Due for a new ASV machine

[Kiralynx]

It's hard to believe that it's been 4.5 years since I first got my Beastie. Beastie is this discontinued model:

https://www.cpap.com/cpap-machine/bipap ... -cpap.html

I'm assuming the current replacement for Beastie is this one:

https://www.cpap.com/productpage/pr-60- ... anced.html

I plan to approach my GP on a script for this, as I'm doing very well with my therapy, and frankly don't need to see a sleep doc, or have another study.

Problem is, I'm not certain exactly how to lay out what needs to go on the script -- and it WILL have to be spelled out in great detail because the local Apria branch has not, in 4.5 years, gotten a single order right, with the exception of my original Beastie, and then, I had to be the one to determine the best settings for it.

I know that I want

• the ASV, plus heated humidifier
• An 8 foot hose (It will come with a 6 foot, so this will have to be extra, and I may just get it from CPAP.COM instead of hassling with Apria, since the last time I ordered an 8' hose, they sent me a 6' one. When I called and told them they'd screwed up, they sent me a 10' hose. They finally got it right on the third try. I suppose the AVERAGE of the first two tries is 2 eight foot hoses....)
• Mask of patient's choice
• Cardreader -- this one will use an SD card, but while my home computer has an SD slot, my travel computer does not. https://www.cpap.com/productpage/respir ... igodigital
• Software -- not sure which one would be best, and will probably get this from CPAP.COM, also, unless Sleepyhead will work with the ASV, and I can figure out how to install it. https://www.cpap.com/productpage/encore ... igodigital

Any thoughts on the exact phraseology of a script?

[-SWS]

Hi Kira!

I'm assuming the current replacement for Beastie is this one:
https://www.cpap.com/productpage/pr-60- ... anced.html

That's the latest Respironics ASV offering alright. The settings on that machine are slightly different. Those settings in your closing signature convert to: 1) EPAP = 6cm (since EPAP min and EPAP max would both be set at 6), 2) PS min = 4cm, and 3) PS max = 8cm. Your script can include either BPM = auto or whatever your current rate happens to be if not auto-rate.

[Kiralynx]

Hi Kira!

I'm assuming the current replacement for Beastie is this one:
https://www.cpap.com/productpage/pr-60- ... anced.html

That's the latest Respironics ASV offering alright. The settings on that machine are slightly different. Those settings in your closing signature convert to: 1) EPAP = 6cm (since EPAP min and EPAP max would both be set at 6), 2) PS min = 4cm, and 3) PS max = 8cm. Your script can include either BPM = auto or whatever your current rate happens to be if not auto-rate.

Hey, SWS! Long time no "see!"

Thanks for the conversion on that. I was wondering how that PS stuff applied as I hadn't had a chance to research it.

[JohnBFisher]

You might want to see if your doctor can include "no substitutions" if he includes the manufacturer. Otherwise, your DME might try to substitute the less expensive Resmed unit. Of course, you might want to talk with your DME about this first, if you have a good working relationship with them.

Just a couple thoughts .. Hope it helps.

[tonycog]

I have the same machine as your "Beastie". I also have a second, identical machine as a backup. My original just turned over 10,000 hours (3.75 years) and my backup only has about 300 hours, so I'm probably good for awhile. But I'm pleasantly surprised to see the price of Respironics' new ASV is "only" $3500. When I got my original ASV it listed at close to $7K. My insurance pays for one machine and that's it, so I'll have to spend my own money for my next one. I'm glad to see the price is at least closer to what I would call "reasonable". Any ideas why the retail price is lower?

[Kiralynx]

You might want to see if your doctor can include "no substitutions" if he includes the manufacturer. Otherwise, your DME might try to substitute the less expensive Resmed unit. Of course, you might want to talk with your DME about this first, if you have a good working relationship with them.

Just a couple thoughts .. Hope it helps.

John,

A good working relationship with them? I get the feeling the current RT shakes in his shoes when I call for a new mask... because I insist that they give me the mask I want, not whatever they have on hand. I also won't tolerate their slipshod method of filling orders. I got tremendously lucky with the first RT when I got my ASV.

No Substitutions -- Dispense as Written. Gotcha.

I know lots of people are very fond of the Resmeds -- it's what my sister and my niece have -- but I've done well with the Respironics, and I see no reason to fix what ain't broke, as the saying goes.

[Kiralynx]

I have the same machine as your "Beastie". I also have a second, identical machine as a backup. My original just turned over 10,000 hours (3.75 years) and my backup only has about 300 hours, so I'm probably good for awhile. But I'm pleasantly surprised to see the price of Respironics' new ASV is "only" $3500. When I got my original ASV it listed at close to $7K. My insurance pays for one machine and that's it, so I'll have to spend my own money for my next one. I'm glad to see the price is at least closer to what I would call "reasonable". Any ideas why the retail price is lower?

Yes, I also have a second, identical machine to my Beastie as a back-up. Beastie has over 12,000 hours on her. My backup might have around a hundred.

Mine was around $7K, also, when I got it. I was very lucky to find a brand new one on the sadly deceased CPAPAuction to be my back-up for about 20% of the list price.

I have no idea why the retail price on the System One ASVs is lower. But I can't say I'm sorry to see that it is!

[StillAnotherGuess]

Problem is, I'm not certain exactly how to lay out what needs to go on the script -- and it WILL have to be spelled out in great detai.
Any thoughts on the exact phraseology of a script?

You want to present to your Dr. the simplest possible script. Not your detailed wish list. 8 foot hoses and card readers you buy on your own. Give the DR. what he will most probably write for you. Drs are not stupid. You need 3 things on your script for an ASV. EPAP setting. IPAP setting, and the words "ASV needed for CSA". You do not need to script min max settings (It is assumed your DME will set up your machine). Anything additional to the 3 required is non-sense. If you happened to get the Resmed, consider yourself lucky. Its the better ASV device.

[Kiralynx]

Problem is, I'm not certain exactly how to lay out what needs to go on the script -- and it WILL have to be spelled out in great detai.
Any thoughts on the exact phraseology of a script?

You want to present to your Dr. the simplest possible script. Not your detailed wish list. 8 foot hoses and card readers you buy on your own. Give the DR. what he will most probably write for you. Drs are not stupid. You need 3 things on your script for an ASV. EPAP setting. IPAP setting, and the words "ASV needed for CSA". You do not need to script min max settings (It is assumed your DME will set up your machine). Anything additional to the 3 required is non-sense. If you happened to get the Resmed, consider yourself lucky. Its the better ASV device.

Yes, I know everything on my wish list won't need to be on the script. Part of that was "thinking out loud," because I've had a set up that works well for me for years, and I haven't needed to think about it.

Why do you say the Resmed is a better ASV?

[johnthomasmacdonald]

You might want to see if your doctor can include "no substitutions" if he includes the manufacturer. Otherwise, your DME might try to substitute the less expensive Resmed unit. Of course, you might want to talk with your DME about this first, if you have a good working relationship with them.

Just a couple thoughts .. Hope it helps.

I was wondering if you consider the more expensive PR unit superior to the Resmed and why?

[StillAnotherGuess]

Why do you say the Resmed is a better ASV?

I have used both devices for years. so actually I am an expert on which machine is better if you truly need ASV mode. The Resmed device is superior because its alogrithum more closely mimics your normal breathing pattern. If you are dealing with Apria, you do not need to worry about superior algorithms. They will only give you the Respironics ASV device.

[JohnBFisher]

Why do you say the Resmed is a better ASV?

I have used both devices for years. so actually I am an expert on which machine is better if you truly need ASV mode. The Resmed device is superior because its alogrithum more closely mimics your normal breathing pattern. ...

I think it depends highly upon the symptoms with which the patient contends. We have members of this forum who found they could not tolerate the "task master" approach of the Resmed ASV unit. If someone has a tendency toward a fairly irregular breathing pattern (in terms of the rate, volume, or both), but otherwise do not have problems due to that irregularity (that is, the rate variance is not connected with central or obstructive apneas), then the Resmed ASV algorithm would not work as well. At least that appears to be the experience of the members of this forum.

I also have both units. It takes me a while to adjust to the Respironics unit - because I do in fact need the "task master" approach of the Resmed. But that's because my breathing irregularities are deeply connected with my central apneas. But I find I do sleep well with the Respironics after a week or so of adjusting to the Respironics ASV algorithm.

However, in this specific case I tend to agree with Kiralynx, if it works don't change it!

[JohnBFisher]

... I was wondering if you consider the more expensive PR unit superior to the Resmed and why? ...

In response to a comment I made, you posted the above question.

No, I do not consider it superior. Rather it has more flexibility in terms of therapy settings. For instance, the Resmed unit does not have the auto adjustment of the EPAP to address obstructive sleep apnea. But not everyone needs that. In fact some people find the change of EPAP disturbs their sleep.

But then I don't find the Resmed unit vastly superior to the Respironics unit. However, if the Resmed unit works, then just the fact that it is less expensive is an obvious advantage.

Let's say rather, that I think the appropriate unit for YOUR needs is the superior unit. Of course, the reality for most of us is that based on our DME we don't have a choice but to go with one unit or the other.

Hope that helps.

[StillAnotherGuess]

However, in this specific case I tend to agree with Kiralynx, if it works don't change it!

Apria won't change it, so Kiralnyx wins with her new Resperonics ASV. And all is well with the world.

[Kiralynx]

Why do you say the Resmed is a better ASV?

I have used both devices for years. so actually I am an expert on which machine is better if you truly need ASV mode. The Resmed device is superior because its alogrithum more closely mimics your normal breathing pattern. If you are dealing with Apria, you do not need to worry about superior algorithms. They will only give you the Respironics ASV device.

Well, everyone's needs are different, and what works for you might not work for me.

This doesn't mean that either Resmed or Respironics is a "better" machine. It only means that each has a different approach.

Resmed may be better for some situations. Respironics may be better for others.