Prisma NIV advice

[Johnboy]

If anyone had been following my journey (and let’s face it why would you!) you will know I have been using a Dreamstation for over 4 years. Initially this went very well and felt rested for the first time in years. However over the last year I felt that I wasn’t feeling as well rested. Having put my Oscar charts up on the board I was advised that the RERA events were causing sleep arousals and that I needed Bipap (NIV) to treat this. Fair play to the NHS as they have responded by agreeing with this and I have now prescribed Bipap. I am being fitted with this next week and the machine is the Prisma (never heard of it). 

In advance of the fitting it would be great to get some views on the machine and the questions etc to ask in order to ensure the best result from the fitting eg masks (currently use 15mm hose and Asmara View mask).

Many thanks in advance.

[OpalRose]

I'm not familiar with the Prisma, but possibly someone else may be able to help.

Also, if you were using OSCAR with your DS, I don't think the Prisma is supported by OSCAR.

Are you able to ask for a ResMed?  If you need a BiLevel, you would ask for the ResMed AirCurve 10 VAuto.

[Johnboy]

Hi OpalRose

I don’t think I can as the local authority is contracted to a specific supplier.

Regards

John

[OpalRose]

In any case, if you know the exact model Prisma you will be getting, you can check this link to see if we have a Clinicians manual for your machine and order it. This way, you will be able to have some insight on how your new machine operates.

https://www.apneaboard.com/adjust-cpap-p...tup-manual

[Gideon]

Ask how you can get detailed charts from it. How detailed? Look at OSCAR charts in this forum. Look at the guide in my signature, still a work in process but it will give you an idea

IMHO getting detailed data is most important feature since That is how you know how to make changes.

And Ask, insistently, about ResMed.

BTW being tied to one brand is an indicator that profit is their motive, not your health

[Johnboy]

Thanks Gideon,

Profit not a motivator for NHS but cost is. So probs awarded a contract to lowest cost machine.

Good advice re data.

John

[SarcasticDave94]

Just to enlighten a bit, no I don't know a thing about Prisma, but you're talking about a very wide range of machines here.

You say this in post 1 above "Having put my Oscar charts up on the board I was advised that the RERA events were causing sleep arousals and that I needed Bipap (NIV) to treat this."

To me, NIV is a Non-Invasive Ventilator. Why exactly do you need this? This NIV is what I'm after, because I have COPD. Any respiratory disease? I don't think RERA qualifies as needing a ventilator/NIV.

Please note that BiPAP does not always mean NIV. BiPAP can be ST, S, ResMed's: VAuto, ASV, ST-A, Stellar and Astral are 2 of ResMed's NIV's, and PaceWave in areas not the USA. Basically BiPAP is the same as saying you're getting a vehicle. Way too broad of a term.

[SarcasticDave94]

PS, I'm probably missing the reference to you being told you need BiPAP NIV. There's discussions about coronavirus and NIV regarding that. You're in several discussions like that, but that seems to refer back to the COVID-19 or coronavirus and using an NIV ventilator as I recall, in case you have real trouble breathing with COVID or getting pneumonia. But I'm missing the place and proof you need a NIV.

[Johnboy]

Hi Dave,

The nurse called it an NIV when she rang. I don’t know which model it is. I don’t have any respiratory disease. I have copied the advice I got from sleep rider. I was communicating with the clinic about RERA treatment and this is where we have ended up. Therefore, don’t know why they are proposing this machine as I certainly don’t require ventilation.

Regards

John



03-12-2020, 12:08 AM 
RE: Is it still working?
Now you know. It's not AHI, it RERA and flow limitation, and your Philips Dreamstation honestly sucks at dealing with it. If I could put you on a Resmed Airsense 10 Autoset, or even better, a Vauto, I could give you back that transformative experience you knew back when. It is pressure support that correct flow limitation, but with the Dreamstation Auto CPAP, your only tool is pressure. With your current machine, I would up CPAP minimum pressure to 15.0 or possibly 16. But I could reduce your pressure with a Resmed using EPR (exhale pressure relief) or pressure support (bilevel). There are often deals on used machines. Anyway, yoru RERA is nearly 3/hour and that is probably under-estimated.

If you want to open a dialog with your doctor, the discomfort and sense of fatigue on your CPAP are valid reasons to increase therapy to bilevel. The target device is a Resmed Aircurve 10 Vauto. If you want to go out of pocket, check out Craigslist, Offerup, Facebook Marketplace, Dotmed and others for good prices on used. For a lightly used Vauto with warranty at $719, or new at $799, Supplier #2. There is a reason I use the Vauto and will never look back at the Philips Auto CPAP.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

[SarcasticDave94]

OK thanks for the clarification. It seems your NHS is surprisingly going overboard and getting you a NIV. A suggestion for your good therapy's sake, try to tell them you just need a BIPAP, a 2 pressure machine and an Auto one. Above that it's real overkill.

I'm looking up Prisma and see what's like a ResMed VAuto to have you armed with a specific Prisma name it model.

---

Have you heard of this model?
"BIPAP BILEVEL PRISMA 25S
With several innovative details, this new BiLevel auto device from Löwenstein Medical sets new technical standards in its product class. Among the features are a large, color touch screen, intelligent trigger functions, and optional TRI-Level, the clinically validated algorithm for maximum pressure effectiveness."
A Löwenstein bilevel.