UARS diagnosis? No improvements on CPAP. What Bilevel machine to get and where?

[empiricismandstatistics]

Hello all, thanks for your help - its massively appreciated. 

I'm a tall very thin male with small facial structure. 
Had 1.5-2 hours wake time on my whoop data so decided to get a Watchpat study. 
Results (attached): 
pRDI: Total events 88. 14.6/hr in REM, 12/hour nREM. Average all night 12.3/hour. (18.7 when supine)
AHI: Total events 46. 8.3/hr in REM, 6.2/hour nREM. Average AHI 6.4 (11.4 when supine)

   
   

I have tried a MAD up to 10mm with no success (persistent high awake time on whoop and subjectively unrefreshing sleep. 
I have also tried a Hypnus CA820W CPAP machine up to 9cmH20 with no success also. 

3 questions: 
1. Can OSCAR software be used with Hypnus device? Any other treatment therapies for UARS you would recommend trying?
2. What Bilevel machine would you recommend for UARS?
3. Where should I get this machine (off-prescription as the waiting list is long before I see sleep specialist again)?

Thank you.

[Crimson Nape]

Hi empiricismandstatistics!  -  
OSCAR does not support the Hypnus CPAP.  If you are experiencing UARS, then a bi-level type of CPAP would be the best choice.  If you are going to purchase this yourself, I would recommend a North American version of the Resmed AirCurve 10 VAuto.  The UK version has some needed parameter settings disabled in that model.  I don't have a clue as to why they did this, but it has proven to hamper obtaining proper therapy for users in the past.

As far as fining a AC10 VAuto, many companies on the Supplier List ship worldwide.

- Red

[empiricismandstatistics]

Thank you.

I would like to make sure I buy a machine with multiple capabilities that can treat the events regardless of cause.
I have read elsewhere that a machine with ASV capabilities also can be very helpful in trialling.

Does the AC10 Vauto have ASV capabilities and, if not, what machine would recommend that has both fixed biPAP capabilities and ASV (I just dont want to be left in a situation where fixed BiPAP is not working and I wished a bought a different machine, would rather buy everything in one go to save time)?

Thank you so much for your help - its hugely appreciated.

[Crimson Nape]

An ASV is designed specifically to address Central apneas, and not UARS. An ASV is also one of the more expensive CPAP types, often costing twice the price of a bi-level CPAP. Based on your initial post, I would not advise this special machine.

- Red

[empiricismandstatistics]

Thanks for help. 

Just wondering if the ResMed AirCurve ASV has all the Vauto capabilities with ASV on top (ie can it be used in the same way with basic bilevel functions)?
Then if that doesnt work I could enable the ASV function?
Or do they work entirely differently and the Vauto has capabilities that the ASV does not?

I think given the compounding effects of good sleep I would rather buy the more expensive device that has both capabilities (if this is the case). 

Thanks

[empiricismandstatistics]

Just wondering what you think of this and if this could provide both capabilities?



'The Philips ASV can act as an auto bi-level as well as an ASV. The ResMed ASV can't, and it's pretty crappy in my opinion. You can't disable the backup rate (which is possible on the Philips ASV). It also forces you to have a minimum pressure support range of at least 5, which is dumb. So for example if you want your minPS to be 3, it forces your maxPS to 8 by default. On the Philips ASV you can set the PS range to anything you want to, so it effectively can become an auto bipap with variable PS.'

[Phaleronic]

It appears that the ASV Model supports CPAP mode and ASV mode only:

https://document.resmed.com/en-us/docume...er_eng.pdf

[empiricismandstatistics]

Something like this?
[DME Link Removed] - Search Supplier #2 for "Refurbished ResMed S10 AirCurve VAuto".

My diagnosis is based on WatchPAT One Home Study (as seen above) but want to make sure I'm not having centrals as well as UARS.
Anecdotally, does this device pick up all centrals if they are occurring?

Thanks so much.

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[empiricismandstatistics]

Another question I have: 


I'm awaiting the official sleep study (due in September 2024) but when I record myself I have long expiratory groans (sexual type sounding) and thrash about in my sleep, constantly moving as per my girlfriend. 
I have a low BMI, tall and thin, and small facial structure.

In essence, I likely have
1. UARS (small retrognathic facial structure and low BMI)
2. Catathrenia (long nocturnal expiratory groaning and sexual type noises). Similar to Newbie-Please look at my charts [Catathrenia] | Apnea Board


I have failed CPAP with Hypnus device. 
In your experience, what device is best mechanistically to treat both conditions (Resmed AirCurve 10 VAuto or ASV (which may treat Sleep disordered Breathing))? I might post another thread to see if anyone has treated catathrenia successfully previously.

Want to buy something that can treat both.

Your expert and experienced opinion is greatly appreciated