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+--- Thread: [Equipment] Longtime BiPAP w/ centrals needs new machine advice (/Thread-Equipment-Longtime-BiPAP-w-centrals-needs-new-machine-advice)
Longtime BiPAP w/ centrals needs new machine advice - memeuro - 07-30-2020
Hi Guys,
Found you guys by accident and uncovered a treasure-trove that has led me into a spiral of indecision.
I have been a BiPAP user for over 5 yrs, and CPAP for 9 yrs before that.
I have the PRespiroincs REMstar 60 Series BiPAP Auto SV Advanced with heated water chamber. The unit is okay. The on/off button is also a knob and is probably one of the worst design features. Fumbling at night to turn it on or off invariably rolls the display into one of the settings and doesn't just simply turn the unit on.
After 5 yrs with this unit and NEVER having ANY water vapor in my tubing and always waking up with a dry mouth I went to a new sleep MD and OMG he went into the settings and changed something and now I have so much water vapor. Why did I accept from the DME that this was the best they could do??? Stupid me.
In any event, I am looking at a new unit. I have a lot of centrals and need a good unit.
My DME is quoting me over $5K with my insurance as total cost, with my cost being around $1K.
How is it possible that I see units online around $1400 and yet the DME has it at over $5K?
I have never used a heated hose in 14 years. Do I need one?
I see a lot of people recommending the AirCurve 10 VAuto.
Just for giggles... as if money was no object... what would you guys choose for a new BiPAP with auto shunt?
I used to travel on planes so carrying it has become normal but a pain.
Is there a unit that actually is easy to turn on and off? If I knew what a pain the Philips was I would never have let the DME sell it to me. Had no idea I could return it.
Learned a lot of lessons.
Would love to hear from some of the guys on here who are experienced and can give me a helping hand.
Thank you so much.
RE: Longtime BiPAP w/ centrals needs new machine advice - jaswilliams - 07-30-2020
My suggestion is a Resmed ASV look at Supplier #2 if out of pocket. A VAuto won’t do what you need
RE: Longtime BiPAP w/ centrals needs new machine advice - Sleeprider - 07-30-2020
Memeuro, the current models for your unit are the Philips Respironics Dreamstation BiPAP Auto SV or the Resmed Aircurve 10 ASV. These are very specialized machines used to treat central and complex apnea, and not just bilevel units used for obstructive apnea. It appears your unit has pretty standard settings of EPAP min 6.0 with PS min 3.0, PS max 15.0. The 60 series has a SD card slot in the top-center of the flow generator that can provide full data to use with OSCAR. If you would like to post a chart, we can learn a lot more about where you are at in your therapy.
The DME may charge $5000 for an ASV unit, but they will be paid whatever their contract allows by the insurance company, which is probably less. I have not seen new ASV units online for $1400, and suspect that is an auto bilevel without a backup or the adaptive pressure support you require. Be careful you are comparing the same machine. It is certainly reasonable to do comparison shopping by knowing which DMEs are in-network for your insurance and doing some comparison shopping. In the ASV category, most members here have found the Resmed Aircurve 10 ASV is more comfortable and effective compared to the Philips BiPAP Auto SV. You should access your clinical settings and copy the settings you currently use to transfer to a new machine. Here is how to access those settings, as well as humidity https://www.apneaboard.com/pr-system-one-philips-respironics-setup-cpap-clinician-menu-instructions
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 07-31-2020
Jeez... wish I found you guys sooner and so glad I have found you now! I just took out the cell modem that was attached to the unit and found the SD card. I downloaded my data into OSCAR and just wow guys!!
Thank you so much.
There is so much data I don't know which way is up LOL
How can I post this without breaching HIPAA? I am used to scrubbing metadata etc. before uploading but I don't even know where to look to make sure no PHI is uploaded.
I did not create a profile using my name or DOB.
I have read great things on this forum regarding the Resmed unit. I have started a new job and wanted to get the new unit in while my COBRA benefits with my previous great insurance are still in effect before I switch to my newer not so great insurance. I will most likely get the Resmed as recommended.
Thank you both @jaswilliams & @Sleeprider
RE: Longtime BiPAP w/ centrals needs new machine advice - SarcasticDave94 - 07-31-2020
I will also vote for the ResMed AirCurve 10 ASV. I don't know the techy aspect, but your data on a post with OSCAR data is as safe as it can get while posting on a public forum.
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 07-31-2020
Do you guys see value in adding the heated hose and tubing? I have not had a unit with one in 15+ years. Wondered what your thoughts were. I always have a very very dry mouth in the morning. And the chamber is filled and most mornings is empty.
I tried uploading an OSCAR sample output from my unit.
Any thoughts guys?
Thank you so much.
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RE: Longtime BiPAP w/ centrals needs new machine advice - Gideon - 07-31-2020
IMHO it is personal choice, I have one and notice a minor comfort improvement.
RE: Longtime BiPAP w/ centrals needs new machine advice - jaswilliams - 08-01-2020
First thought on your graphs you need a Resmed ASV rather than a Philips one. I’m sorry I am not good at making recommendations on reducing Hypopnoeas on one of these. But it looks like your max PS is limiting what your machine can do I would suggest raising the max PS to 15 to reduce the Hypopnoeas I don’t use a heated hose nor humidifier on my ASV I like cold dry air but it’s personal preference
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 08-01-2020
(07-31-2020, 07:42 PM)bonjour Wrote: IMHO it is personal choice, I have one and notice a minor comfort improvement.
Thank you for letting me know. Appreciate it.
(08-01-2020, 01:08 AM)jaswilliams Wrote: First thought on your graphs you need a Resmed ASV rather than a Philips one. I’m sorry I am not good at making recommendations on reducing Hypopnoeas on one of these. But it looks like your max PS is limiting what your machine can do I would suggest raising the max PS to 15 to reduce the Hypopnoeas I don’t use a heated hose nor humidifier on my ASV I like cold dry air but it’s personal preference
Thanks for letting me know. I will get switched to the Resmed and go from there.
Thanks again. I do appreciate the advice.
RE: Longtime BiPAP w/ centrals needs new machine advice - Sleeprider - 08-01-2020
Resmed is much easier to adjust and more quickly responds to events which is very important with ASV. The specific model is the Resmed Aircurve 10 ASV.
Meanwhile I want you to try some new settings in auto SV mode:
EPAP min 6.0
EPAP max 12.0
PSMin 3.0
PSmax 15.0
Breath rate auto
This should help wit the hypopnea and unresolved CA.