen levels than with CPAP. Keep in mind, the use of EPR and Flex, there is a low level of pressure support in many CPAP and APAP machines, but if ventilation (oxygenation) is a concern, most doctors will turn to Bilevel.

Tidal volume is not the only driving force for oxygenation.

It seems to be common (at least I have noticed it with the Resmed folk) to call their ASV or ST or AVAPS machines bilevel machines. They are all bilevel but they are somewhat more than a simple VPAP S or VPAP Auto machine. I am afraid that it can be confusing to some including me. I think that, if we are talking about a bilevel machine with a backup rate, we should make that clear.

Best Regards,

06-05-2015 10:15 AM
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