30 years of OSA therapy. Where do I go next??

[rudyrx]

Hello all,
It has been along time since I posted on this forum but need some advice from some of you in the know. After 30 years of OSA therapy ranging from the very first CPAP machine ever made (just kidding) to a UPPP, GGA, and a few other assorted surgeries and dental fixes for OSA, I am at the crossroads of buying the best machine and newest for me at this time.
After some rather weird morning symptoms to the poiint of being pretty disoriented for 2 to 3 hours off and on for a few mornings lately, my daughter insisted on letting her drive me to the ER for evaluation. ER doc diagnosed me with Hypercapnia or an increased CO2 level in my blood. So that was somewhat of a surprise to me since I tend to focus and have always looked at O2 values in the limited reports I have access to with my current system. This event plus the fact my backup APAP went haywire, I am in the market for the best machine out there after using an auto-pap (the Devilbiss intelipap machine) with many miles on it for the last several years. Cost is not a concern at this time since we all know health is so much more important.
ALSO-- At issue here is the fact that I have been over the past few years considered a "chronic Pain Patient" and am being treated with opioids which I wished I didn't, but we have few choices in life at times. I have been on pain meds for about 10 years now after being run over by a boat and trailer on a boat ramp-Long story. Yes I know the sleep apnea and pain meds don't mix, but don't go there since I am a pharmacist and my doctors are all well aware of this fact, but I still need apnea therapy As a result of my recent visit to the ER and all these other issues, the focus on the Servovent or Vpap type since there is much new data coming out in this area. Does anyone have any first hand knowledge of using this type machine? I am looking at buying a ResMed Air Curve 10 SV from the folks at CPAP.com as I have done for many years with all my apnea needs.
I use a full face mask either a Hybrid or a ResMed Quattro FX alternating between the two. Any thoughts or comments are welcome since I am trying to decide what machine to buy and if the ResMed Air Curve 10 SV is the best choice for my use as my number one machine and put the APAP in semi retirement as a emergency backup.
Thanks to all of you in advance for your comments or thoughts.
RUDYRX in OREGON

[Julie]

Hi, it's not clear if e.g. a new study indicated that you need an ASV machine, or if you're just thinking about getting one. If you don't need it, the newest Apaps out there are the Resmed Airsense 10 autoset and the comparable one from Respironics (see Cpap.com for details). I don't suppose you've ever considered trying to lessen the need for opiods by e.g. smoking something that's now legal (medically in most places) and may be more effective as far as overnights go - less impact on OSA or Cpap? I don't normally bring that up, but in your case I really wonder how much the Rx meds are affecting your sleep.

[Sleeprider]

You may fit the profile for use of the Aircurve SV. Opioid use is often associated with central apnea. Regardless, I think the machine can be configured to work in several modes without ASV as well. It might be useful to have a study and prescription that would allow you to be reimbursed, or insured for a more expensive device like this, and knowing the cause of your hypercapnea could be useful. At this point you're making some assumptions regarding cause for this health issue.

Anyway, there are quite a few members that use this type of machine and even those that don't require adaptive ventilation seem to do very well with this approach. Best of luck.

[jnk]

I wonder if the nature of the root cause of the high CO2 levels in your specific case may be key somehow, or may point to machine needs or contraindications for certain machines. I am certainly not qualified to parse any of that. Maybe putting words like ASV, hypercapnia, opiates, etc. into your subject line might get more attention from the more medically experienced ones who sometimes glance at the subject lines of threads here.

[rudyrx]

THANKS for the responses from all. My error in not telling you in the first message I am scheduled my #??? sleep study next week. The elevated Co2 levels came from blood gasses at ER visit. I am aksing the question if indeed there is Central apnea at play here about use of the Aircurve 10 AV is a good machine in this area since published studies use VPAP as the preferred choice in this pt profile. I guess I got a little ahead of myself in not waiting for the results. I will get back to you all after I get my study results back. Thanks again for the replies and yes I have considered the use of a certain other agent for pain and have no objection to it what so ever.
RUDYRX

[Pugsy]

Yes...if it is determined that centrals are present in numbers high enough to warrant concern the ResMed AirCurve10 AV would be an excellent choice of machines to do both...take care of obstructive apnea and take care of any central apneas too.

Their product page isn't as helpful as the product page for the S9 Adapt was but now I can't seem to find the old product description page. The AirCurve 10 ASV is pretty much the same as the S9 Adapt model 36037.
I can't seem to get to web pages for ResMed outside the US and that's where the other product descriptions were.

http://www.resmed.com/us/en/consumer/pr ... 0-asv.html