Returning bipap user - 10 years later need new sleep study?

[Wayne02]

First some back-story:

I was diagnosed in about 1997 using a sleep study that was done in a hospital. Sleep doctor at the time prescribed a cpap, the went to a bipap when the cpap would not cut it.

Was sold an old discontinued model (at the time) style bipap that works great for me. Treating the apnea likely saved my life. You won't find a bigger proponent of cpap/bipap then me. I guard that old, huge, heavy, noisy bipap machine with my life.

I did not set foot in the docs office for the next 10 years. I did not know that insurance would replace hose, mask etc every 6 months. I had a custom made headgear and just purchased replacement nose pillows and replacement filters every so often over the Internet. I kept my hose clean, kept the humidifier chamber clean and they have served just fine for the last 10 years. I did wear out a fitting in the mask assembly a couple times but just replaced it with the equivalent from the plumbing section of the hardware store. I would adjust my pressure twice per year as I would bump it up .5 in the winter when I put a couple pounds on, then bump it back down in the summer when I dropped those few pounds.

Fast forward to this month when I returned to the docs office to see if I could get a new machine that would run on 12v. I find that my previous doctor is retired on a yacht somewhere and everyone of the quality techs is long gone.

I tell the new doc that I would like a machine with the same operational characteristics as my 1997 and one that would efficiently operate on 12v. He prescribed the respironics m-series which the insurance approved and I picked up this morning after meeting with the doctor. Hopefully the m-series will work as well as my old reliable.

Now the doc says I should have another sleep study done. Apparently the studies are now done in clinics with "technologists". He says I will try to sleep half the night with no bipap and half the night with their "industrial bipap machine". He claims that the pressures I was prescribed by the original doc back in 97 are "odd" in that there is such a wide gap between inhalation and exhalation pressures, 15.5/4. However, he also acknowledged that it is hard to argue with the success I've had over the last 10 years as well.

I was wondering if any of you had second sleep studies done and if they proved beneficial or not????

Thanks
Wayne

[bdp522]

By all means go for the study. Things change over time and you could always go back to your old pressures if you feel better with them. Just think, with a new study you might be able to feel even better than you do now.

Brenda

[blarg]

I'm surprised he wants to put you up for a split night. It's pretty well established that you have apnea...

Perhaps a BiPAP titration only is in order?

[Goofproof]

If you hadn't already got the "M"agic Bi-PAP, the best deal would have to get the Remstar Auto BiPAP Classic, and the software and reader. Then you could have had a sleep study every night at home for less that the sleep study and the machine you got. Jim

[Patrick A]

[quote="Goofproof"]If you hadn't already got the "M"agic Bi-PAP, the best deal would have to get the Remstar Auto BiPAP Classic, and the software and reader. Then you could have had a sleep study every night at home for less that the sleep study and the machine you got. Jim

[Wayne02]

The Remstar Auto Bipap will not run on 12vdc. You need to buy a special cord from Cpap.con to run it on DC That's why I went to the M-Series auto Bipap, so I can use it in my Motor Home.

Yes, same here. This is the reason for going with the M-series. I wanted the most efficient 12v model and the 12v run times are much longer on the m-series than the legacy (respironics auto bipaps) machines. The respironics tech quoted me ~7 hours for the legacy, and ~25 hours for the m-series. That's the difference between one night and 2-3 nights in the back-country for me.

I had a legacy loaner for this past weekend on a two night camping trip. They also loaned me the special 12v adapter cord. Running off of two fully charged, healthy, 12v dc deep cycle batteries, I got 10 hours run time before the batts were run low enough that the bipap timed out in error. My hope is the m-series will do better than this as the specs seem to indicate.

I did discuss the issue of the card deal with the doctor also, and he indicated that 90% of the time they don't use the card for true diagnostic purposes but as proof of compliance for difficult insurance company issues. He indicated that they have had somewhat limited success with actually using the recorded data as a true diagnostic tool, but that it was a, "good sales feature". Who knows if this was true or not [shrug]

Even my ancient 1997 bipap has a data port, cable, and software to download all the stats, but I've never had call to use it in the past 10 years. Similarly, my wife has used one of the respironics bipap autos (legacy series) for a couple years now and never had reason to pull that card out and use the data. Would it be nice to have the data collection feature, sure I suppose it would, but not at the expense of 12vdc run time.

Wayne

[Patrick A]

Wayne

I had ordered a new Remstar Auto Bipap. I called Respornice and was asking about a power pack I was thinking of buying.


I told the customer service Rep. His name was Tom or Todd I don't really remember(need more coffee and Old Bushmills )

Anyway he explained that using any 12v hook up the machine I had ordered he said I would be lucky to get 6 to 8 hours out of the battery or their batterypack.

So that is why I went to the M series and I saved my self $165.00 bucks. Being as I already had or have two of the cables that the M-series uses.

So if you get your M series before I get my M-series let me know how you like it.

[Goofproof]

I realize 12 Volt is easyier to deal with, but there might be a true reason most Bi-PAP's run on 24 Volts. The BiPAP is supposed to be a heavy duty PAP, the specs used to be 4 cm to 30 cm, now they are selling 12 volt downgrades, rated 4 to 25 CM.

That's life, getting what you want, but that doesn't make what your getting better. If you run a motor off 24 volts instead os 12 volts and the motor does the same work (Output), it will draw 1/2 the current and run twice as long on the same amps.

Where the loss of power comes in is using a converter to 110 volt A/C.

OTR Trucks have 24 Volt DC power too. Jim

I go by the idea, Smaller, Lighter, Cheaper = Weaker.

[ICantGetNoSleep]

Got a picture of the ancient relic?

[Stefernie]

You definitely need a new study after this long.

I forget who said it, but yes, you may just need a new titration study.

A split night doesn't sound like a bad idea though, just to see where your apnea currently is with no treatment.

[Wayne02]

Did the sleep study the night before last. Went a little less than two hours without a machine. The tech was a little confused that the doc had called for a split study since I have been on bipap for 10 years. He was even more confused when I told him that the doc had already written the prescription for the new machine, the insurance company had approved it, and I had received the machine. [shrug]

At any rate, I gasped my way through the two hours, then they hooked me up to their bipap, and played with the pressures for awhile. Finally, I had enough of the crappy sleep and left the building at 5am. (Tech said I was technically "awake" at 4am so no use in hanging around if couldn't sleep) I guess the tech is not supposed to tell the patients anything about the study but he told me they ended up at 12/8 for the pressure. When I asked him if there were many apnea's during the first two hours he looked at me and said, "yeah, it was pretty bad". Almost like I had sleep apnea or something... LOL

I love how they have you fill out a "post sleep study survey" with questions like, "do you feel well rested and alert this morning?" "did you sleep soundly last night?" Heh, well let me think about that for a moment... I was in a strange bed, in a strange room, with 6 billion wires stuck on me, two cameras watching my every movement, doors slamming, voices talking outside the room, people coming in and out of the room during the night... oh yeah, I slept just fine!

Oh well, it's a done deal now, and maybe the new info will be helpful.

[Wayne02]

Got a picture of the ancient relic?

I'll try and take a picture of it this weekend when I swap out the new m-series in its place.

[Wayne02]

I go by the idea, Smaller, Lighter, Cheaper = Weaker.

In general, I agree with this, that certainly seems to be the trend with consumer goods these days as the manufacturers pull cost out the products, oftentimes at the expense of quality.

I will say that my wifes 2 year old respironics auto-bipap legacy machine (I think this is the one that folks on this forum refer to as the "tank"?) is less robustly built than my old machine. And, this m-series I just received seems less robustly built than my wife's machine.

My old machine weighs a ton and is huge in size but is very well built. When I was issued that machine they did not have padded cases for them, so I ended up using an old un-padded gym bag, which I used to tote that machine all around the U.S. and Japan over the last 10 years. At times it was not treated gently, but just keeps on ticking. Only time will tell if my new m-series will last as long.

[Wayne02]

Wayne

I had ordered a new Remstar Auto Bipap. I called Respornice and was asking about a power pack I was thinking of buying.


I told the customer service Rep. His name was Tom or Todd I don't really remember(need more coffee and Old Bushmills )

Anyway he explained that using any 12v hook up the machine I had ordered he said I would be lucky to get 6 to 8 hours out of the battery or their batterypack.

So that is why I went to the M series and I saved my self $165.00 bucks. Being as I already had or have two of the cables that the M-series uses.

So if you get your M series before I get my M-series let me know how you like it.

This is pretty much the road that I have traveled as well. I received the m-series the night before last and it came with two 12v cords, one with alligator clips, and one with cig adapter end. I will have to wire in two power port female cig adapter outlets in my rv for these machines. One on each side of the bed, one for my wifes machine and one for mine.

This new machine is set at my current pressure of 15.5/4 which I have been using on my old machine for the last 10 years. I tried the new machine but only made it two hours before going back to the old machine for the night. Just not the same rhythm/sensitivity I guess.

The sleep study I just did ended up at 12/8 according to the tech. The doc is off next week so I won't see him to review the sleep study results for another week and half. I'm going to use this time and play with the pressure and sensitivity settings on this m-series and see if I can get it dialed in for my use.

Wayne

[Wayne02]

Old machine on the left, m-series on the right.

Had a bit of a breakthrough last night with the new machine. The problem I was having with both the loaner legacy auto bipap, and to a lesser degree my new m-series is the inspiratory cycle would shutdown before I was done inspirating.

I played with the bi-flex settings but that did not help much. I then disabled biflex completely which gave me access to the rise time comfort setting menu (biflex has to be disabled to make use of rise time). I set the rise time to 1 and that took care of the problem for the most part. The machine now has smooth transitions between inspiratory and expiratory cycles like my old machine has, and is not cutting me off 7/8th of the way through my inspiratory cycle.

I had the new machine set at my current prescription which is 15.5/4 but had to turn the inspiratory pressure down because 15.5 on this new machine was too strong. I then tried 13.5/6 and that was much better. I'll continue to play with the pressures till I hit the sweet spot. The sleep study I had the other day ended up at 12/8 so maybe I'll try that next.

Wayne