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

[colvid]

You can change the pressure on the Dream, thanks to some good YouTube videos. Turn on the machine and then hold the right button on the  top and press the round knob  in for about 4 or 5 seconds and a screen showing "Therapy" comes up. Press the wheel again and pressure settings are shown and you can then type in your number.
Initially, my AHI readings were in the 30 or 40 range. Pressure from the Sleep Study people had a pressure at "4". I gradually increased the pressure and with a pressure of 10.5, my AHI was .8 last night and 1% periodic. I was almost ready to give up until I found the videos.
Larry

[My3rd3y3]

Well my Sleep Doc,  She must of already received my Tritration as I see my settings were changed remotely

Big Change!

Now its -

ASVAuto
Min Epap - 7.0 vs 14 lol
Max Epap - 15.0 vs same
Min PS - 1.0  vs 4.0
Max PS 15  vs 11 i think

Hope since the tritration was on a philips that these numbers work for me on my Resmed

[ajack]

The chart will show if epap 7 is enough, if not the auto will raise it to what a good setting would be.

[My3rd3y3]

Well, had my 90ish day follow up and after Tritration follow up. The doc thinks that just maybe I’d be better off switching from what I’ve had the past 4 years and Swapping out my Resmed ASV for the Philips Dreamstation BiPAP AutoSv. We have not been able to get my numbers sub 5 at any pressure setting on the Resmed and the past 4 years have only been able to get my ahi down to 8ish average. Sure there have been the odd night of a sub 5 here and there, but nothing consistent. I tritrated on a Philips “ASV” (sorry pale, BiPAP autosv) just a few weeks ago and they got my ahi down to zero. I do not know how I feel about the switch, but hell what can it hurt? What’s the worst that could happen? Lol UGG! Higher AHI or Lower AHI I guess lol....

I’ve already spoken to my DME I swore I’d never deal with again, since they would not rent me or lend me as they promised a philips. They have gotten the paperwork together and she’s handing it to the RT to schedule the swap...... if it totally sucks, I can always find a secondhand Resmed ASV either the Aircurve again or the S9 adapt as I did like that one.

Only get one exchange/swap with my insurance or DME

Hopefully this will help or I dunno, Seems there are a few more settings with the Dreamstation as far as BPM - Breaths Per Minute and Ti - Inspiratory Time Setting...... I know it’s just feels so natural on the ResMed and when I was Tritrating on the Philips is was like I had to adjust my breathing to the machine vs the machine adjusting breath by breath but may be this will help. Ugg I hope

[My3rd3y3]

Was just informed from the DME that they are planning on setting me up with a refurbished Respironcs SVauto - is that normal or standard when exchanging a pap or?

[My3rd3y3]

Well most everyone says the ResMed is far superior to Philips, or have said I am dumb for doing this and would never go with a Philips Dreamstation ASV (Bipap AutoSV) but I today am going to exchange my new ResMed Aircurve ASV for the Philips Dreamstation Bipap AutoSV - DSX900H11.

This is my second ResMed Aircurve ASV and well over the past close to 5 years, I have not been able to get my AHI below the "avg or normal" 5.0 number. My Doc can't figure it out either as to why we cant with many diff pressure settings, get it to a great or even average number. I did tritrate just recently on a Philips Machine, and while it felt weird and felt I was working against the machine and it was not as normal feeling as my Resmed machine, they were able to get my AHI down to ZERO, a number I never have been able to ever get before on my ResMed. She thinks that the only thing we have not tried was changing the machine as we have tried for the past 4-5 years with the ResMed to get my AHI to an acceptable level. So maybe I am the ODD BALL that needs the algorithm that the Philip's delivers vs the ResMed. 

I am sure this Dream Station has it's issues, at least I do not use the humidifier on my ResMed as I hear it goes thru water and the chamber is small. Now I wonder what the settings should be, its going to be pre set by the tech person - but there are like two other settings the Philips has vs the ResMed -- Breaths per Min and Ti setting I guess inspiratory time setting can be set to whatever ? or simply auto 

I guess the worst case thing would be me having to find a used ResMed ASV if this Philips is worst for me then the ResMed

[DeepBreathing]

Well most everyone says the ResMed is far superior to Philips, or have said I am dumb for doing this and would never go with a Philips Dreamstation ASV (Bipap AutoSV) but I today am going to exchange my new ResMed Aircurve ASV for the Philips Dreamstation Bipap AutoSV - DSX900H11.

I'm coming very late to this thread but I noticed what you wrote above. The best machine is the one that gives you the best results. If the Philips works for you then that is the best machine. Let's face it - Philips haven't gone out of business, so their machine must work for a sufficient number of patients to keep it viable. We always say with masks that every face is different and you need the mask that suits you best - the same goes for machines.

The potential downside with the Philips is that there are more manual settings involved (as you mentioned above) and getting these tweaked just right will probably make a big difference in how comfortable and effective the machine is for you.

[My3rd3y3]

Thanks yea your totally right and I’ve never looked at it that way and I am glad you said it like that.

[Sleeprider]

I think my earlier responses have been open to using a Respironics machine. While the Resmed seems to be more comfortable for the majority, you have never achieved efficacy using it, so a change may be just what you need. The titration suggests you achieve efficacy at lower pressures with the BiPAP SV, so go forth my son with my blessings.

As far as getting a refurbished machine, I would look for something with comparable hours to what you're turning in. You have expressed a willingness to trade, so this isn't too much different. As long as the machine is free of smoking odors and mechanical problems, and is at a reasonable number of run-hours, then it's fair for the DME to exchange in this fashion. I know Medicare won't object, and will only pay for the one machine. Your used machine will likely become someone else's refurbished.

[My3rd3y3]

They said it has zero hrs, I guess factory reset or? I dunno hope this goes well, I was not able to make my appt Friday as my wife and I went to Atlantic City for a lil get away. Hope to reschedule it for this week. Sad about your friend