Had Titration Study - BiPap Recommended - What Machine Shoud I get?

Hi all, Hope everyone had a great 4th! I had a titration study on 6/27/18 for the first time. My insurance company didn't approve the titration study after I had my initial sleep study in October of 2017. They allowed me an A-PAP machine instead. Well, now, after I fully paid for the Dreamstation, my PA was unhappy with my continued CAs and reordered the tiriation study. This time the insurance company approved the study. Of course, the PA says I now need a need Bi-PAP machine and has sent the script to the company that supplies my equipment, Respitec. To be honest, I have little confidence in the company to figure out what machine would really be the best for me, so I am reaching out to the group to see what they think.

I have attached my study report with the personal stuff blacked out. I have gone through the forum trying to learn about Bi-PAP machines but have come away very confused as there seem to be a number of different kinds. I would kind of like to stick with a Dreamstation model only because I am familiar with it due to my current model and I like using the DreamMapper app on my iPhone. But if i need to go another route I will.

Based on the results of this test, does anyone think that one machine would be better than another? I really respects the opinions on this forum and understand that these are only opinions.

Thanks in advance for any thoughts.

My own personal preference is the ResMed Aircurve 10 VAUTO. The Responics Dream Station auto bipap is also good. The DME will probably try to give you a single pressure machine since it looks like your prescription will be written for a fixed pressure of 11 with a PS of 6.

If the diagnosis was Central Apnea, you will need an expensive ASV machine.

Thanks. This is starting to get confusing. I just read the following on this website - https://www.sleepdr.com/the-sleep-blog/ ... p-and-asv/

"Recent studies show that ASV isn’t for everyone: ASV therapy is contraindicated in patients with chronic, symptomatic heart failure (NYHA 2-4) with reduced left ventricular ejection fraction (LVEF ≤ 40%) and moderate to severe predominant central sleep apnea. These patients may benefit from BiPAP or bi-level PAP and low flow oxygen. For more information, see the study links at the end of this post."

So at this point, I am not sure what I am supposed to get - a regular Bi-PAP or the ASV machine. My deductible for the year is about met so it would cost me the same for either machine.

Thanks. again.

Gator5000e wrote: ↑

Mon Jul 09, 2018 3:24 pm

chronic, symptomatic heart failure (NYHA 2-4) with reduced left ventricular ejection fraction (LVEF ≤ 40%)

Do you have heart problems?

According to the PSG Report, no central apneas were detected at pressures of 11/5. He did sleep for like 3 hours at those pressures, at least according to the report. It sounds like they intend to prescribe a regular bi-level device, not an ASV, or any other backup rate capable machine.

ChicagoGranny wrote: ↑

Mon Jul 09, 2018 3:32 pm

Gator5000e wrote: ↑

Mon Jul 09, 2018 3:24 pm

chronic, symptomatic heart failure (NYHA 2-4) with reduced left ventricular ejection fraction (LVEF ≤ 40%)

Do you have heart problems?

Yes, some minor ones - irregular beats (fib and flutter). Cardiologist is not overly concerned as they are short in duration.

Okie bipap wrote: ↑

Mon Jul 09, 2018 12:33 pm

My own personal preference is the ResMed Aircurve 10 VAUTO.

+1

Gator5000e wrote: ↑

Mon Jul 09, 2018 4:03 pm

ChicagoGranny wrote: ↑

Mon Jul 09, 2018 3:32 pm

Gator5000e wrote: ↑

Mon Jul 09, 2018 3:24 pm

chronic, symptomatic heart failure (NYHA 2-4) with reduced left ventricular ejection fraction (LVEF ≤ 40%)

Do you have heart problems?

Yes, some minor ones - irregular beats (fib and flutter). Cardiologist is not overly concerned as they are short in duration.

But, do you have *those* heart problems, mentioned in what you quoted? Besides, it's not like you get to pick whether you want an asv or plain bilevel, unless you're paying cash in a Craigslist deal.

I've used both Resmed and Respironics BiPAPs and the Resmed works best for me. However, I don't have many CAs.

I am wondering if the fact that you are already comfortable with the Dreamstation and that you can set both maximum and minimum Pressure Support if this is probably the best machine for you. There is anecdotal evidence that varying the PS max and min can be effective. The Aircurve VAuto does not have variable PS.

On the other hand, I consider PS the most important part of the Rx for most prescribed bilevel and believe it is important that it should not vary during autobilevel use. That is why I consider the ResMed autobilevel approach the most valid, medically speaking. Not to mention its being the most comfortable for me.

Thanks all. I received a call from my supplier and it appears that I am getting the Dreamsation Bi-PAP. I guess I will find out how that works when I get it next tuesday.

Gator5000e wrote: ↑

Tue Jul 10, 2018 7:32 am

I received a call from my supplier and it appears that I am getting the Dreamsation Bi-PAP.

Auto or Pro? https://www.cpap.com/cpap-machines/bipa ... e.php#:::1::::

I would really prefer the Auto. It can do everything the Pro can do plus a lot more.

ChicagoGranny wrote: ↑

Tue Jul 10, 2018 8:17 am

Gator5000e wrote: ↑

Tue Jul 10, 2018 7:32 am

I received a call from my supplier and it appears that I am getting the Dreamsation Bi-PAP.

Auto or Pro? https://www.cpap.com/cpap-machines/bipa ... e.php#:::1::::

I would really prefer the Auto. It can do everything the Pro can do plus a lot more.

I have no idea but I guess I will find out when I get to my appointment next week. I will make sure to ask for the auto. Thanks for the heads up.

Gator5000e wrote: ↑

Tue Jul 10, 2018 7:32 am

Thanks all. I received a call from my supplier and it appears that I am getting the Dreamsation Bi-PAP. I guess I will find out how that works when I get it next tuesday.

You don't have to take it if you don't want it. You can refuse it and hold out for the Resmed.