(08-17-2013, 05:27 AM)kittyhawkchild Wrote: Can you purchase an ASV machine without a prescription? The doctor would not give me mine and that really made me mad.
Hi kittyhawkchild,
Before you even consider buying an ASV machine, please understand that often people have a moderate number of central apnea events in the initial weeks and months of PAP therapy. These often reduce in number and mostly go away within 2 or 3 months, and are usually not cause for concern.
On the other hand, if your initial "baseline" sleep study without CPAP treatment showed central apnea events, then it may be less likely that central events will go away all by themselves as your system adapts to treatment. For your own records, you should ask for a copy of your sleep study reports. Not short summarirles, the full reports, including time plots of the data taken all night.
If needed, ASV treatment is usually more challenging and usually takes even more effort to get used to than standard CPAP therapy. This is because during central apnea events the machine may need to increase your inhale pressure perhaps as much as 10 cm H2O higher than your exhale pressure, if it needs to do all the work of breathing for you. Usually, only full face masks can handle these high pressure changes without malfunctioning.
Also, if you have complex or mixed apneas, some obstructive and some central, you may need a high exhale pressure to avoid the obstructive events, and if at the same time you intermittently need help to avoid central events, the ASV machine may need to raise your inhale pressure perhaps 10 higher than your already-high exhale pressure, and this can create bothersome leaks which may wake you up unless the mask straps are tight enough to prevent "mask farts" from a full face mask.
But if the straps are too tight this will be uncomfortable and also not good. I use a cloth mask liner made by RemZzz, which goes between my full face mask and my face, and prevents mask farts and allows the straps to be loose enough to not cause discomfort.
Also, the high pressures which an ASV machine may occasionally need to deliver will increase the likelihood that some air will get swallowed (aerophasia), which can be bothersome to some people (in addition to leading to belches and whatnot in the morning).
That said (that an ASV machine may not be needed, and if needed may be challenging to get used to and to manage the problems resulting from high pressure), an ASV machine can be adjusted to deliver treatment like a simple constant-pressure CPAP machine or an APAP machine like yours or a bi-level machine or an ASV machine.
So I think you would be able to buy an ASV machine and have it delivered to you adjusted for your present pressure prescription, and after you receive the machine either you or your doctor would be able to readjust the settings to whatever may be appropriate to treat your central events.
But of course an insurance company would surely refuse to reimburse for an ASV machine (these cost between $4000 to $6000 from most DME vendors) unless it is specifically prescribed. Usually there is a lengthly pre-approval process needed before gaining approval for insurance to cover an ASV machine.
So you would be paying for an ASV machine totally on your own, without any reimbursement for the machine itself. By the way, the cost of a brand new "open box special" ASV machine such as the ResMed VPAP Adapt (but ask first to be sure it would be model 36037, not the older ResMed VPAP Adapt model 36007) is less than $2000 from
Supplier #2 on our Supplier List, and used machines are even less. (A link to our Supplier List is given at the top of our forum pages.)
Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
