[Equipment] Changing bipap device?

[Moemah123]

Hi Everyone,

After a month of using bi-pap and consulting members on the forum, I am still not seeing the huge benefits I expected and alot advised to swap ST device for Vauto given i have OSA. My question is how do I get my Dr to change equipment to Vauto? With the corona virus going on seems my cpap company wont take the device back once issued so i am not sure what my options are. It feels bad to be stuck with a machine that will not help me further any thoughts will help

Thank you!

[staceyburke]

Everyone has different means and circumstances but when I needed a new machine and the DME told me it would take another 3 years before insurance would pay for it, I bought a used one from Supplier #2 on the suppliers list at the top of the site.  The total cost was $799 for a ResMed s10 VAUTO.  I just did not feel I could wait 3 years before getting good therapy.  It may seem like a lot when insurance should pay for it but I felt it was well worth it for about 2000 hours of decent sleep.

The amount of hours I had on mine was less than 1 month.  My son got one from the same company with less than 2 full nights.... same price.

[Sleeprider]

Moemah, the Resmed Clinical Titration Protocol has a lot of good information on the intended use of the different machines. https://www.resmed.com/us/dam/documents/...er_eng.pdf It makes no sense to put someone on a ST machine when they do not need the backup rate, and would be better served by and auto-adjusting bilevel that smoothly delivers positive bilevel pressure with Easybreathe™ which is far more comfortable. If you read through the titration protocol, you will learn more about these machines, how they work and their intended use. That understanding is the path forward to a discussion with your doctor.

[Moemah123]

Hi Sleeprider,

I kept sending my Dr multiple times with this exact information, his answers are usually the same "Your sleep study has detected centrals with need for backup rate so that's why you have ST" No matter what i mentioned to him about CA being with VAuto, he claims i need backup rate. I don't know if even centrals are associated with backup rate, i requested my sleep study but that is all the info he is telling me or dodges my questions about VAuto with. Do you know if CA really need backup rate?

[Sleeprider]

That's fine, but the right therapy for central or complex apnea is the ASV (adaptive servo ventilator). This acts more like a Vauto with low pressure support and low EPAP pressure until you need pressure support to treat a central. Again, read the titration protocol and what the ST is intended to treat vs what the ASV is supposed to treat. CA events need a backup rate, but they need more than the 4 cm of pressure support that your ST can provide. It is simply the wrong device.

[SarcasticDave94]

Then Dr. Duck has no understanding how to treat central apnea. The ST is not correct. Use that same ResMed info Sleeprider provided to show the doc ASV is correct, ST is wrong. You need the ASV, specifically the ResMed AirCurve 10 ASV. The ASV has the backup rate the quack says is needed AND it's the right treatment machine for CA. Don't actually tell the doc I think he/she needs to stand up so his/her brain can breathe.

[Moemah123]

I appreciate both your help, hence why i started my thread asking what are my options if my Dr keeps replying with generic replies and avoiding my questions, telling me to be patient and i will see results etc. Would changing Dr's at this point help or what are my real options to get ASV, my insurance is supposed to be pretty good so that's why i am looking for guidance.

[Gideon]

The doc need to understand that the ST is failing you. That it is not doing the job.
Read this wiki http://www.apneaboard.com/wiki/index.php...P_Machines and note the section on symptoms. Be honest but through. Above all else when asked how you feel do not respond I feel fine.

[Sleeprider]

Here is a thread by a member, emmylouwho, that was issued a ST machine and subjected to many sleep studies. Her story is like yours. On the last couple pages, she is finally authorized for ASV and now has a new doctor. You should read the comments, because you also need to change your medical team. No one deserves to be treated with poor therapy and generic replies that do not solve the problem. There is an extremely simple solution with ASV, and you don't even need a new insurance approval. The ST and ASV are the same category for insurance reimbursement, but they work very differently. http://www.apneaboard.com/forums/Thread-...-questions Feel free to ask her some of your question and how she dealt with the doctors and problems.

This is a copy of post #31 I made in that thread:

RE: New Dx, 4 sleep studies in 3 weeks, feel left hanging with questions
Remember what I said about ST...that's what they gave you. You are using the BiPAP ST with EPAP 14, IPAP 18 and PS 4.0 with a backup rate of 12 breaths per minute (BPM). The black hash marks at the top of your chart are timed triggers for IPAP backup breaths. There are a lot of them. This only happens when you don't take a spontaneous breath within the timing set.

Please read the titration protocol https://www.resmed.com/us/dam/documents/...er_eng.pdf. Read about ST and why it is absolutely the WRONG choice. You were not even told this is not CPAP! The insurance HCPCS code for your ST is E0471, the same one as ASV. You could have been provided the right technology, but these clowns are really messing with you, most likely because they are incompetent to be treating complex sleep apnea. This B.S. should be strongly confronted, and you should be looking for a more competent medical team and supplier. Finally, don't take another Philips machine. The effectiveness and comfort of the Resmed is much greater. With a Resmed Aircurve 10 ASV and very low pressure, compared to this ST, you could achieve less than 1- AHI within two nights of starting therapy. You really do belong on ASV.

[Moemah123]

I will give that a thorough read thank you, but as this will likely take a long time to fight back against system, probably months. Is it even wise to continue using ST? or go back to my Auto CPAP which I have? i dont want to end up doing more harm if it makes no sense to use ST, appreciate your thoughts