Trying to Purchase a philips respironics Bipap asv dsx900 in the UK?

Diagnosed with Severe sleep apnea, currently on a Resmed airsense 10 CPAP, Pressure 10, Pressure relief on 3. Feels like I’m exhaling against a brick wall, dispute my IPAP pressure being super low for my AHI. Given my sleep, my IPAP should be much higher but it’s literally impossible for me as I can’t exhale. Even at pressure 10, it’s horrible, I get constant mouth leaks when exhaling (I use a nasal mask, FFM gives me severe Aerophagia). overall I want a BIPAP and preferably “the best”. Hence the PR Bipap ASV PSX900, problem is I’m finding difficulty finding stores that ship to the UK, if anyone has any legit links/stores/websites, please help me out. Thanks!

G'day Randoers7.

It's unlikely you'll get a Philips machine in the near future - there has been a world-wide recall due to the fact their internal foam insulation has been found to break down and release carcinogenic gases. The alternative Resmed Aircurve 10 CS Pacewave ASV is generally regarded as a more comfortable machine that gives better results for the majority of people.

However, ASV machines (Philips or Resmed) are designed for the treatment of central sleep apnea. They are not for ordinary obstructive apnea, which raises the question of which type of apnea do you have? The Resmed Airsense CPAP, Elite and Autoset are all suitable for obstructive apnea, as are the Aircurve 10 S and VAuto. These are possibly the machines you should be looking at - they are also a LOT cheaper than an ASV.

The Resmed Airsense 10 CPAP is their absolute base level machine with very limited capabilities and no useful data output. Not recommended at all.

Hi Randoers7,

You don't say on what basis you were diagnosed or are being treated – is it by the sleep medicine department at one of the 150 NHS foundation trust hospitals? Or by a specialist in the 'private' sector?

And you don't say if it is the sleep-medicine department at one of the 150 NHS foundation trust hospitals who have issued you with the fixed-pressure machine you've got. Or if, on the other hand, you bought the machine within the private sector, either from some specialist who is seeing you, or direct from ResMed UK in Abingdon, England.

What you do say is that you think you need a bi-level machine so that the pressure difference – or relief on breathing out – is bigger because the level of 3 which you use at the moment isn't enough, and you "can't exhale".

a. If you wish to continue as an NHS patient, then your first step is to go back to the sleep-medicine department, and tell them that. And after they have heard your story, they might agree to 'try you' on a bi-level*.

If they did do a trial run – of, say, a month – so they can see from the data on the SD card that it's clearly helpful – then they might make an 'individual funding request' – that is, ask to spend extra money on your case so that they can supply a bi-level ...

.. but they would get to decide which make of bi-level since, as is true of almost all SMDs within the NHS, they will have standardised on one of the two major manufacturers and not the other.

b. If you are an NHS patient, but the SMD is unwilling to spend the extra money, then you can ask them to at least write the prescription, and you will buy the machine yourself, direct from the manufacturer's site in the UK.

c. If you are a private patient, then your next step is simpler than that – but more expensive. You go back to the doctor who diagnosed you, and tell him or her your story. And if he or she agrees – for a fee – that a bi-level is indicated, then they can either sell you one from their 'stock cupboard', or they can write a prescription – or 'scrip' – for you.

There's even a downloadable e-mail version.

You can then contact either Philips Respironics UK in Chichester, England or ResMed UK in Abingdon, England as is appropriate, and buy direct from them. Both of these make their UK profit margin from selling in bulk to the NHS. This leaves them free to sell a smaller number of machines direct to those members of the public who wish to fund their own treatment.

They will even send you the form to fill in so that there's no VAT.

* The staff at the SMD might also try you out first on the latest auto-adjusting model before trying a bi-level. The policy at each foundation trust hospital in the UK is set by the hospital.

rick blaine wrote: ↑

Sun Oct 03, 2021 6:53 am

Hi Randoers7,

You don't say on what basis you were diagnosed or are being treated – is it by the sleep medicine department at one of the 150 NHS foundation trust hospitals? Or by a specialist in the 'private' sector?

And you don't say if it is the sleep-medicine department at one of the 150 NHS foundation trust hospitals who have issued you with the fixed-pressure machine you've got. Or if, on the other hand, you bought the machine within the private sector, either from some specialist who is seeing you, or direct from ResMed UK in Abingdon, England.

What you do say is that you think you need a bi-level machine so that the pressure difference – or relief on breathing out – is bigger because the level of 3 which you use at the moment isn't enough, and you "can't exhale".

a. If you wish to continue as an NHS patient, then your first step is to go back to the sleep-medicine department, and tell them that. And after they have heard your story, they might agree to 'try you' on a bi-level*.

If they did do a trial run – of, say, a month – so they can see from the data on the SD card that it's clearly helpful – then they might make an 'individual funding request' – that is, ask to spend extra money on your case so that they can supply a bi-level ...

.. but they would get to decide which make of bi-level since, as is true of almost all SMDs within the NHS, they will have standardised on one of the two major manufacturers and not the other.

b. If you are an NHS patient, but the SMD is unwilling to spend the extra money, then you can ask them to at least write the prescription, and you will buy the machine yourself, direct from the manufacturer's site in the UK.

c. If you are a private patient, then your next step is simpler than that – but more expensive. You go back to the doctor who diagnosed you, and tell him or her your story. And if he or she agrees – for a fee – that a bi-level is indicated, then they can either sell you one from their 'stock cupboard', or they can write a prescription – or 'scrip' – for you.

There's even a downloadable e-mail version.

You can then contact either Philips Respironics UK in Chichester, England or ResMed UK in Abingdon, England as is appropriate, and buy direct from them. Both of these make their UK profit margin from selling in bulk to the NHS. This leaves them free to sell a smaller number of machines direct to those members of the public who wish to fund their own treatment.

They will even send you the form to fill in so that there's no VAT.

* The staff at the SMD might also try you out first on the latest auto-adjusting model before trying a bi-level. The policy at each foundation trust hospital in the UK is set by the hospital.

I was Diagnosed with Severe Obstructive Sleep Apnea by a NHS hospital, I informed my Sleep specialist 11 months ago that I had these issues, he adjusted the pressure for my CPAP, these issues Persisted. I then informed my sleep specialist I would like to get a Bi-PAP due to my Aerophagia and due to my inability to exhale at higher pressures with a CPAP, my sleep specialist understood, informed me that a referral was made as at their hospital BIPAPs can not just be prescribed and given, they need to be approved of or prescribed elsewhere.

Here I am 7 months later waiting, typical NHS treatment. I would rather not wait longer hence me wanting to purchase one by myself however will talk to my sleep specialist or to my referral about getting a prescription for a PR PSX900, if they’re willing to fund it, great, if not I’ll purchase it myself via the prescription.

Thank you for your advice.

Respirator99 wrote: ↑

Sun Oct 03, 2021 5:46 am

G'day Randoers7.

It's unlikely you'll get a Philips machine in the near future - there has been a world-wide recall due to the fact their internal foam insulation has been found to break down and release carcinogenic gases. The alternative Resmed Aircurve 10 CS Pacewave ASV is generally regarded as a more comfortable machine that gives better results for the majority of people.

However, ASV machines (Philips or Resmed) are designed for the treatment of central sleep apnea. They are not for ordinary obstructive apnea, which raises the question of which type of apnea do you have? The Resmed Airsense CPAP, Elite and Autoset are all suitable for obstructive apnea, as are the Aircurve 10 S and VAuto. These are possibly the machines you should be looking at - they are also a LOT cheaper than an ASV.

The Resmed Airsense 10 CPAP is their absolute base level machine with very limited capabilities and no useful data output. Not recommended at all.

The model I am after is not enlisted within the Recall models. As mentioned prior, I am after a BIPAP due to my inability to exhale using a CPAP and also due to Aerophagia issues, hence a CPAP for my Scenario is not sufficient, I've tried it for 7-8 months. Reasons I am after an ASV, is due to my research into DR Barry Krakows work, reasons are long. Central’s are not mutually exclusive to Central sleep apnea, I do experience them myself, hence I’d like an ASV to eliminate all Central’s, Apnea’s, Hypopneas and Reras if possible.

Thanks for the advice.

Hello again Randoers7,

You say "typical NHS treatment' – no, it's worse than normal – because of the pandemic.

In most UK hospitals, the sleep-medicine department is part of the Lung Function department (formery Chest Medicine before that got split into Cardiology and Lung Function). And many of the staff have been taken from their normal duties and allocated to the extra wards and beds dealing just with the pandemic.

At my nearest big hospital, the Accident and Emergency department ('the ER'), has been converted into two complete and separate streams – one for suspected or confirmed Covids, and the other for 'all the rest' – the car crashes and the severe cuts and the fallen-off-a-ladder.

When you say "informed me that a referral was made" that suggests to me that an individual funding request has been made on your behalf – but, I suspect, it is sitting in a pile of other paperwork somewhere because there hasn't been staff free to process it.

In other words, it's a decision that's yet to be made.

Since, from what you say, your doctor agrees that you would benefit from a bi-level machine, then IMO you might as well get the scrip now and buy the machine now. It should last you for a good five years.

As to further waiting – for all you know, the decision to supply a bi-level may go in your favour but the hospital might say they can't afford it because of all the extra money they've spent on dealing with the pandemic.

Common sense says I should add: 'if you have the means'. In case no-one has informed you, a new bi-level machine from either of the two main manufacturers costs in the region of £1,300, while a new ASV machine costs over £4,000.

rick blaine wrote: ↑

Mon Oct 04, 2021 7:56 am

Hello again Randoers7,

You say "typical NHS treatment' – no, it's worse than normal – because of the pandemic.

In most UK hospitals, the sleep-medicine department is part of the Lung Function department (formery Chest Medicine before that got split into Cardiology and Lung Function). And many of the staff have been taken from their normal duties and allocated to the extra wards and beds dealing just with the pandemic.

At my nearest big hospital, the Accident and Emergency department ('the ER'), has been converted into two complete and separate streams – one for suspected or confirmed Covids, and the other for 'all the rest' – the car crashes and the severe cuts and the fallen-off-a-ladder.

When you say "informed me that a referral was made" that suggests to me that an individual funding request has been made on your behalf – but, I suspect, it is sitting in a pile of other paperwork somewhere because there hasn't been staff free to process it.

In other words, it's a decision that's yet to be made.

Since, from what you say, your doctor agrees that you would benefit from a bi-level machine, then IMO you might as well get the scrip now and buy the machine now. It should last you for a good five years.

As to further waiting – for all you know, the decision to supply a bi-level may go in your favour but the hospital might say they can't afford it because of all the extra money they've spent on dealing with the pandemic.

Common sense says I should add: 'if you have the means'. In case no-one has informed you, a new bi-level machine from either of the two main manufacturers costs in the region of £1,300, while a new ASV machine costs over £4,000.

Hello Again,

Thanks for the advice, Which Bi-Level Pap would you recommend? From what I’m told Philips has been superior to Resmed due to software used. Also, where would I purchase the pap you recommend? Thanks.

If you're a purchaser in the UK and being treated within the NHS– which you are – there are two separate issues – well, three if we start with: should I stick to the two main manufacturers or should I consider other brands?

Answer to that: as I said above, there are 150 foundation trust hospitals in the UK and almost all of them have standardised on either Philips Respironics or ResMed. With very few exceptions, they provide only one or other of these two.

So if you're buying your own machine AND you want to go on being treated by the NHS, then your choice is restricted to these two.

Now with respect to these two, the issue of 'which machine is better?' is really subservient to the issue of: 'which brand does my sleep-medicine department deal in? Because I want to fit in with them.'

The reason you want to fit in with them is that each NHS hospital uses the software created by their chosen manufacturer to read that brand's machines. SMDs which have standardised on Philips machines use the Philips software. SMDs which have standardised on ResMed machines use the ResMed software. There are very few hospitals which deal in both.

Why is that important? Well, you need the staff at the SMD where you are a patient to be able to read the SD card from your machine in order for them to see that the treatment is working, and for the consultant, as head of the department, to sign the letter telling the DVLA that you're OK to drive, and that you can keep your driver's licence.

If you're not bothered by the loss of your licence, or have never driven, then that isn't an issue. But if you do drive. and you want to keep on driving ...

As to which of the two main brands has the better bi-level – I don't have an opinion. I don't know enough. You need to ask somebody like Pugsy – who, I'm happy to say, is the most incredibly well-informed and helpful person I know of in this field.

But what will you do if the 'better' machine (and it may only be a slight difference) is not supported by your SMD? If you decide that you really must have that machine, then the only course of action I can think of is: for you to go back to your GP and ask to be referred to a hospital which has standardised on that brand of machine. (That is, if keeping your driving licence is an issue.)

From what you say above, I get that you are being treated by a SMD which has standardised on ResMed.

As to where to buy if you were buying your own machine. Well, there aren't many dealers of new machines in the UK. And that's because something like 90 per cent of sleep apnea patients in the UK are supplied with a machine by the NHS. So there isn't much demand outside of that.

In fact, I know of only one independent retailer in the UK. They are in Walton-on-Thames. And from memory, they do not deal in new bi-level or new ASV machines.

For the same 90-per-cent reason there isn't a very big second-hand or second-user market in the UK.

Not only are 90 per cent of machines supplied by the NHS, but the machines they issue to patients stay the NHS's property – even if a patient uses it for ten years. If a patient decides the treatment is not for them or if they give up – or if, as would be in your case, there's an upgrade in the capability of the machine – then the NHS takes the previously-issued machine back, so that they can clean it up and give it to someone else.

Now, with few or no dealers in new bi-levels, and few sources of second-user bi-levels, then that leaves purchasing direct from one or other of the two main manufacturers.

Neither makes their machines in the UK, but each has a base in the UK. As I said above, Philips Respironics UK is in Chichester, down on the south coast, and ResMed UK is in Abingdon, near Oxford. And both sell direct to the public. And both have web sites on the internet.

One other possibility is that you could buy a second-user machine from a dealer in America. The relevant issues to consider are: (a) is it safe? (2) how many hours of use does the machine have? and (c) if sending overseas, does the dealer have experience in providing the paperwork for smooth passage thru UK customs?

With regard to all three of those points, people on this forum speak highly of www.secondwindcpap.com.