Which new Bipap or ASV machine?

[Rural]

My unusual circumstance:

I'm a physician doing relief work overseas. Like many docs, I'm not a "good" patient. I've had sleep apnea issues for some time and I need to do something about it. I won't have access to a sleep study for at least 6 months.

I need at least a CPAP but for comfort I'd prefer a Bipap. I'd prefer ASV capability should centrals be an additional issue as not having to ship multiple machines is more important than cost to me. Data capability is required to help guide therapy in the boonies though the machines I've been looking at all seem to offer the necessary data.

Assuming that money isn't an issue it seems as though I should purchase just a Bipap and hope that I don't have and/or don't develop central issues, or, purchase an ASV machine and set it to run, if possible, in CPAP or Bipap mode.

The following machines seem to be what I think I need:
Option A (Bipap only)
Resmed VPAP Auto
Respironics DS760HS

Option B (ASV capable)
Resmed VPAP ADAPT SV
Respironics Ds960 AutoSV


Thoughts/understanding:
-The Resmed VPAP ADAPT manual seems suggests that it has a "CPAP" mode. I would accept this if I didn't need the ASV mode.
-On the Philips webside it states that the Respironcs DS960 AUTO SV will not operate like an auto CPAP or auto Bipap for obstructive events, but goes on to say that the "obstructive component..is treated by adjusting the C/Bipap pressure levels."
-Other postings on this website suggest that, so long as long apneas are not present, adjusting I/Epap levels are possible with both the Resmed and Respironics ASV machines that may effectively allow the machines to act as a CPAP or Bipap.

Are the thoughts/understandings correct? Any other advice would be appreciated.

I applaud all of you who take the opportunity to take charge of your health and help others when "the system" clearly is letting you down.

Many thanks as best regards.

[HoseCrusher]

I like your thinking but let me poke some holes in your logic.

First of all without a diagnosis you are shooting in the dark.

This is important to understand because most people don't need the additional pressure that is available in BiPap machines. It is very likely that you could be adequately treated using an APAP machine.

Using an APAP machine allows you to do a self titration. That would allow you to dial in the pressure that works best for you. If you have a machine that offers EPR you have a mini version of the BiPap machine. EPR is limited to a maximum drop of 3 cm H2O but if your self titrated pressure is 12 that would be a 25% reduction in exhale pressure.

Since you won't know if centrals are an issue or not I think you would be better off with an APAP machine with EPR.

Keep in mind that the data recorded by the machine is all based upon air flow data. It is extremely helpful but is not a primary diagnostic tool.

Since you are planning to have a sleep study in the near future, this type of machine would give you some help and has a high probability of totally taking care of your needs.

Just some thoughts to consider...

[Rural]

I appreciate the feedback and your logic as well.

In my specific circumstance I'm in a situation where shipping costs are a substantial percentage of the overall purchase cost. Statistically it would indeed seem that an APAP machine will offer at least an 80% chance of providing what I need. I may end up going that route.

Thanks again for your input and time.

[musculus]

If money is not an issue then why not ASV?

My unusual circumstance:

I'm a physician doing relief work overseas. Like many docs, I'm not a "good" patient. I've had sleep apnea issues for some time and I need to do something about it. I won't have access to a sleep study for at least 6 months.

I need at least a CPAP but for comfort I'd prefer a Bipap. I'd prefer ASV capability should centrals be an additional issue as not having to ship multiple machines is more important than cost to me. Data capability is required to help guide therapy in the boonies though the machines I've been looking at all seem to offer the necessary data.

Assuming that money isn't an issue it seems as though I should purchase just a Bipap and hope that I don't have and/or don't develop central issues, or, purchase an ASV machine and set it to run, if possible, in CPAP or Bipap mode.

The following machines seem to be what I think I need:
Option A (Bipap only)
Resmed VPAP Auto
Respironics DS760HS

Option B (ASV capable)
Resmed VPAP ADAPT SV
Respironics Ds960 AutoSV


Thoughts/understanding:
-The Resmed VPAP ADAPT manual seems suggests that it has a "CPAP" mode. I would accept this if I didn't need the ASV mode.
-On the Philips webside it states that the Respironcs DS960 AUTO SV will not operate like an auto CPAP or auto Bipap for obstructive events, but goes on to say that the "obstructive component..is treated by adjusting the C/Bipap pressure levels."
-Other postings on this website suggest that, so long as long apneas are not present, adjusting I/Epap levels are possible with both the Resmed and Respironics ASV machines that may effectively allow the machines to act as a CPAP or Bipap.

Are the thoughts/understandings correct? Any other advice would be appreciated.

I applaud all of you who take the opportunity to take charge of your health and help others when "the system" clearly is letting you down.

Many thanks as best regards.

[squid13]

If money isn't an issue I'd start out with the S9 Vpap Adapt Auto 36037 and start with the default settings and go from there, that's what I did and over a period of time working with just the min epap and min ps setting got my therapy just right. What ever you get come back and we can get you the clinical manual so you can access the SECRET SETTINGS . I know people say you need a sleep study but sometimes you got to do what you got to do. With the Adapt auto you have 3 machines in 1 Cpap, Asv, and Auto Asv.