Switching to AutoB on Philips Dreamstation

[ellenos]

I have an appt with a new sleep doctor next week and wanted to prepare.  Its been years since I looked at statistics so I downloaded Oscar and the first night I changed flex setting.  I didnt realize there was an AutoB mode so I switched to that last night.  I have a new mask on order, lots of leakage.  But can anyone explain why the AHI was so high with AutoB?  I was hoping to find out what a good EPAP/IPAP was.   I have attached my latest Oscar file.

Thanks
Ellen

   

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[Sleeprider]

You have been using fixed bilevel pressure of IPAP 10/EPAP 8 for about 5-years. When you turned on AutoB mode, the machine was set to default starting pressure of EPAP min 4.0 with PS 2.0 to 8.0 and max IPAP 25.0. These settings are clearly not optimized for your needs and the low starting EPAP pressure is the reason for your higher obstructive apnea and hypopnea. You need the EPAP minimum pressure of 8.0 to hold your airway patent against obstruction, and your summary does not offer insights on any other settings that may be better than the fixed BiPAP-S mode you have been using. If you want to experiment with AutoB pressure, I think you should start with EPAP min 8.0, EPAP max 10.0, PS 2.0-3.0. These settings allow some auto-pressure movement but are much closer to what we already know works better for you.

Your history on this machine show you probably do not need bilevel pressure beyond what you could obtain with a Resmed Autoset CPAP using EPR. We prefer to see your data presented as the Daily Details rather than the summary statistics. There is much more information about settings, respiration, events and performance of the machine in treating you on the Details chart. See Organizing Your Oscar Chart in my signature links.

[ellenos]

Thank you so much for these insights - I have changed the setting for AutoB to what you suggested.  We had a similar conversation in 2017 when I purchased the DreamStation - I did try the CPAP version thru the DME and did not find it as comfortable as the BiPap - though I recall you said a Resmed would be different.  I am now waiting for Phillips to replace the machine though I am considering purchasing a ResMed Airsense.  Given what you suggested, I might try the Airsense CPAP because I am now on Medicare and I don't think they will allow the BiPap.   I will post a Daily as you suggested.  I really appreciate your help here.

[Gideon]

Medicare will cover what your doctor prescribes.i just bought (rent to own) a new VAuto under Medicare plus AARP supplement with only deductible to be paid next year, I already met my deductible this year and also should next year so effectively nothing out of pocket.

And you do not want the CPAP as it has no detailed data, at least the Elite, which is a CPAP but with data, but you want the AutoSet which is an APAP.  All of these are the same billing code.6

[ellenos]

Thank you - how did you do rent to own?  Through a DME?  I also have satisfied deductible for the year.

I should be able to get my doctor to write a prescription for the AutoSet APAP.

-Ellen

[Gideon]

Thru a DME, they gave me no choice and I didn't press it as effectively it will be no cost for me.
If you can try Hart Medical as they seem to have resmeds in stock.