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[SirGaspAlot]

The one I have listed is exactly what I have- a Dreamstation auto-bipap.

[squid13]

You would need an ASV machine for complex apnea.

[SirGaspAlot]

Yes, except being a retired Navy guy like yourself, of course you know Tricare will not cover it. At all. So according to my Dr., this will supposedly "respond well" to an autobipap.

[SirGaspAlot]

I'm thinking it's time for a chat with the Doctor.

[palerider]

The one I have listed is exactly what I have- a Dreamstation auto-bipap.

Auto bipap machines *detect* centrals, they do *nothing* to treat them, you have to have an asv , as squid13 said, or the older, poorer tech, the s/t.

[palerider]

I'm thinking it's time for a chat with the Doctor.

Post some charts, let's see if you have a central problem... Howtos in my sig.

[SirGaspAlot]

I'm thinking it's time for a chat with the Doctor.

Post some charts, let's see if you have a central problem... Howtos in my sig.

I'm nowhere near a computer but last nights AHI was 53 clear airway events and 35 obstructive apneas. That's from my Dreammapper app.

[Okie bipap]

Yes, except being a retired Navy guy like yourself, of course you know Tricare will not cover it. At all. So according to my Dr., this will supposedly "respond well" to an autobipap.

Do you qualify for treatment through the VA? If you do, you may be able to get one through them.

[Pugsy]

What is the model number on your machine...should start with DSX and 3 digits and maybe a combinations of digits and letters at the end of the first 3 digits.
The model you have showing in your profile...the DreamStation BiPap Auto is model number DSX700xxx.
It does NOT treat central apneas. It ignores them. To actually treat a central apnea the machine has to be able to force a breath at a timed interval and with a higher PS (difference between inhale and exhale) that the BiPap Auto can ever deliver. It simply won't/can't breathe for you when you have a central. I will flag them but it will ignore them in terms of trying to prevent them from happening. It just can't respond fast enough with big enough and any sort of timed back up rate for if you don't breathe on your own.

So either you have chosen the wrong machine in your profile or someone doesn't know what the machine can and can't do in terms of central apneas.

[SirGaspAlot]

DSX700T11C is what I have.

[Pugsy]

DSX700T11C is what I have.

That is indeed the DreamStation BiPap Auto...and it does NOT have any abilities to do anything in terms of the central apneas that might be happening.
It has no back up rate available to force a breath and it simply won't even try to respond to central apneas because it can't increase the pressure as needed between inhale and exhale to force the breath.
Simply can't do it. I own the prior big brother model PR S1 model #760....so I know exactly what it can and can't do.

Now maybe your doctor is hoping that with time any central apneas you have have will disappear on their own..and that would leave the Bipap Auto treating the obstructive stuff...and he might be doing that if your centrals popped up during the titration sleep study and you didn't have many when doing the diagnostic sleep study....that does sometimes happen so not totally impossible.
All depends on how many centrals we are talking about here 2 per hour average or double digit per hour averages.

This machine can actually treat centrals.
https://www.usa.philips.com/healthcare/ ... ion-system

[palerider]

I'm thinking it's time for a chat with the Doctor.

Post some charts, let's see if you have a central problem... Howtos in my sig.

I'm nowhere near a computer but last nights AHI was 53 clear airway events and 35 obstructive apneas. That's from my Dreammapper app.

The *count* of events is meaningless without the hours, which is why AHI is an hourly average.

If you only slept two hours, then those are terrible numbers. if you slept 10 hours, then it's 'good enough' for doctors purposes (but not mine).

The fact that it says 53 centrals, however, is further evidence that your machine does nothing for centrals.

[Pugsy]

I would be having a heart to heart with the doctor...not the DME at this time.
Figure out first if the DME even gave you the machine the doctor wanted you to have for those centrals. DMEs have known to supply the wrong machine and not what the doctor ordered because either they are stupid and won't learn which machines do what or they don't care.

If its possible that the doctor may be thinking that your insurance will require a "fail" with the current machine in terms of effective treatment before it will spring for the higher dollar machine. This sometimes is what happens. Insurance won't approve payment for the more costly machine without proof the cheaper machine won't do the job.

If you had centrals without being on cpap....not much chance of them going away on their own. Very remote chance maybe of those centrals ever reducing since cpap didn't cause them. Something else caused them if they were present on the diagnostic sleep study in large numbers (over 5 or 10 per hours) during the diagnostic sleep study.
Now if they developed only during the titration study it might (stress the might) be that they centrals will go away with some time and that's what the insurance company would want to prove or not before paying for a newer and more expensive machine.

Best thing now with this machine that won't/can't do much to reduce the centrals is talk to your doctor about how he plans to address the centrals and at the same time address the obstructives. You probably need a different machine unless those centrals shown are related to the apnea obstructive events. I have seen that happen so it's not impossible...reduce the OAs/hyponeas and the centrals reduce because they most likely are post arousals because of the obstructive stuff happening and with the reduction of the OAs the chances for SWJ centrals (not real) or numerous sleep onset centrals (normal to see and not usually a problem unless causing problems of some sort with sleep itself or O2 levels.

[chunkyfrog]

How accurate can the event count be if the mask is leaking/causing excessive arousals?
As time passes, many things tend to level off by themselves.
Also, I have found a mask liner to be effective in keeping the mask quiet--even if leaks still occur.

[palerider]

If you had centrals without being on cpap....not much chance of them going away on their own. Very remote chance maybe of those centrals ever reducing since cpap didn't cause them. Something else caused them if they were present on the diagnostic sleep study in large numbers (over 5 or 10 per hours) during the diagnostic sleep study.
Now if they developed only during the titration study it might (stress the might) be that they centrals will go away with some time and that's what the insurance company would want to prove or not before paying for a newer and more expensive machine.

Heck, the bipap could exacerbate the centrals.