Time for new machine

[Born2Bwild]

Hi everyone
Long time lurker in need of your advice on choosing next sleep machine. I have been using autosense 10 apap til now and my insurance is approving a new one. I am somewhat disappointed with this machine because of the whining noise on exhale, I tried to take it back to DME but he said it’s very quiet. Any how, I read about bilevel machine in particular the aircurve 10 being the latest technology for better sleep. My question is do you guys see this as the best sleep therapy out there or is it recommend only for those of us who have severe apnea? Without playing a doctor, my doctor will write my machine choice on the prescription.
The next challenge would be finding a DME who will order it for me through insurance. I would love to order it from cpap.com as it cost less but it’s considered out of network.
Thank you for your advice and recommendations

[Pugsy]

What pressure settings are you using now?

[Born2Bwild]

Currently 7 to 12

[zonker]

Hi everyone
Long time lurker in need of your advice on choosing next sleep machine. I have been using autosense 10 apap til now and my insurance is approving a new one.

other than the whining noise on exhale, is your apap therapy optimized? i see in your reply to pugsy that you are currently using min of 7 and max of 12. why are you setup that way, if you don't mind me asking.

what i'm trying to get to is, i don't see the value of jumping to a bilevel machine if you don't have your current apap set up to do the best that you can do.

bilevel has a specific functionality, which others can explain to ytou much better than i.

it seems wasteful to me to spend more money chasing something that may or may not help you if you haven't tried all the options with your current machine.

good luck!

[Born2Bwild]

“other than the whining noise on exhale, is your apap therapy optimized? i see in your reply to pugsy that you are currently using min of 7 and max of 12. why are you setup that way, if you don't mind me asking.

what i'm trying to get to is, i don't see the value of jumping to a bilevel machine if you don't have your current apap set up to do the best that you can do.

bilevel has a specific functionality, which others can explain to ytou much better than i.

it seems wasteful to me to spend more money chasing something that may or may not help you if you haven't tried all the options with your current machine.”

This might sound like dumb question:optimized?
Since I got the prescription and the cpap I haven’t gone back to the doctor. I will need to see him before ordering because it have have to prescription
Thanks for the response

[zoocrewphoto]

How long have you had the current machine? Other than the sound, is there a reason you are getting a new machine? I didn't think those were out long enough to qualify for a new machine. (Most insurance companies require 5 years).

It also sounds like you aren't sure if the current machine is set ideally for you. Have you ever looked at the data? Do you check the on-screen info? Unless you have need for the special features, I wouldn't see any reason to buy a more expensive machine.

[zonker]

This might sound like dumb question:optimized?
Since I got the prescription and the cpap I haven’t gone back to the doctor. I will need to see him before ordering because it have have to prescription
Thanks for the response

there are no dumb questions in my humble opinion. and what you have asked is a key question.

what does optimized mean? why am i saying that? well, let me start by saying this. when i went to the sleep doctor four years(!!) ago, i figured that the doc would put me on one of these cpap machines, monitor my progress and then, in no time, i'd be cured of this pesky sleep apnea thing. and i'll bet you that you had the same expectations as well.

one and done. one size fits all. boy, was i wrong! it turns out that it doesn't really work that way. at least, not in my case. and certainly not in the case of many who come to this forum. i suspect that the same is true for you.

we are just that much different from one another. we each sleep differently. and what makes up our ahi is different. so we each should actually take charge of our own therapy. we can, and should, make changes in the pressure settings of our machines.

but we shouldn't go changing things willy nilly. we should first gather data about our sleep. this can be done with software, which sees what your doctor sees when s/he looks at the same data. armed with that data, you can post it here, for forum members to look at and suggest changes in your settings.

right now, you say you are set at 7 and 12. that might not be set right for YOU. many of us operate our machines under different pressures. mine currently is set at a minimum of 15.4 and a maximum of 20. this is what works for ME. my therapy is optimized to get me the best treatment i can get.

the software spoken of is oscar-
https://www.sleepfiles.com/OSCAR/

and you might also want to look at the link at the bottom of my post for newbies.

folks are here to help, so don't be afraid to ask.

and especially if you have ANY questions about what i've typed.

[Pugsy]

With your relatively lower pressures and you didn't mention having problems exhaling (other than the noise which BTW is unusual for the AirSense machines) or problems with air in the gut/aerophagia.....you might have some push back from the insurance company in regards to their paying for the more expensive bilevel machine.
Usually person has to justify the need for a bilevel and just having a doctor write the RX might not be enough reason.

Do you use EPR now? If so, at what setting?

[Born2Bwild]

I have to admit that your posts were an eye opening to me,thank you so much for your responses. Since I got on it 4 years ago I always monitored my sleep on my air and I have used the software other than Oscar to see my sleep. Events per hour are always under 1 with occasionally central apnea. I will have to download OSCAR and look at it more closely at my therapy and I will try to post the results.
Epr?
As far as the insurance, they assured me that I qualify for new machine every 3 years. I intend to keep this one as a backup. I can see from lots of profiles here that resmed is still the leader in this field.

I humbly accept your constructive criticism and I’m not trying to replace the machine for every small reason. I still believe that what I got is very good, it’s just a defective unit. I tried to take it beck months after I got it to DME but like I indicated he said that machine works flawlessly and wouldn’t accept to replace it. I stoped using him and used cpap.com since
Again thanks for the responses

[NoOnesPerfect]

EPR is expiratory pressure relief - it lowers the pressure to make it easier to exhale, so that with an EPR set to 3, if you had pressure set to 10 for when you inhale, the pressure would be reduced to 7 when you exhale. It’s primarily a comfort setting to make it easier to adapt to using the APAP.

[Pugsy]

Didn't mean to sound critical of your wants...just wanted to explain that getting insurance to pay of a bilevel machine might not be so easy.

IMHO...the current machine making the whining noise...not normal and the DME should have replaced it under warranty.
I have an AirSense 10 machine...it's silent and most people will tell you the same thing. Noisy whine doesn't qualify as "working as it should" to me. That to me is a defective unit and I would have raised bloody hell about it.
But that's water under the bridge now anyway.

If you use EPR your current machine is already functioning as a bilevel machine....just with some limitations.
If you can get a bilevel Auto...by all means get it...even at your relatively low pressures it's a sweet machine. If I had the money I would get one. EPR at 3 is like PS at 3 but I happen to really like PS of 4 which the AirSense 10 models can't do. I make do with the EPR at 3 but if I had my choice....I would rather use PS of 4. I have used the older S9 version of the AirCurve 10 VAuto.....really sweet machine but I bought mine privately. No way would I ever get my insurance to get on board with paying for a bilevel. My pressures are similar to yours.
Now when people need pressures in the mid to upper teens...easier to justify need for bilevel.

[zonker]

I humbly accept your constructive criticism and I’m not trying to replace the machine for every small reason. I still believe that what I got is very good, it’s just a defective unit. I tried to take it beck months after I got it to DME but like I indicated he said that machine works flawlessly and wouldn’t accept to replace it. I stoped using him and used cpap.com since
Again thanks for the responses

oh! please forgive me and i hope i didn't come across as a pompous twit. obviously, you ARE monitoring your progress and taking a hands on approach.

it's too bad they didn't take your concerns seriously regarding your noisy machine. and i'm not sure how to advise to proceed.

i still think a bilevel machine is overkill for your situation. you have asked about epr and others have responded. i don't have a lot to add to the conversation.

pay close attention to what pugsy tells you. she has a wealth of experience to draw from.

she won't let you down.

good luck!!

[Pugsy]

i still think a bilevel machine is overkill for your situation.

It probably is overkill...just like when I used the S9 Adapt (ASV) for 3 years and didn't need it for centrals. It was overkill for my situation but it hurts nothing to overkill something. Especially when in the overkill process we stumble onto something that for some strange reason or other allows us to sleep better and longer. I had that happen with my first bilevel usage. I didn't technically "need" it but I found out that for some strange reason I slept better/longer with bilevel than with single pressures.
I found out I was sleeping on average 45 minutes to an hour longer using bilevel and when my sleep is already fragile I will gladly take any improvement I can get. We never could figure out why my body liked bilevel so much...but it did.

There's no law that says we can't overkill something if that's what we want to do and we want to spend our own money to do it.
Getting insurance onboard though...different can of worms.

[zonker]

i still think a bilevel machine is overkill for your situation.

There's no law that says we can't overkill something if that's what we want to do and we want to spend our own money to do it.
Getting insurance onboard though...different can of worms.

true. you never can tell what you might find if you try.

OP said in last post he's going through cpap.com, so i guess he's not using insurance?

[Holden4th]

My diagnosis is purely for obstructive sleep apnoea so I don't really need anything more than an APAP machine. However, a fair amount of research suggested that using BiLevel/BiPAP would improve my sleep experience. A good analogy could be made with cars. I don't need much more than a car that has all the basic amenities as the majority is around the city. That doesn't mean I can't drive an Audi or a Jaguar to get an improved driving experience.

In my case I found that upgrading to BiLevel did make a significant improvement to my sleep experience and I would recommend that anyone try it out.