Replacement for system one bipap?

[pamedwards]

Hi everyone. I am feeling a bit overwhelmed as I have not had to explore much about treatment options since getting my system one bipap about 7 years ago, so not really a newbee but yet not too informed either. The amount of info on this site is amazing ! Can anyone tell me what might be a replacment for my machine that is recalled? I have registered it, not called my dr yet or tried to figure out next steps yet. Just letting this sink in and trying to educate myself. I would like to educate myself before I do speak with my doc. I am on the lowest setting because of getting air in my abdomen during my sleep machine assessment. I believe I had both central (mostly) and obstructive (lesser) on my test years ago. The system one has minor info as far as I can tell, I check it every day and normally have very low AHI, occasionally a bad nite. My annual appointments and reviews have been ok so really Ive just been gliding along till this announcement and feel lost. I see about OSCAR on here, and it seems very helpful and important, are there any machines that might replace my bipap and have the OSCAR capability? I do have medicare. Thanks so much for any guidance !

[Pugsy]

The System One model machines are all compatible with OSCAR....so you can use it right now if you have a SD card in the machine.
If you don't have a SD card in the machine you can get one at WalMart or similar store. They are cheap. Any generic SD card 32 GB or smaller will work just fine.

Exactly which model System One BiPap do you have? Should be on the bottom of the blower...a 3 digit number beginning with P or maybe DS.
We need to know which model you are using to be able to advise what to look for with another brand machine because there are about 8 different "bipap" models with Respironics and some of them do special things. If your machine is one of the "special" models you would want a similar "special" model in another brand and most likely the ResMed brand.

[pamedwards]

Thanks for the reply ! It says Bipap pro, DOM then under that line is a line saying REF in a box with 660P beside it. I do have a sd card in the machine so now will have to learn what to do with it ! Thanks for any suggestions, ps I dont want another philips.

[Pugsy]

Don't blame you for not wanting another Phillips product and it's unlikely that Phillips will have a DreamStation 2 BiPap available anytime soon anyway.

The Model 660 is a fixed bilevel machine...doesn't auto adjust pressures and doesn't treat central apneas either which was my main concern.

Go ahead and install OSCAR and get some details as to how many centrals you might have been having on that machine.
OSCAR calls the Clear Airway (CA) events and depending on how many you are having might point to a need for a different machine that can deal with centrals. A few centrals isn't a big deal but a substantial number night after night probably needs to be dealt with by a different kind of machine.

Otherwise...assuming no need for special central treatment
The ResMed AirCurve 10 S model is pretty much going to do what the model 660 BiPap Pro does. Fixed bilevel mode and fixed cpap mode available. 2 machines in 1.
A better choice would be the ResMed AirCurve 10 VAuto... it has fixed bilevel mode, fixed cpap mode and auto bilevel mode available.
3 machines in 1.

BTW...the term BiPap is actually a marketing term for Respironics bilevel machines and other brands call their bilevels by other names.
The term bipap has sort of become a generic term for bilevel capable machines but the only real "bipap" is the Respironics bilevel.
All the other brands use the term bilevel in their product description since that is a technically more accurate description.

So it's not a ResMed BiPap....ResMed has elected to use the term AirCurve to denote their bilevel devices and they have at least 6 different bilevel models.

The ResMed AirCurve 10 VAuto is what I use...super nice machine.
I sometimes need a much higher pressure during the night so I use the auto bilevel pressure adjusting mode. Allows me to use lower pressures when lower works and only use higher pressures if/when I need them.
It's also much quieter than Respironics (I have also used a System One BiPap in the past). You won't we sorry with a ResMed bilevel machine.

[pamedwards]

Thanks so much, that is so helpful ! I think I recall the dr saying years ago that an auto type wouldn't be good for me because of my air problem during my assessment using the machine. I mean it was bad I went to the er. Anyways, I will learn about OSCAR and see whats up in the data, and then with your suggestions about Resmed and what I learn from the OSCAR data, I will be much better informed to talk to the dr. My initial sleep study was done by dr #1 and his interpretations were different in different sections of the report, and didnt recommend a pap, but rather just oxygen ! so went to this one - dr 2 who didnt repeat the sleep study just did the try the machine sleep study at the lab with the bad air results and then chose this machine for me. I could probably use a new sleep study. Thanks again, I am looking forward to seeing what OSCAR says and also not in case its terrible.

[Pugsy]

Here's the deal...the auto adjusting capable machines have fixed mode available if someone needs fixed mode or prefers it.
It's there in case it is needed though.
Insurance companies pay by HCPCS billing code....not by brand or model...so the HCPCS billing code for the fixed bilevel machine is the exact same billing code as for the auto capable machine. E0470 for the bilevel without back up rate (which is what your 660 model is).
Back up rate capable machines are what deal with central apneas and they actually act like a ventilator and force you to breathe if you don't breathe on your own. The model 660 machine or even the auto bilevel...can't force you to breathe they don't have back up rate setting capabilities.
It's always better to have something and not need it than need it and not have it ....especially if the cost out of pocket or to insurance is going to be the same.

[pamedwards]

Thanks for the reply again, I am really trying to get these concepts. You mention auto adjusting capable machines and that they can have a fixed mode. And they have the same billing code. The 660 is a bilevel without back up rate and backup rate capable machines deal with central apneas. The 660 or the auto bilevel need back up rate capabilities to force breathing if central and not breathing. I guess I don’t know what a back up rate capability is? Is that what you mean by the Resmed Air Curve 10 VAuto being 3 machines in 1? You say it has fixed bilevel mode, fixed cpap mode and auto bilevel mode available. Not sure what a back up rate concept is that you introduced in this reply or what machine has it. Sorry for my confusion. Thanks for any help understanding!

[Pugsy]

Backup rate is totally something different from the BiPap you currently have or the VAuto that I use.
With yours (and mine) machines our own breathing triggers the inhale and exhale but with a machine that has a back up rate setting it will make you inhale and exhale even if you aren't breathing to trigger it. It will force a breath.

If you didn't have a lot of centrals or don't have now...you don't need a back up rate machine.
That's why I said get OSCAR up and running....lets see if you even need back up rate.
Sometimes central apneas will go away or reduce to acceptable levels with cpap or bilevel machine use without back up rates.
A few centrals here or there...not alarming and actually is normal.

[pamedwards]

Thanks for explaining, guess that bridge will get crossed if needed.

[pamedwards]

Ok I feel like I need a degree to get all this. I attached a very very very rare very bad recent night and a more normal night. Thanks for helping and any feedback. The charts labels are all jumbled I have it set to standard. If any further pics or clarity on the charts are needed please let me know. And sincere thanks !

[pamedwards]

oops the blocked number for the bad night is 8.66
I also have an older cms that I used to record my sleep the recent week I stopped using the bipap due to the recall news if that would be of interest for comparison.

[Pugsy]

viewtopic/t158560/How-to-post-images-for-review.html

Read the above link...examples of what to show on the graphs.
Yours are so tiny...impossible to evaluate and we don't need all those anyway.

Do you have more good nights or bad nights?

Do you have periods of time during the night where you are awake but the mask and machine are on but you just can't seem to fall asleep?

[pamedwards]

I fall asleep easily with the mask on at bedtime but when i am awakened to being hot and heart beating hard, or other, i will be awake for a while with no
Mask and will fall back asleep with no mask for an hour or maybe 2. Its not menopausal more likely autonomic problem from my underlying post viral syndrome for decades. So when mask is on i am asleep. I have a bad nite with high numbers maybe 2 or 3 times a year. Most days ahi on machine is not up to 5 some days very low. My sleep was always better until an injury 9 yrs ago with bad pain that disrupted my sleep and circadian rhythm for about a year and Its been bad since then and my underlying condition worsened.
I will read the link and post what it suggests tomorrow. Yes the charts are tiny for me too and i have no idea what to check for yet. Thanks so much for assisting me.

[GrumpyHere]

Yes the charts are tiny for me too and i have no idea what to check for yet. Thanks so much for assisting me.

The easy way to set the OSCAR graphs in the preferred format:
1. Go to View menu - Reset Graphs - Standard.
2. In View menu, turn on Sidebar,
3. Again in View Menu turn off Daily Calendar and Pie Chart.

[pamedwards]

Hi again, here are the revised screen captures with the charts of interest (i think) expanded. The headings are still jumbled ? I had to expand them manually, the suggestions from GrumpyHere had them small like in my original posts. Thanks again for the help and any feedback. I had such a bad nite last nite I am going to post that screenshot here, if it belongs in a new post let me know.