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Re: IPAP/EPAP Differential

Posted by RenoTom on August 22, 2002 at 21:38:56:

In Reply to: IPAP/EPAP Differential posted by Optimistic on August 22, 2002 at 19:33:27:

When we discuss BIPAP and it's pressures, it is usually in a manner that dismisses the epap pressure so that it seems irrelevant, with the ipap pressure doing all the work.
Some of us do this even though we know that this is not the case. I do it to simplify the discussion and avoid confusion. There are however some situations where the issue comes up where we do need to get into it, like now.
To start out the clarification, we must point out that although there is a general understanding that obstructive apneas occur during inhalation, this is probably not the case. It is thought that obstructive and mixed apneas occur during exhalation. Furthermore hypopneas are thought to occur during the inhalation side of things.
Labs use different protocals for titration. Some labs titrate by adjusting epap pressures to eliminate obstructive and mixed apneas, and by adjusting the ipap pressures to eliminate hypopneas. They then boost the epap pressure to match the ipap pressure for a CPAP setting.
As you can see one pressure is not related to the other.
There is a thread back in Nobember of 2001 that discusses this, and is the source of my information. Kevin (in Walla Walla) contributes a lot and wrote the intended information, but the whole thread is good. The URL is: http://www.sleepnet.com/apnea78/messages/122.html
Hope this helps.
RenoTom

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