Not everyone with sleep apnoea takes to CPAP therapy. Those with severe sleep apnoea and central sleep apneas are advised to undergo BiPAP therapy instead.
Bi-level PAP machines are breathing devices similar to CPAP machines. This type of breathing machine uses bi-level positive airway pressure for patients with obstructive or central sleep apnoea. Basically, a BiPAP machine delivers air under higher pressure when the patient inhales, then delivers lower pressure air when the patient exhales. It was designed for patients who have difficulty exhaling against CPAP pressure.
BiPAP machine is recommended for:
Just as a CPAP therapy is not for every patient with sleep apnoea, so is BiPAP therapy. Who are then qualified to use BiPAP machine?
- Patients who feel uncomfortable with CPAP machine as they feel pressure or discomfort while exhaling. BiPAP has a lower expiratory pressure than a CPAP.
- Patients undergoing CPAP therapy but are still in need for Bilevel treatment, and possibly APAP therapy too.
- Patients who have ventilatory impairment such chronic obstructive pulmonary disease (COPD), restrictive thoracic disorder, or obesity hypoventilation syndrome.
- Patients with central sleep apnoea and are not getting better with CPAP therapy.
- Patients with neuromuscular diseases and adult respiratory distress syndrome (ARDS).
Advantages of BiPAP Therapy
The use of BiPAP machine for the effective treatment of all types of sleep apnoea is a possibility what with its numerous benefits.
It seems that the compliance rates of patients with BiPAP machines are excellent. It has been observed that in terms of improvement in blood gas levels and clinical status, BiPAP therapy is quite effective. C-Flex is new BiPAP technology termed expiratory pressure relied. This gadget monitors the patient’s airflow while exhaling, reducing the pressure based on the patient’s requirement. At the end of the expiration, the pressure is readily increased to stop airway collapse. An example of this technology is the Philips Respironics BiPAP Auto with Bi-Flex System One REMStar 60 Series with Heated TUBE Humidifier.
Patients with central sleep apnoea that is linked to cerebrovascular accident, or cardiac failure can be treated with BiPAP. Patients suffering from COPD are best treated with BiPAP therapy.
Disadvantages
Incidence of central apneas may occur with BiPAP titration. This is probably due to the increased lung volume when the air for inspiration or IPAP is higher than the air used for expiration or EPAP.
BiPAP machines are a bit more expensive than standard CPAP machines. This could be a disadvantage for some as PAP machines are not exactly cheap.
As with regular CPAP machine, BiPAP mask may leak air. It may cause general discomfort such as rhinitis, nasal congestion and dry nose.
BiPAP machines are usually built small to fit standard bedside night tables. They run quietly enough so as not to disturb your sleep, your bedmate and the rest of the household. Most BiPAP models come with humidifiers.
Call us at CPAP Victoria now if your CPAP therapy seems to be ineffective.
