Original Question: I had a sleep study done. Within two hours of falling asleep, the tech was waking me up to tell me it was very evident I had sleep apnea. She tried a couple of different masks on me the rest of the night. I can tell that wearing whichever type my doctor suggests, it's going to take some getting used to. I know though it's a necessity and I'll feel much better after I start using a CPAP. 

Additional Question: I thought BiPAP was recommended for polio survivors over CPAP. C stands for continuous and folks with neuro-muscular diseases and possible weakness in the inter-costal (chest) muscles and diaphragm that may make it difficult to breathe out adequately against a continuous pressure system thereby causing the CO2 level to rise, which is very dangerous. Bi stands for bi-level which allows for lower pressure between breaths.

Additional Question: Even with sleep apnea in a polio survivor, a BiPAP is usually recommended not a CPAP.  Apparently Medicare will not pay for BiPAP unless a sleep study shows that CPAP is not workable for the patient.  If I'm not mistaken, one of the most important tests is vital capacity sitting up and especially lying down. Most doctors don't perform the lying down vital capacity. It only takes but a minute but tells a lot about your breathing capacity/weakened respiratory muscles.

Dr. Bruno’s Response: I refer to Dr. John Bach as the “Lord of the Lungs”. BiPAP is usually required for polio survivors but in the US, insurance won't pay till you fail with CPAP.  Another stupidity in the system . . .

In addition, during testing, we ALWAYS recommend that carbon dioxide must be measured. Polio survivors often retain CO2 even when O2 is normal.

More information from Dr. John Bach is available HERE

Richard L. Bruno, HD, PhD

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