Bipap Auto or Bipap ASV

[kirbini]

I have been using a AirCurve10 ASV machine for 5 years and I think it is about time to replace it. I don't have many OSA events, in fact, I often don't have any just some unclassified apneas and some central apneas. Mostly, I have Central apneas and when i bought the ASV machine I was having a lot of them because I was using Kratom for pain management and didn't realize that because it has opiate like qualities it was affecting my breathing. I discontinued the use of it about a year ago and my system is cleaned out. I bought a new AirCurve 11 Auto because it was several hundred dollars less than the AirCurve 11 ASV. I have not unpacked it because I am not sure if I should use the auto instead of buying another ASV. I also have a AirSense Auto and have tried using it but it does not control my CSA. My question is do you think the AirCurve Auto would suffice or should I get another ASV?

Attached is a typical night's data - my AHI usually runs anywhere from 2 to 6. It works so I don't mess with it. Sometimes I have leaks.

[mlmollenkamp]

If your events are dominated by centrals an auto BIAP isn't an optimal solution. BIPAP is mostly used to make CPAP more comfortable. I have complex apnea with mixed central and obstructive events, but I usually have about 3 central for every obstructive. EPR on a auto CPAP (S10 in my case) makes my central apneas dramatically worse. EPR is basically a fixed form of BIPAP with just 3 settings. I bought an AirCurve ASV out of pocket because I wasn't happy with the results I was getting with an S10, but insurance wouldn't approve an ASV. I still use the S10 for short term travel, but I feel better with the AirCurve ASV. I can get by with an S10 or even a fixed CPAP, but its difficult to get settings that work well enough with any consistency.

If you could borrow an auto CPAP or a BIPAP and run it for a few nights you could see if central events still dominate.

I would add that my ASV was used, but it only had about 700 hours. It was about the same price as a new S10 or S11 Autoset.

[bwexler]

Not an expert on this.
I have never used a BiPap Auto.
I have been using an ASV for about 12 years now.
First insurance bought me a Philips which I used for about 5 years. I still have it.
Than I bought a used Resmed Aircurve 10 ASV Used out of pocket. This has now replaced the Philips as my travel machine.
Than I bought another used Resmed Aircurve 10 ASV Used out of pocket. I then convinced my Medicare Advantage Plan to reimburse 80% of the cost. I used simple logic. Insurance could pay for 5 years of copays or pay up front less than ONE year of copays and be done for five years. That was the same logic I used on myself, to convince me to buy the used (low hour) machines even if insurance did not cooperate.

I now own three machines and am set for about three remaining years before I have to go machine hunting again.

[Nocibur]

My WAG is your issues were not related to altitude (because 4500 ft isn't a lot and you should have acclimated because you live there), it wasn't Kratom (because there's no scientific data that it wreaks that much havoc on SDB), and based on the limited information available IMO you got plain ol' TECSA perhaps tainted by a reduced EF.

The best answer is get another diagnostic NPSG F/B NPSG with CPAP Titration instead of DWing and then using syllogistic reasoning to find diagnostic zebras.