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Why would I want CPAP, APAP, BIPAP, or ASV?
#1
I am reading that every one has different needs and hence a different machine. What do the different machines try to solve?

I understand the APAP is prescribed when a home study is done and no titration study is done. Kinda shotgun the pressure settings.

What about the other machines?
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#2
CPAP is just straight pressure. Just 11, or 8, or 16.

APAP is a range of pressures and adapts to your immediate breathing pattern. It increases pressure when there is an indicator of a RERA or apnea. A setting would be say 8-12. Pressures start at 8, but go no higher than 12. APAP machines can ALSO be set to cpap. Maximum pressure is 20 cm.

BIPAP/Vauto - similar to APAP but EPR is set at greater range and I think Bipaps/Vauto go to a pressure of 25. You might have a setting of 13/19. 19 cm to breathe in and 13 to breathe out. It can reduce problems with aerophagia as an example. These can be set to either auto or straight pressures. But there will always be 2 pressures.
Bipap is Respironics name. AirCurve™ 10 VAuto is Resmed's name - same machines that have extended EPR settings.

ASV(Resmed) or BiPAP autoSV Advanced (Respironics) - is for people who have many central apneas (i.e. Cheyne strokes apneas). Hardly anybody gets this.

Most people can tolerate a straight pressure and a range of pressures, but not all. Some find that changing pressures wakes them up, makes them uncomfortable or elevates blood pressure.

EPR allows you to breathe out more comfortably at a lower pressure. Newer cpap and apaps allow you up to 3 cm lower pressure for breathing out. Bipap range is much greater.

In my opinion, for most people, an auto-cpap is your best buy UNLESS you've already found that straight pressure is the only thing you can tolerate. Most insurance will not pay for a bipap unless you have failed with a cpap.

Finally, keep in mind that each company has a different algorithm for treating patients. While many will benefit from either, some do better with one manufacturer than the other. It would be great if everybody could try each machine, but that rarely happens.
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#3
ASV (AutoSV for Respironics) is a bit different. It uses an algorithm not two set pressures and is used primarily for the treatment of central and mixed Apnea and Periodic Breathing. It is the third level of machine.
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#4
Mosquitobait is very close. The Resmed version of a BiPAP is named BiLevel. It seems that BiPAP has become the defacto generic name for the machines in this realm. . . Kind of like Kleenex is to facial tissue and Scotch is to cellophane adhesive tape. The BiPAP machines go from 4 to 25cm pressure and allow a greater differential pressure between the inhale and exhale. The CPAP's, both straight and variable pressure models, normally go from 4 to 20cm in pressure (1 exception that starts at 3cm) and only allow up to a 3cm difference between inhale and exhale. The ASV, Auto Servo Ventilator, is at the top of the therapy chain. It is primarily the last resort in Central/Clear Airway apneas and will initiale an inhale cycle if the patient doesn't respond after a programmed time limit.

I'm generalizing this but normally you have to fail one level of therapy to advance to the next higher level of therapy. So it would be: CPAP->BiPAP->ASV. So will the machine prices.

I hope I'm not telling you how to make the watch in case you were just asking for the time.

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#5
Actually this what I was looking for. I have a lot of CAs if you call 1 to 3 per hour a lot but I am beginning to think it is sleep/awake junk. They come in bunches 3 to 5 in a short time, then quiet for an hour. My OAs and HAs are practically nil so my AHI is between 1 and 3 every night, all CAs. But I think I am half awake for all of them.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#6
Turn your EPR setting down to 1. EPR can sometimes cause more clear airway events.

You can also look to see what your 90% pressure number is. Look on SleepyHead and see if you can determine if the Clear Airways were triggered during a high pressure.

If you don't hit a pressure of 16, you may want to bring that max pressure down a bit to 14 or 15.

If you would post a screenshot, more accurate advice can be given.
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#7
Bipaps change pressure when the user switches between inhaling and exhaling. The ASV changes pressure according to an algorithm to encourage the user to make that switch between inhalation and exhalation, trying to keep the user on a pattern (and maintain breathing). That can be pretty annoying while you are awake and transitioning to sleep. When awake and consciously breathing the machine can cut pressure mid inhalation or exhalation if your breath rate changes and catches it unaware. But you learn to "dance" together and usually once you are asleep the machine takes the lead.
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#8
(06-22-2016, 12:11 PM)bons Wrote: Bipaps change pressure when the user switches between inhaling and exhaling. The ASV changes pressure according to an algorithm to encourage the user to make that switch between inhalation and exhalation, trying to keep the user on a pattern (and maintain breathing). That can be pretty annoying while you are awake and transitioning to sleep. When awake and consciously breathing the machine can cut pressure mid inhalation or exhalation if your breath rate changes and catches it unaware. But you learn to "dance" together and usually once you are asleep the machine takes the lead.

This is a good way to put it. It is indeed pretty annoying while you're awake. If for some reason you don't fall asleep fairly quickly, the ASV action can actually make it more difficult to fall asleep--at least, that's been my experience.
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#9
1-2 an hour will not typically cause any concern. My Dr was looking for 20-40+ an hour before he took notice.

It could be SWJ, or just getting used to pressure changes, or turning over in bed, or .......
It seems we all do strange things while we sleep and just because we can now see what we did at night does not mean it's a problem.

Been there, done that. Smile
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