Sierra

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.

I don't use the ResMed software or their site, so I can't help you there.

On SleepyHead I know it is a beta version, and has a few minor bugs, but nothing I am aware of that is serious. I just helped a friend download it from the site below and it worked fine on his laptop. The 1.0.0-Beta-2 version is what I use and is the current one available for download. It should work on Windows XL. I used the Sleepfiles.com USA download mirror site.

SleepyHead Download

The symptoms you are having with getting summary data only, suggests some issues with your data card. If the CPAP cannot write to the data card it only saves summary data. Make sure the data card is fully inserted in the ResMed machine, and the card is unlocked. You should see a message on the ResMed pop up briefly when you insert it showing the card is being prepared for use. Then when you put the card in your computer so SleepyHead can read it, make sure it is in the locked position. Some users apparently have trouble with the computer writing to the card and that messing up the formatting of the card.

Hope that helps some

I forgot to mention a couple of other things I do to try and keep in the mask in place when I sleep. I was using a memory foam orthopedic pillow, but found it was too firm and when I side sleep it would dislodge the mask due to the pillow pushing back. I switched to a softer down alternative pillow ($18 a pair at Costco). And I found an old satin pillow case to make it easier for my head to slide around without dislodging the mask and straps. My next purchase is going to be a Rest & Renew Satin Pillow Protector from Bed Bath and Beyond ($10 in Canada, $8 in US). They are sold to help keep your hairdo in place when you sleep. I just want to keep my CPAP mask in place! Hope that helps some...

Yes, I believe you are correct. It sounds like your BiPAP is set to an EPAP of 11 cm, with 3 cm of Pressure Support. That is essentially the same as a ResMed APAP set to 14 cm of pressure with 3 cm of EPR.

I would think through the pros and cons of a travel CPAP though. We have a Z-1 that goes unused. The new AirSense full APAP 10 has a nice travel bag that is fairly compact, and it has two velcro straps on it that will secure it to a roller travel suitcase that has a two pipe extension handle. And, a CPAP is a medical device, so it does not count as an additional item or weight to your standard travel allowance.

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

I think the Brita filters are just activated carbon and do not remove dissolved minerals. It would be no improvement over tap water. There is another water purification device called Zero Water that does remove dissolved minerals that would be good to use. However, for just a visit or holiday I would not be bothered with the expense of getting one. Some bottled water may be RO water. I have seen it in some south vacation destinations like Mexico.

In Canada I found it at a place called Sleep Yedi for $25 plus shipping:

Sleep Yedi - Halo Chin Strap

I see that it is available in the US at CPAP.COM for $24:

CPAP.com - Halo Chin Strap

If you have a ResMed CPAP there are some interesting comments in the Clinician Manual.

"Note: Under conditions of high leak with EPR enabled, AHI detection may not be optimal." "Apnea-Hypopnea Index—average AHI during the selected period. AHI and AI are calculated for times of low leak only." "Happy Face for Leaks: Good—if the 70th percentile leak is less than 24 L/min."

So it seems that ResMed does not trust the machine to correctly identify apnea events when there is a high leakage rate, which it looks like they set at 24 L/min or higher. And, for that reason it appears they ignore the high leak rate periods of time during the night. It is my observation using SleepyHead that there seems to be very little indication of apnea events based on the flow signal trace during these high leak periods. If that is the case, then it seems like the process of ignoring high leakage periods, would tend to increase the reported AHI, because periods of time where there are very few apnea events are being ignored.

If you ask for a copy of the sleep report it should have the times or ratio of times that you sleep on your side, back, and stomach on it. Sleeping on your back is the easiest for using a CPAP, and side sleeping can be tolerated. Sleeping on your stomach with a mask on can be difficult.

With an AHI of 12 you are in the mild apnea category. A CPAP may still be the best option, but a dental appliance may also work for you. It should be easier to tolerate in all sleeping positions. I see there is a dentist contributing here, so perhaps they will comment. If you go the dental route you should discuss it with your doctor and dentist.

If you go the CPAP route, you are in the category where a fixed pressure CPAP might be prescribed. I would resist that, and insist on an automatic CPAP or APAP. There is little difference in the cost, and the APAP is more flexible. The ResMed AirSense A10 AutoSet is a very good choice. But, the mask could be your biggest issue - finding one that stays on and doesn't leak. Be sure to try different masks to see what works.

The most comfortable mask I have tried is the ResMed AirFit P10 nasal pillow type. However, I find the headgear that keeps the mask on your head very poor, and I have had the same issue as you have. The mask falls off in the night. One solution that I have found is to wear a chin strap like the Breathewear Halo. It not only keeps the mask in place, but it helps to keep your mouth closed. You put the mask on first, and then the chinstrap over it. The other solution I have tried is wearing a nylon and lycra head cap. They sell them for swimming, and other purposes. Just be sure to get one that is not waterproof, and is just fabric, or it would be way too hot. Speedo and others makes them. Again, put the mask on first, and the cap on second. The only downside of the cap is that depending on how tightly it fits, it can leave a mark on your forehead.

Hope that helps some.