Obst & Central Apnea - on ASV. why do most say- resmed vs dreamstation auto sv?

[My3rd3y3]

I have both obstructive and Central Apnea's.   On a reg cpap my AHI is around 70-90,   without anything its over 100.

I started pap about 8 years ago with a Philips Respironics System one,   switched dr's,  2 new sleep test's one reg and one to show failed bi-pap and I get the brand spanking new -  Resmed Aircurve ASV .   It made a world of diff for me that is for sure!   My AHI has never really been below 5.   it averages about 7-10

I am eligible for a new machine  -  I am going to be married to this machine for the next 5 years so just nervous and want to make the right decision 

My local DME's that my insurance prefers are no longer selling Resmed products -  I am sure I could find one online etc further away that does sell Resmed. 

On a few diff forums,  I have read that most people prefer resmed over philips products and some even state my AHI would be even higher on a Philips Dreamstation Bipap Auto SV (There ASV)  VS the machine I currently have a Resmed Aircurve ASV.

I was looking at the specs on the Dreamstation and it seems I cannot adjust the ipap,  is this true?   Product link - https://philipsproductcontent.blob.core....3f68bd.pdf

OR is it like comparing 2 of the same thing just made by different manufactures and everyone has a fav??  Like nike vs reebok /  BMW vs Benz / Ford vs Chevy??

Thank you in advance for your input

[Sleeprider]

Therapy is delivered differently by Resmed and Philips ASV machines. Both use the same basic principles of auto-SV treatment by including algorithms that increase EPAP pressure for obstructive apnea, and using pressure support to increase the volume of flow-limited breaths and to cause a breath during central apnea. Resmed uses an algorithm that measures the patient's breathing rate and volume, then trys to maintain that, while Philips is based on settings for volume and respiration rate. The difference can be described as Resmed seems to work with you, while you need to work with the Philips. The outcome is not so simple and the machine that works best for any individual depends on what works best and is most comfortable. There are reviews for both devices in the CPAP Review forum here.

Ask your DME if it is possible to use the Philips machine on a trial basis. You should be able to make a good comparison of efficacy within a week or two. I'm not optimistic this is available, but you won't know without asking. I think it would be great if both of the manufacturers would support a trial program for these very high-end and espensive machines.

[SarcasticDave94]

Both brands of ASV have the possibility of achieving AHI under 5, but the probability is more likely with a ResMed IMO. I believe the results are due to the different brand algorithms involved.

Like Sleeprider suggested, ask for a Respironics ASV trial. I myself would fight to be able to stay with the ResMed.

[ruach]

For me, I just switched from Respironics System 1 ASV to a new ResMed AirCurve ASV, and I feel I sleep so much easier with the ResMed as compared to the Respironics. I feel like the ResMed adjusts to how I breathe, and is much quieter!

With the Respironics, I felt like I was fighting against the way it wanted me to breathe. Also, it was much noisier, where I could hear the airflow going in and out, and also the sound of my own breath seemed to be magnified- all that to say, I had a difficult time sleeping with the Respironics.  Also, my AHI with the Respironics, shows that it was 3.5, but every week or two, it would spike up to 7 or even 10 or higher.

With the ResMed ASV, my first two nights AHI were Zero - never had a Zero with the Respironics, and last night my average was .2 -

I also agree if you have a chance to test one out, that would be the best option. My Sleep Doctor had me go in for an overnight Sleep Study and it showed that I slept much better with the Algorithm of the ResMed. I started the night with the ResMed Algorithm, and after they changed the Algorithm to the Respironics, I wasn't able to sleep the rest of the night.  That is how I was able to receive a new prescription for the ResMed ASV.

[My3rd3y3]

My Dr,   she has no prob at all me staying with another Resmed Aircurve ASV -  non at all  ---  its just DME's in my area are not carrying Resmed's anymore.   2 places use too are no longer carrying them,   the other went out of business totally.    I have state medicaide / delaware blue cross blue shield highmark.

She is a smart cookie as far as being a sleep dr goes -   she is also the dr that reads sleep studies for most every diff sleep center in this area as well as having her own practice (she is the one along with you amazing forum fokes helped me fight to get off a cpap when I have both central and obstructive apnea and had ahi's in the 40-70 range while on the cpap and going to my orig sleep dr)   

but also thinks both machines are very similar etc.  so she might not be well versed as far as the diff algorithm's go 

If I called her office I am sure she would write it and state must have Resmed ASV 

She just had me convinced during my last appt she thinks it would be the same therapy wise.   But with reading on what 3 or so diff forums not 1 person as jumped in and said hey -   I have a Philips Respironics dreamstation bipap auto sv  --  since they are both what under 5 years old its people that have had system 1 asv's...   i dunno UGG lol 

The only experience I have with Philips is I started cpap on a system one auto or whatnot..........     got smarter by coming to the forums,  meetings lots of amazing people and heck one even found me a sweet used S9 Resmed Vpap adapt with asv till I was able to jump thru the hoops of insurance,new sleep studies and finding a new sleep dr.  and I got my new Resmed Aircurve ASV.  

Worst then buying a new car is the feeling I feel lol

[Fats Drywaller]

It sounds like your sleep doctor is indeed a smart cookie, as you say, and congratulations on that; you're lucky.

The magic words that she needs to include in the prescription, along with a specification for the Resmed Aircurve 10 ASV machine (not just any generic ASV machine), are "Dispense as written." Once that is down on paper, you'll be able to present that Rx to a DME and basically force the DME to order the Resmed machine for you.

A local, in-network, brick-and-mortar DME has to order whatever equipment is on the prescription if the DME doesn't have it in stock, if the prescription requires a specific make & model. You might want to check with your insurer about that: once you have the specific Rx from the doctor, tell the insurer's patient-support rep what the situation is and ask him or her to intervene with the DME on your behalf if necessary. Usually, all it takes is one phone call from the insurer to the DME, and the droid at the DME should immediately straighten up and fly right.

With DMEs, you have to be persistent, otherwise they'll always try to have everything their way so as to maximize their profit margins on the equipment that they dispense. They make more money from a Philips machine than they do from a Resmed machine, and that's the only reason they do that dishonest crap of refusing to provide a particular make & model. But they can order anything from any manufacturer at any time.

Also, if you haven't already read this, be sure to read (and print a copy, and read again on paper) this wiki article: Dealing with a DME.

[Spy Car]

Having only used a ResMed ASV I can not compare the two brands.

But given the technical brilliance of the ResMed and less-than-positive reviews of the Respironics, I personally would not switch.

Bill

[Mark Sadler]

I used the Dreamstation ASV for 6 months. My DME only provided the Dreamstation, so I purchased a new Aircurve 10 ASV out of pocket. 
After my first night i felt soo much better than I ever had on the Dreamstation that I never used the Dreamstation ASV again!
Just my experience.

[My3rd3y3]

Thanks for your input so far everyone!    I did email my dr's office yesterday and while they already sent the one prescription to the close DME that only now carries Phillips products,  they told me that if I indeed wanted a Resmed Aircurve ASV like I have now,   that I would have to call my insurance company and ask them to find me a DME vendor who they use that carry's Resmed Products.  It just seem's not many people say get the dreamstation.   I thought it might be atleast worth trying a diff one but the reviews are horrible it seems on even the reg cpaps so I can only assume those product issues carry over to the ASV.     At least Ill have a back up machine.

Not sure if any of these things can effect my AHI / Therapy....   I started to take - Testosterone 1.62% (40.5mg in 2.5 grams of gel) X 4 packets daily.    This was added as I started to see an Endocrinologist -   She ran some tests and also a an MRI on my brain.   There was a Tumor on my pituitary gland and also a separate sac or something attached to it.   That has thrown off my Hormones and well my Testosterone level was way below the avg woman/ 90 year old man and was in the 30-50 range vs normal 650-1070+ ng/dL .    

I have also noticed that I seem to wake up nightly a few times a night.,   While I have had this ASV for 3+ years now,  I think when my machine jacks up the pressure in the high/mid 20's I awaken and it does seem my body requires higher pressures.   I think this might show it below?   I dunno if this is the proper screenshot that's needed to show it.

Screenshot 1


Screenshot 2

[My3rd3y3]

Above I just wanted to see what would happen if I lowered the min Epap and raise the max PS, It did seem to lower my ahi to 5ish but I do not think that is the correct setting I need, as the next night was 11. ugg