BiPap Machines

Hi All! I saw a BiPAP question was asked and I'd like to ask another. I appreciate your indulgence and any suggestion you can offer. I began the sleep machine journey over 5 years ago when diagnosed with severe obstructive and central sleep apnea with upper airway resistance syndrome and moderate hypoxia. Looking back on the report, I was to have received the Remstar Pro M Series BiPAP, but instead have been using the Respironics One System Auto SV with humidifier. I just had another sleep study since I'm still back to being very tired during the day. The diagnosis/report showed obstructive, mixed and central sleep apnea with moderate oxygen desaturation. The machine recommended is the Remstar Pro DS 460 Series with heated humidifier. Does anybody know what the difference is between the Remstar Pro DS 460 Series and the Respironics One System Auto SV? Does anybody have any knowledge or experience with these machines?

There is a world of difference between those two machines. The Remstar Pro DS460 is a fixed CPAP. A fine machine for simple OSA. It has nearly no capability to respond to changing pressure needs through the night, and more importantly does not provide breath by breath pressure support to provide separate exhale and inhale pressures or to increase pressure in the event of central apnea or periodic breathing.

The PRS1 Auto SV HS960 is the newer version of the machine you have been using. Depending on how you setup your machine, it is capable of auto pressure titration, separate EPAP and IPAP and pressure support for centrals and periodic breathing. Apples and oranges. There is no comparison.

Both machines provide full data, and work with Sleepyhead. Your machine is a little more difficult to download data from the Smartcard and use with Encore software. Have you ever looked at your efficacy data?

Can you look at the bottom of your machine and post the actual model number?
Remove the humidifier tank before turning it over or water will get into the blower unit and likely ruin it.

It would also be helpful if you would register so you can show your actual equipment.
If your report shows complex sleep apnea (both obstructive and central apneas) it's puzzling how they could get to prescribing a Respironics 460 machine which won't help much at all.

I really appreciate all the help. Thank you! I was getting nowhere on searches. I'm still at work now. When I get home (after I take out the pups) I'll check my machine for the number and register. I'm assuming it won't make a difference if I change my e-mail to my personal address instead of work?

ForeverTired wrote:I really appreciate all the help. Thank you! I was getting nowhere on searches. I'm still at work now. When I get home (after I take out the pups) I'll check my machine for the number and register. I'm assuming it won't make a difference if I change my e-mail to my personal address instead of work?

FT, your work email probably filters email from social sites, and as a result you have not seen the verification link request to complete your registration. You may need to use a revised user name like ForeverTired1 to do a registration with an email address not filtered to prevent social sites.

I checked my machine and I currently have the BiPAP Auto SV Sys One, DOM. There were a few numbers on the back: 950P, PO3749241. I also have a REMstar Heated Humidifier 1056215 / H01126038. The mask is a ResMed Quattro Fx, full face mask, #61700. I am expecting to change to the Amara View. I
couldn't find where to add this information so it shows up with the post. I also wrote down all the device settings, so if that would be of use, I can post them. Thanks again for your help.

ForeverTired wrote:I checked my machine and I currently have the BiPAP Auto SV Sys One, DOM. There were a few numbers on the back: 950P, PO3749241. I also have a REMstar Heated Humidifier 1056215 / H01126038. The mask is a ResMed Quattro Fx, full face mask, #61700. I am expecting to change to the Amara View. I
couldn't find where to add this information so it shows up with the post. I also wrote down all the device settings, so if that would be of use, I can post them. Thanks again for your help.

go into user control panel, profile, and put the following into your signature:

Respironics 950p, quattro FX

out of all of the numbers and names and stuff, that's all that's necessary so that folks here know what you've got, and don't need to ask, and can give you appropriate comments.

When I was at work, our work computer's filter blocked social sites, but cpaptalk was not blocked,
Either missed, considered medical/scientific, or simply more useful than the usual fluff.
Using your home email is the safest bet.

I want to thank you again for your previous responses. That information has been very helpful. To update, yesterday I had an appointment with the sleep doctor regarding my last test. I stated that I felt the SV is the machine needed to control sleep apnea, so when my brain does not send the message to breathe, the machine will do so for me. Then I asked the doctor, "isn't that important - for me to breathe" and he responded "no, not really." I kid you not. He finally agreed to prescribe the SV, but neglected to tell me that the study only titrated me for BiPAP settings, not SV settings, which I learned from the DME company. I also learned that the doctor's recommendation was for BiPAP levels on a CPAP machine, which is not possible. Not even to mention he was not aware that the System One machines had been phased out for the Dream Machines. My DME company called the sleep study center and only then was it disclosed that the sleep center no longer offer an SV sleep study and no longer prescribe SV machines. It was never disclosed to me at any point that they no longer addressed SV patients - not when making the appointment stating I needed to be retitrated for my SV, not before the sleep study - where I even brought in my machine, and not from the doctor. I have called my insurance carrier to note this information in my record as I will probably need a proper sleep study done since this facility and doctor do not feel it is important to address central sleep apnea.

Does anybody know of any qualified doctors in the Baltimore area? And does anybody have any suggestions on next steps? Has anybody had a similar experience?

What you are seeing is likely fallout from the SERVE-HF study last year.
Both ResMed and Respironics have issued recalls of their ASV models related to the study and I suspect the risk control folks are removing potential lawsuit risks by making sure they are not in the chain if an ASV user dies.
Don't you just love liability lawyers!

JDS74 wrote:What you are seeing is likely fallout from the SERVE-HF study last year.
Both ResMed and Respironics have issued recalls of their ASV models related to the study a!

oh? please provide references, since SERVE-HF only applied to one small subset of ASV users.

ASV Product recalls:
ResMed 1st Ref
ResMed 2nd Ref
Phillips

Like palerider said, very limited...

The Resmed recall effected only...

The identified safety concern is a significant increase in the risk of cardiovascular death in
patients with symptomatic, chronic heart failure (NYHA 2-4) with reduced left ventricular
ejection fraction (LVEF ≤ 45%) being treated with Adaptive Servo-Ventilation.

JDS74 wrote:ASV Product recalls:
ResMed
Phillips

a "product recall" means they're taking that product off the market to either destroy or rebuild them to address some safety issue.

this is not a product recall, it's a recall of previous advice for whom the machine is recommended.

The reason I’ve joined this thread was because I searched “SERVE-HF” and this was the only hit.

I’ve just found out about the SERVE-HF study (from my sleep doctor). He told me that after the study released its findings all ASV patient records were scanned and those to whom the “specific” characteristic “low ejection fraction heart failure and predominant central sleep apnea at baseline” applied were notified not to continue using their BiPap ASV, etc. Apparently, I was not among these patients.

What is:

• - low ejection fraction heart failure
  - predominant central sleep apnea at baseline

My questions (per the Phillips link http://www.sleep.org.au/documents/item/1838 provided by JDS74 below):

• - What does “reduced left ventricular ejection fraction (LVEF ≤ 45%)” mean?
  - Is this the only criteria involved in the study?
  - I suffer chronic afib and have a pacemaker (to control heartrate< 50)? Do either of these ‘conditions’ relate to the study?

Also:

• - Apparently (BiPap ASV) machines are affected by this study.
  - Are ALL BiPap ASV machines affected (I understand the Resmed and Respironics employ slightly different algorithms)?
  - Is mine? (see below)