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BiPAP machine functionality?

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conversationpc +0 points · almost 3 years ago Original Poster

I was diagnosed with sleep apnea several years ago and obtained a BiPAP machine. For years, I didn't use it due to a claustrophobic type feeling. Since then, my symptoms have gotten worse, to the point where I literally cannot stay awake at all times during the day, mostly if I'm sitting still, while working, watching TV, etc. Previously, the pressure setting on my machine was 11 and now it is to be set to 18. I haven't met with the therapist as of yet but will be doing so in about a week and a half.

The machine in question is a Philips Respironics BiPAP Auto Bi-Flex with an attached removable humidifier. I'm trying to find out if the machine can only function as a BiPAP or also as a CPAP. Does anyone know for sure? I've been doing Google searches, which lead me to believe it does but I'm not certain I'm finding the right information. I don't want to have to buy a new machine if I don't have to.

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Sierra +0 points · almost 3 years ago Sleep Patron

I found this statement in the user manual for the machine:

"Available Therapies The BiPAP Auto Bi-Flex device delivers the following therapies: • Bi-level – Provides one level of output pressure during EPAP (Expiratory Positive Airway Pressure) and a second higher level during IPAP (Inspiratory Positive Airway Pressure). • Bi-level with Bi-Flex – Bi-level therapy with pressure relief upon exhalation to improve patient comfort based on patient needs. • Auto Bi-level – Delivers spontaneous Bi-level therapy while automatically adjusting EPAP and IPAP levels to meet the patient’s needs. • Auto Bi-level with Bi-Flex – Auto Bi-level therapy with pressure relief upon exhalation to improve patient comfort based on patient needs. The following therapy modes may also be available: • CPAP – Delivers Continuous Positive Airway Pressure; CPAP maintains a constant level of pressure throughout the breathing cycle. • CPAP with C-Flex – Delivers CPAP therapy with pressure relief upon exhalation to improve patient comfort based on patient needs."

It sounds like there may or may not be an option for CPAP. A true CPAP runs at a single fixed pressure. Are you sure that is what you want. The other option is an Auto CPAP or APAP. With that the pressure is adjusted to suit your pressure needs from minute to minute. In Auto Bi-Level mode it should operate similar to a APAP.

The link below is to the Provider Manual. If you go into the provider menu you should be able to see what modes your machine supports.

BiPAP Auto Bi-Flex PROVIDER GUIDE

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conversationpc +0 points · almost 3 years ago Original Poster

I would think the Bi-PAP functionality is preferable but the provider who called said it needs to be CPAP. I would think as long as the inspiratory pressure is as prescribed, it wouldn't really matter if I have a Bi-PAP as compared to a CPAP.

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Sierra +0 points · almost 3 years ago Sleep Patron

There really is not all that much difference between a Bi-PAP and an CPAP in how it operates. With a Bi-PAP you are typically prescribed and set a EPAP (exhale) pressure. Then there is a Pressure Support setting. That is the amount of pressure you get extra on Inhale or IPAP. So for example if your EPAP pressure is set at 15 cm and Pressure Support at 3 cm you would have 18 cm on inhale and 15 cm on exhale. In the CPAP world (ResMed terms) you could get essentially the same thing if you set Pressure (which is really IPAP) at 18 cm, and then set the EPR at 3 cm. The end result is the same. 18 cm on inhale, and 15 cm on exhale.

The fundamental difference between a BiPAP and CPAP however is that while a CPAP is limited to 3 cm of EPR, the BiPAP can go higher in the split between EPAP and IPAP to as much as 10 cm. Also the maximum IPAP pressure that the machine is capable of is higher at 25 cm instead of the CPAP limit of 20 cm. There are also some more subtle features at least in the ResMed models which allow adjustment of how the machines decides to switch from IPAP to EPAP and back. The basic purpose of the Bi-PAP is to provide more breathing assistance than a standard CPAP can provide. That should not mean that you cannot dumb down the settings of a Bi-PAP to make it behave like a standard CPAP.

If your machine does not support a true fixed pressure CPAP mode, I'm sure it can be still set up to provide essentially the same thing. You would just set the minimum and maximum pressure limits to the same value or if forced to with a 0.2 cm difference -- which is essentially zero. I rather doubt you need a new machine. It just needs to be setup properly. That Provider Guide that I gave you a link to should allow you to do that. If you need help, post again, and I will have a closer look at the guide and let you know how I would set it up.

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sleeptech +0 points · almost 3 years ago Sleep Enthusiast

Any BiPAP can work as a CPAP. However, it is not entirely correct to say that they are the same or EPR can do the same job. BiPAP is a far more complex machine used to treat different disorders than OSA. Using BiPAP when you don't really need it can create problems with your breathing. Make sure you have the right treatment and that the doctor explains to you why it is the right treatment.

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Sierra +0 points · almost 3 years ago Sleep Patron

"I'm trying to find out if the machine can only function as a BiPAP or also as a CPAP. Does anyone know for sure?"

To get back to your original question these steps should tell you for sure:

  1. Plug in your machine to power it up.

  2. Rotate the round knob until the Setup or wrench icon is highlighted.

  3. Hold the round button down and at the same time the ramp button a little below and to the right. Hold them both for more than 5 seconds until you hear a quick double beep. The Provider screen should appear.

  4. Rotate the round knob again until the Setup or wrench icon is highlighted. Press the knob to bring up the Provider Setup menu.

  5. The first item on the list should be the Mode. Rotate the knob to highlight the Mode line, and take note of what mode it is in. The manual is not totally clear on how to select options, but assuming it is similar to ResMed, you would press the button while the Mode line is highlighted, and it should either rotate through the various options, or bring up a list that you can select from by rotating the knob. Check to see if one of the options is CPAP. It it is there then your basic question is answered. If you want to make it operate like a CPAP press the knob again to select it.

  6. Rotate the knob to bring up the last option which should be Back which you would select to return to the Provider Menu. Rotate the know to highlight Exit, and then select that. That should take you right back out to the Patient menu. Then you can power down the machine.

Hope that works in definitely answering your question. And, like I posted before, even if you don't have the CPAP option, you should still be able to simulate that mode by using the BiLevel Mode.

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TuzaHu973 +0 points · almost 3 years ago

New to BIPAP this week. I've got the same problem and only been on BIPAP for 4 days. I was DX with OSA a few months ago while in the ICU for massive pulmonary embolism from a DVT I didn't know I had. It took 2 months to get my BIPAP. My pressures are high, 23 and 19. During my sleep study I had apnea 168 times an hour with oxygen sats dropping to 34%. My pulmonologist said I set new records! I don't know how to read the info on the machine yet, it's a Dream-something. In the past 4 days of using the BIPAP I've now got sores on my face from the mask and have fallen asleep at the wheel 3 times driving my truck while stopped at red lights in traffic. I'm exhausted due to lack of sleep with this beast on my face. It blows in when I want to exhale. I'm dreading going to bed every night now to have to strap this beast to my face and spend the night with it blowing my mouth open and shut. The water compartment is so tiny it runs dry after 4 hours so I have to fill it up again in the middle of the night (I live in the desert). I'm so disappointed that I feel worse off with treatment than without.

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wiredgeorge +0 points · almost 3 years ago Sleep Enthusiast

You have dangerously low O2 levels while sleeping. MANY health issues may result so you had best figure out how to make therapy work. You said "they" a number of times but you need to get your therapy fine tuned by YOU. The mask is leaking because your mouth is open. Find a way to keep your mouth shut which is caused by a sagging jaw once you are relaxed. I use a boil and bite (MMA style) mouth guard. Other use straps and others actually tape their mouth shut. Figure that out and the water reservoir won't run out. You will also limit dry mouth.

If you have sores on your face, change mask types. I use an Amara View after trying a few masks. It is soft and fits under my nose and over my mouth. My pressures are higher than yours at 25/21 so it will work with your pressure.

Its up to you to take charge of this thing as a sleep doc or person working in the DME place that gave you your equipment isn't as interested as you should be. Stick to it and figure things out and ask questions and you will get there where therapy isn't a chore and is actually allowing better sleep. BTW: I was falling asleep while riding a motorcycle before therapy. That was fixed once I got therapy right for myself. There is hope.

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sleeptech +0 points · almost 3 years ago Sleep Enthusiast

What kind of mask do you have? It sounds like many of you problems could be resolved with the correct mask. And, if you have OSA, why are you on BiPAP and not CPAP? Especially if the pressure fluctuation is uncomfortable, why is it even there when you don't need it?

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sleeptech +0 points · almost 3 years ago Sleep Enthusiast

Yes, your machine can run as a CPAP. In fact that's the only way we use that particular model. From your description it may well already be running as a CPAP.

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