[Equipment] Starter user advice

[Zerox]

Hi,

My father was diagnosed for Severe OSA with a significant O2 denaturation.
AHI 78/hour
Was advised to get a Bipap and an oxygen concentrator

The suggestion from the Technologist in the report:
"Suggests BIPAP S/T 25/+15, rate 14/min, I-time 1.3 sec with oxygen bleed in of 6 LPM."

Apparently there is multiple types of Bipap and Am not sure which to get.
Any advice or thoughts?


Thanks in advance

[Gideon]

What other medical conditions does your father have, including what kind of apnea? Any cardio, pulmonary or neurological conditions?
And post a copy of his sleep test.

Based on the recommended machine
Something is going on that we do not know about. I'm thinking Central or mixed apnea, possibly COPD or severe Asthma, or even CHF. We don't know and it makes a difference.

[SarcasticDave94]

Yes, agreed. When docs start choosing the ST machine, there's something else in the mix above basic Apnea. And I'm not including the need for supplemental oxygen as the something else. Respiratory disease or Central Apnea are in my mind to see if they're on the doctor's radar.

[Zerox]

What other medical conditions does your father have, including what kind of apnea?  Any cardio, pulmonary or neurological conditions?
And post a copy of his sleep test.

Based on the recommended machine
Something is going on that we do not know about.  I'm thinking Central or mixed apnea, possibly COPD or severe Asthma, or even CHF.  We don't know and it makes a difference.

73 years male
Weight: 142 kg
BMI: 47.9 kg/m2

Other conditions:
Type 2 diabetes mellitus, Hypertension and Mixed hyperlipidemia.
These are controlled by medications.

Latest pulmonary function test found normal total lung capacity, but with obstruction and gas trapping.
The physician assigned obesity as the culprit and is not stressing out on the use of asthma/copd medications.

The type of sleep apnea diagnosed is obstructive.

No cardio condition diagnosed other than HTN
No neurological condition diagnosed other than peripheral neuropathy due to DM

Sleep study     sorry for the low quality.

[SarcasticDave94]

In my opinion:

Possible reason for ST is due to Apnea plus diagnosis of COPD, any level, and including somewhat the addition of supplemental oxygen.

Myself, I'd be asking about the better, newer therapy machine called ResMed AirCurve 10 ST-A instead of older, dumber ST. Apnea plus COPD will be best treated with this ST-A in iVAPS, a ResMed variant of the ventilator mode AVAPS.

[Zerox]

In my opinion:

Possible reason for ST is due to Apnea plus diagnosis of COPD, any level, and including somewhat the addition of supplemental oxygen.

Myself, I'd be asking about the better, newer therapy machine called ResMed AirCurve 10 ST-A instead of older, dumber ST. Apnea plus COPD will be best treated with this ST-A in iVAPS, a ResMed variant of the ventilator mode AVAPS.

I am finding a concerning number of bad experiences on AirCurve 10 ST on this forum.
Not dealing with that 100%

Any thoughts on loewenstein prisma30ST?
It got the following modes:
CPAP, APAP, S, T, S/T, autoS/T,  aPCV
I am finding the description of aPCV is some what similar to AVAPS.

[Crimson Nape]

After reading many cpap problems, the ST model has to be one of the most difficult CPAPs to get tweaked to the patient's needs. Hopefully, armed with this knowledge, you will dig your heals in and refuse to let it win out.

While my CPAP in no way near as finicky as yours, now that it is set for me, I have to check to make sure it is on. This wasn't always the case.

Good luck!

[SarcasticDave94]

aPCV seems to be a ventilator mode equal to the pressure control ventilation mode. The AVAPS you mentioned is in the ResMed's ST-A in their version called iVAPS.

I don't know much at all about the Löwenstein machines. The Prisma30ST is this according to their website:

"Major features in prisma30ST:

Varied ventilation modes: CPAP, APAP, S, T, S/T, autoS/T, aPCV
Broad pressure range (4 – 30hPa)
Target volume ensured in any position
SCOPES (for COPD and hypoventilation) – indication-specific pre-settings that simplify settings for the user
Extremely quiet even at high pressures"

To me this sounds similar to ResMed's ST-A, at this level of searching, except for no equivalent AVAPS. Possibly this is in between ST and ST-A.