Help Choosing the Right Machine

[janelleb1985]

Hello,

I was recently diagnosed with sleep apnea (and got some excellent help from this board)! Now, I am posting for my partner who has also now been diagnosed with sleep apnea.

He received 2 diagnoses: severe obstructive sleep apnea (86AHI) and mild central sleep apnea (7AHI). Due to insurance issues he had his study done through Lofta, and we will be self-paying for his machine. He had an 02 nadir of 64%, and spent more than half of his total sleep time below 90% 02. 

Lofta recommended an Airsense 10, and said the focus will be on treating the severe OSA, and seeing how the central apnea responds.

Since we are self-paying, and can't afford to try multiple machines, I wanted to draw on the knowledge of folks in this board about whether that seems to be the best treatment approach, and if the Airsense 10 is the best machine to start with?

Thanks!

[gainerfull]

Since you are paying for the cpap out of pocket you might even consider an older generation cpap w/ low operating hours (< 5,000hrs)  from a reseller or from dotmed:

[DME Link Removed] Try searching dotmed for Resmed Bi-level CPAP.

If it were me, I'd target the Resmed Aircurve 10 vauto because it has both a CPAP (constant pressure) mode and a BIPAP (bilevel) mode but does not offer APAP (auto) although it does offer auto bipap. This way, you can start them out on a constant pressure and see how they respond to therapy, resolving mask leaks, increasing comfort and improving sleep.

If they have trouble adjusting to therapy then switch to bipap auto mode to make it easier to breathe out against the pressure and share the OSCAR data and solicit suggestions from this forum.

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[srlevine1]

IMHO, I would dual-track an investigation into the oxygen desaturation issue and request a lung function test and an echocardiogram to rule out breathing issues and any potential pulmonary hypertension. (Between 17 and 53 percent of people with sleep apnea also develop pulmonary hypertension.) This would also determine a left ventricular ejection fraction which can affect your choice of a machine when it comes to central apneas/ Generally, adaptive servo-ventilation (ASV) machines are contraindicated in patients who have a left ventricular ejection fraction (LVEF) below 45% and predominant central sleep apneas.

More information about machines can be found at https://www.resmed.com/en-us/sleep-apnea...0-bilevel/

I like the idea of a used machine but would have reservations about selecting and investing in a machine without the advice of a qualified sleep specialist or at least a competent respiratory technician who can evaluate your history and current conditions.

Best of luck, -- steve

[OpalRose]

If you have a copy of the sleep study, post it here for review.
Redacted of personal information.

[Ed in SoDak]

I can't speak to the issues of suitability for your husband's particular health status. I was advised I should use a non-invasive ventilator such as bipap for my COPD with excess carbon dioxide in my blood owing to shallow breathing that leaves too much CO2 behind.

I found a ResMed S9 VPAP Adapt on dme for $400 with only 5 hours on its clock. It did indeed look like new and works fine.

Last night was my first trial of using any sort of cpap/bipap machine and I found the S9 Adapt to be quite easy to set up and use. I'm using one of my wife's old Fisher Paykel masks till I make a decision on which mask to use, with my mustache and nasal allergies.


Paypal credit made it possible to order it now and pay for it over the next 6 months with no interest.

Hope this helps!
-Ed