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diamaunt
Unread post  Post subject: Reddit user asks: "Should I just get a bipap"  |  Posted: Tue Feb 06, 2018 7:05 pm
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Jason, your thoughts please...

reddit user wrote:
I have just been diagnosed with OSA, about to go and see my consultant about treatment. I expect I will be offered the CPAP. Having read up on it, given the choice is it always better to get a BIPAP? Sounds like this helps by letting you breath out more naturally which is greatly appealing to someone new to this.

reddit idiot wrote:
Using a BiPAP, when unnecessary to keep you breathing, will generally induce central apneas because as it starts to breathe for you, your body loses the instinct to breathe itself. It should be fairly obvious training your body to forget how to breathe is not advisable, and adding central apneas on top of OSA is not helping your sleep apnea.

As far as your concern about breathing out more naturally, most modern auto CPAP machines detect when you are exhaling and lower the pressure significantly so you don't have to breathe out against the pressure.

I have used both BiPaP and auto CPAP with this feature and there is no difference in the ease of exhaling.

My opinion if you are just starting is not to complicate your situation even further by starting the wrong therapy that will likely make your apneas worse. BiPAP is not a better therapy, it is just the therapy that you have to use if you are unfortunate enough that your body actually forgets to breathe on its own.


I say the second poster is an idiot that doesn't understand *anything* about "bipap" machines, and is only operating in some ignorant fog after reading a comment of yours somewhere on youtube:

the mighty lanky lefty wrote:
QUESTION

I don't really understand why EPR(BiPAP) could cause RERAs? Is it because of a quick collapse of the airway during pressure relief?

REPLY

TheLankyLefty27

9 months ago

Yes, exactly. It can also throw off the CO2/O2 balance and result in Central Apneas in certain people.

Want to insult and swear at him too?


My position is that idiot is taking your comment *completely* out of context, and conflating the 15%(or so) of people that are prone to complex sleep apnea into a generic and misdirected dread of bilevel machines in general, aside from not even remotely understanding the difference in machines with, and without a backup rate.

Am I full of poo?

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TheLankyLefty
Unread post  Post subject: Re: Reddit user asks: "Should I just get a bipap"  |  Posted: Thu Feb 08, 2018 11:14 pm
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diamaunt wrote:
Am I full of poo?
Depends if you've had your coffee and a bran muffin yet.... :? (bad joke? I don't even know where the line is anymore.)

You're correct. I would say that my statement was taken out of context big time.

Bilevel should only be used for people that are having Central Sleep Apneas (though they may need a back up rate or even ASV), have COPD, have CHF, or are having difficulties tolerating *high* cpap pressures.

It's definitely not better.....unless you need it. You know you need bilevel when you've tried CPAP and see how you react to it in lab. Getting the pressures and mode of therapy correct is often more art than science.

The first three lines written by the person you're referring to as *less than average* sounds like they are trying to use their own words to describe something I have said in the past, but it came out a little wonky. The last statement I would agree with
reddit idiot wrote:
My opinion if you are just starting is not to complicate your situation even further by starting the wrong therapy that will likely make your apneas worse. BiPAP is not a better therapy, it is just the therapy that you have to use if you are unfortunate enough that your body actually forgets to breathe on its own.
, though you're not being "trained" to not breathe. (I'm being nitpicky here) Your brain isn't getting the signal that it needs to breathe, then by the time it figures it out it sends a double strong signal to hyperventilate, then when it figures out that you're hyperventilating it overcorrects the other way again.....and again....and again.

It's not that your breathing is being trained. It's the O2/CO2 balance and how normal or abnormal your body systems are sensing and reacting to it.

To your point though, some people are just much more susceptible to this than others. To know which one a person is you just have to go through the process. CPAP (or APAP), Bilevel, Bilevel with backup, ASV. I think 15% might even be a high estimate (only say that because we are going through accreditation and that number is way higher than people that actually went on ASV or bilevel with backup rate for those with low ejection fraction.)

Sorry for the late response. I'm volunteering with my boys baseball league in addition to coaching this year. This last week has been rough with meetings, rules changes, drafts, assessments, coaching clinics....etc!

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diamaunt
Unread post  Post subject: Re: Reddit user asks: "Should I just get a bipap"  |  Posted: Thu Feb 08, 2018 11:25 pm
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TheLankyLefty wrote:
Sorry for the late response. I'm volunteering with my boys baseball league in addition to coaching this year. This last week has been rough with meetings, rules changes, drafts, assessments, coaching clinics....etc!

Spare time? who needs spare time in their lives?

Another friend of mine did the cub scout master thing with his boy last year... NO spare time at all for *months*.

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