Question machine setting/HI AHI

Does the AirSense have a Ti min/max setting like the AirCurve?

Nope.

Thanks Pugsy...
Just finished my new Sleep Study. AHI of 39, no Centrals, all OA.

My Sleep Dr changed my Rx to EPAP 8 with PS 4, and IPAP 16. I get my new AirCurve on the 22nd, But I went ahead and changed my S9 Bilevel to these new settings... Now my AHI is through the roof: The last 3 nights this is what i have gotten:

CAI 13.27 Settings EPAP 8- PS 4
CAI 9.24 EPAP 9-PS 4
CIA 12.98 EPAP 9-PS 4

My AHI avg is 1.0 with a setting of EPAP 12-PS 1 I told the sleep center this but they would not try a Titration at this setting because a Bilevel must have a PS pf at least 4.

I had the same problem 5 years ago and i even tried an AutoSet, but could not get it to work at any setting (not even EPR of 1 with EPAP of 13). When I went to a Bilevel and changed Ti to 2.5 things started to work. Not sure what other differences there may be between the two machines but it seems the Bilevel is what works when set right.

My fear is if I change my settings to get my 1.0 AHI back they will say i don't need the Bilevel and take it back and give me a CPAP instead. I seem to need the Ti control to get things in control. A default of setting of 2.0 just does not work for me: it disrupts my sleep.

Use whatever you like on your current machine, The RX from the Doc will ensure you get a BiLevel as those settings are not availiable on an autoset. When you get your new machine configure it how you like... what is the issue ? Your pescription is for your new machine..

JW thanks for the reply.

The problem is have to use the new machine for at least 4 hours a night for 21 out of 30 days before Medicare will pay for the machine. The Sleep center wants to download my SD card, in addition to what mt DEM sends them from their downloads, in two weeks and at the end of the 30 day period (assuming I make compliance within 30 days, which is no problem for me....if I can ride out the PS of 4 that long)

I forsure can't sleep with a EPAP of 8...It is too low...I feel like I am falling into the Mask, and I am starting to have some OA's which i don't with my old settings. I am sure I can get them to change it to 10 but the PS to 1, I am not sure about without the "Why are you on a bilevel" conversation....And anyway with A PS of only 1, I need a EPAP of 12 not 10.

I have been using CPAP/Bilevel for 5 years and I know what works for me. I am getting real frustrated dealing with people who think they know me and my cpap needs better than me after ONE night of little sleep in their lab.

My sleep is being really disturbered. I am waking real tired and not in a very good mood. Also i don't know what the forces that be will think of a 10 pluss AHI with 100% being centrals.

So I guess, my question is...If I make the changes I need to, and let them have a fit about it, but I do use the machine as required every night for 30 days and have an AHI of 1...will they/can they take the machine back?....Or does anyone know???

I don't mind fighting with them over this, if they can't take the machine back because of it.......if they can, I will just go to my doctor and get some sleeping pills for the 30 days...and then tell them to go jump......

Medicare are only really interested in compliancy not the machine settings

Wanna bet they only look at the hours of use and don't pay much attention ( if any attention) to the AHI or settings????

They won't try to take the machine back. Medicare is already paying them or will pay their portion in payments very soon.
They don't want to confuse Medicare and risk messing that up...and your doctor is already on board and prescribed the bilevel.

There's no reason for the DME to want to take the machine back. They don't get to make that decision unless you fail hours of use compliance which you won't fail. Settings alteration or AHI isn't grounds for taking a machine back.

The DME doesn't get to decide what machine you end up using...that's the doctor and Medicare who make that decision.

Thanks a lot for reply and support..right now i need it.. This board can be sooo great at times..

OK I guess I should chill out.....it's just the doctor I am dealing with is not my regular doctor but the Sleep Center doctor....and he is not on board with me....I have never even seen him or talked to him.....I just wanted to make sure he could not/or would not yank my machine......

Yes my regular GP Doctor is supportive......he is great....for a doctor.......

Thanks for putting up with my whining and paranoia........I will put my machine back to where it was and rest up encase there is a fight ahead.....

Your primary care doctor/family doctor...trumps the sleep center doctor anyway.

Usually a sleep center doctor isn't even bothered with the compliance side of things. They have someone who looks to see if you are using the machine at least 4 hours a night for the required number of nights and if you are they don't look further and there's zero need for the peon to bother the sleep center doctor.

Now...I don't know if you were told this but I think you need to have a face to face with a doctor prior to the 91st day after getting the new machine. This can be with your primary doctor and all he has to say is "so and so is using the machine and it's working well"...that's all that is required by Medicare. The face to face can be ANY doctor...and obviously you don't really want to go see the yahoo at the sleep center.

So if you happen to see your family doctor for ANYTHING prior to that 91st day...get him to document that you are using the machine and doing well. Will save you a visit.
Medicare does NOT require the face to face to be with the sleep center doctor.

I agree that existing user ought to be allowed to keep their existing settings when going to a new machine. If the new machine is a comparable or higher model, it is possible to do that oneself (even if you are told otherwise). However, if the new machine is a "downgrade." you won't be able to do this.

I am not aware of an cases in the U.S. (or elsewhere) where the "compliance police" checked for anything other than number of hours, mask fit, and AHI.