Where can I try a Bi-Pap in the UK?

[canyouhearmeaya]

I had a private sleep study done last year through 'Intus' and they concluded was UARS (15 RDI), I went through the NHS afterward and they said there was no problem because I didn't have 'Sleep Apnea', but of course as you all know, UARS scoring and sleep apnea is different, and those that have had to deal with the NHS have probably also experienced how useless they can be with any SDB outside of conventional sleep apnea.

I tried APAP therapy with a ResMed Airsense 10 Autoset 'For Her' (went for 'For Her' to try the alternative mode as well as I heard it dealt with RERAs differently.) No relief. However the machine continuously shows lots of Flow Limitations throughout the night, but having tried various pressures I can't seem to get any relief. (I also struggle to exhale against much pressure, which I understand is fairly common in UARS.)

Does anyone have any idea where I might be able to get my hands on a Bi-PAP in the UK to try it, without a prescription? In desperate need to try it, as i've had no success with other options. (APAP, Mouthpiece)

[rick blaine]

Hello again, canyouhearmeaya,

As a matter of forum etiquette, you might remind people that you started what became a very long thread back in June and July of 2018.

As to your current request – it seems what you have is UARS, and you have tried treating that with APAP. (You bought your own Aursense 10 Auto because, under the NHS guidelines, they weren't going to supply a machine for you.)

That is a very capable machine, but apparently did not help you. What makes you think a bi-level will make the difference?

As to the practicalities, I'm quite well-informed on provision for sleep-disodered breathing in the UK, and I can't readily tell you who in this country would let you trial a bi-level. I do know of two sleep medicine departments who have voluntarily 'moved patients up' to a bi-level. But said patients quite clearly have OSA, and weren't doing well on APAP.

There are a few places in the private sector that will let you hire an auto for a week, but not, AFAIK, anything more sophisticated.

The lung function department of any of the 150 foundation trust hospitals no doubt has a stock of bi-levels, ASVs, and ventilators. But you would have to (a) be referred to them, and (b) convince them that it's worth trying a bi-level on you.

You could call either Philips Respironics UK or ResMed UK and say you want to buy one. But bi-levels are a good bit more expensive than the APAP you already have tried. And the same cost-factor comes into play if you were to by a second-user bi-level machine from overseas and import it.

The best idea I can come up with is for you to ask your GP to write to a few of the nearest lung function departments and as a courtesy ask if you might be trialed on a bi-level.

Do you understand? Not as a clinical necessity – not as part of the NHS contract – but as a courtesy.

I don't know much about UARS. I'll leave it to those who do to say whether, you having tried the best APAP there is, whether or not a bi-level might make that much difference.

[canyouhearmeaya]

Hi Rick,

Thanks for the reply. The reason I thought Bi-PAP would be worth a go is purely going by what I've read online with other peoples experience, that UARS patients often need a greater disparity between inhale and exhale pressure, which Bi-PAP would offer. The airsense 10 I have as you have said is a capable machine, however only offers EPR upto 3, which from what I understand is often not enough for many with UARS. My own experience has mirrored this with difficulty exhaling against the machine, especially against pressures above 9/10.

I have an appointment with my GP on the 20th of January so that is something I will bring up also - I'm just not overly hopeful, especially as I've already been through the sleep department.

I'm assuming the flow limitations the CPAP is throwing back through sleepyhead are the problem - there seems to be a fair amount of them, but the APAP seems to provide no relief. Not sure what else to try.

[Jas_williams]

LSAT is selling a used Low hour Resmed VAuto buy it ether use a shipping service or pay LSAT to ship internationally all you will need is the UK power cord of your autoset for a reasonable sum. You can always resale later if it doesn’t work.

Vat will be due on import so allow an extra 20%

[canyouhearmeaya]

LSAT is selling a used Low hour Resmed VAuto buy it ether use a shipping service or pay LSAT to ship internationally all you will need is the UK power cord of your autoset for a reasonable sum. You can always resale later if it doesn’t work.

Vat will be due on import so allow an extra 20%

Good spot! Thanks, I've dropped LSAT a PM to enquire. So are you saying I can take the power cord from my UK Airsense 10 and just plug it into the back of the Aircurve, without the need for any adapters etc?

[Jas_williams]

LSAT is selling a used Low hour Resmed VAuto buy it ether use a shipping service or pay LSAT to ship internationally all you will need is the UK power cord of your autoset for a reasonable sum. You can always resale later if it doesn’t work.

Vat will be due on import so allow an extra 20%

Good spot! Thanks, I've dropped LSAT a PM to enquire. So are you saying I can take the power cord from my UK Airsense 10 and just plug it into the back of the Aircurve, without the need for any adapters etc?

Absolutely just use the figure 8 cable and the brick with the aircurve but or use your autoset psu

or you can buy one of these as the power brick is dual voltage

https://www.amazon.co.uk/Pharos-Industr ... ure&sr=8-3

[canyouhearmeaya]

LSAT is selling a used Low hour Resmed VAuto buy it ether use a shipping service or pay LSAT to ship internationally all you will need is the UK power cord of your autoset for a reasonable sum. You can always resale later if it doesn’t work.

Vat will be due on import so allow an extra 20%

Good spot! Thanks, I've dropped LSAT a PM to enquire. So are you saying I can take the power cord from my UK Airsense 10 and just plug it into the back of the Aircurve, without the need for any adapters etc?

Absolutely just use the figure 8 cable and the brick with the aircurve but or use your autoset psu

or you can buy one of these as the power brick is dual voltage

https://www.amazon.co.uk/Pharos-Industr ... ure&sr=8-3

That's great, thanks!

[Jas_williams]

The only thing that won’t work on a us version of the machine in the uk is the cellular modem. But as your not reporting to anyone it’s not an issue and the SD card gives much more information.

[D.H.]

LSAT is selling a used Low hour Resmed VAuto buy it ether use a shipping service or pay LSAT to ship internationally all you will need is the UK power cord of your autoset for a reasonable sum. You can always resale later if it doesn’t work.

Vat will be due on import so allow an extra 20%

It's a shame that they're charging VAT on medical equipment. I suggest you request that it be waived (the worst they can say is "no").

Alternatively, I believe that you can travel to Thailand, see a doctor, be tested, and be sent home with appropriate equipment for much less that the U.S. (or U.K.) price. You will need to cover air fare, meals (Thai food might be problematic for westerners), and accommodations for nights that you're not in the sleep lab. I'm not sure if you'll need to pay VAT if you're carrying it personally. Note that xPAPs are medical equipment and are not counted against your baggage max when flying home.

[rick blaine]

Hey, D.H. – please do not post about import duty on goods coming in to the UK or about Value Added Tax at any time when you don't know what you're talking about.

1. Customs duty. If anyone brings goods into the UK – whether in person or via a carrier – then, depending on the declared value, there is either: no customs duty, duty at the current lower rate, or duty at the current higher rate.

2. Value Added Tax is not charged on medical equipment, provided the end-user is a patient and has claimed exemption in writing or via the usual forms.

But – and it's an important 'but' – VAT may be charged on the customs duty – if there is any payable. See above about the three-part range.

3. Shipping. The recipient does have to pay VAT on the cost of shipping, even though the shipping service began outside the UK, and the fee for that shipping goes out of the UK.

And that's it.

[tan]

I had a private sleep study done last year through 'Intus' and they concluded was UARS (15 RDI), I went through the NHS afterward and they said there was no problem because I didn't have 'Sleep Apnea', but of course as you all know, UARS scoring and sleep apnea is different, and those that have had to deal with the NHS have probably also experienced how useless they can be with any SDB outside of conventional sleep apnea.

I tried APAP therapy with a ResMed Airsense 10 Autoset 'For Her' (went for 'For Her' to try the alternative mode as well as I heard it dealt with RERAs differently.) No relief. However the machine continuously shows lots of Flow Limitations throughout the night, but having tried various pressures I can't seem to get any relief. (I also struggle to exhale against much pressure, which I understand is fairly common in UARS.)

Your story looks very familiar. And, yes, VPAP has helped me personally, and not only because of its pressure support variance, but also because of its configurable trigger/cycle setting (very high in both cases). I think someone else here, (slowriter?), mentioned the same

[D.H.]

Hey, D.H. – please do not post about import duty on goods coming in to the UK or about Value Added Tax at any time when you don't know what you're talking about.

1. Customs duty. If anyone brings goods into the UK – whether in person or via a carrier – then, depending on the declared value, there is either: no customs duty, duty at the current lower rate, or duty at the current higher rate.

2. Value Added Tax is not charged on medical equipment, provided the end-user is a patient and has claimed exemption in writing or via the usual forms.

But – and it's an important 'but' – VAT may be charged on the customs duty – if there is any payable. See above about the three-part range.

3. Shipping. The recipient does have to pay VAT on the cost of shipping, even though the shipping service began outside the UK, and the fee for that shipping goes out of the UK.

And that's it.

The idea that taxation of one type or another might apply was based on a prior posting. Verifying everything that every posting claimed would be a full time job! My point was that if they collect (or attempt collect) any form of taxation, the OP should respectfully request that it be waived (and refunded if already paid). The worst possible answer to such a request would be a simple "no!"