BiPap St Cost $$$$$

Yikes. Not sure how why I typed that. 83% was my lowest if I recall correctly. I don’t think I got enough sleep in the tests to get any lower.

Edit: I see that’s in the actual report. I will need to ask about that because we never talked about O2 being that low. I wonder if that was a type-O in the report. I’ll look through the entire report again

tsduke wrote: ↑

Mon Sep 09, 2019 10:36 pm

Yikes. Not sure how why I typed that. 83% was my lowest if I recall correctly. I don’t think I got enough sleep in the tests to get any lower.

You didn't type it -- it was a pasted image from the actual report.

I edited my post. Thanks for catching that. Something for me to review.

The reason ST and ASV treat complex apnoea is they have a backup rate and provide pressure to encourage you to breath when you don't.


The downside of the ST is it is a fixed pressure machine and provides the pressure all of the time every time you inhale if you need it or not, where an ASV monitors your breathing on a breath by breath basis and only provides pressure when you need it.

You can get a used Resmed S9 Vpap adapt the big brother of the Resmed Aircurve 10 ASV from the link below for $150 you will need to buy separately a hose,mask and an addon humidifier available from SecondWind

I have bought two machines from this supplier with no issues and so have others.

https://www.dotmed.com/listing/cpap/res ... 21/2848450

tsduke wrote: ↑

Mon Sep 09, 2019 9:07 pm

Really?!?!? Thanks for the apologies but I see nothing wrong with being upset of $6500 charges for a device that's nohwere near that high retail. My statement below from earliier post is in the context of not giving my money to the DME my ST came from only. And how is my inability to get a machine other than a ST without a "NEW" prescription playing victim? Other than that all I said was I'm not sure the cost is worth it until I see effectiveness from treatment.

To each their own. All who want to bash on me go ahead. Every forum has to have them. In my current situation I will not shell out $4k to my current DME.


"it's not about affording the bill either as I can. I'm choosing not to on principle and I like to be wise with my money. Another part is I don't want to be a part of providing my DME that kind of profit when the only thing they care about is my compliance so they get paid."

In this post, you say that you were only complaining about the DME, but in previous posts you said you were considering buying life insurance instead of a machine, and talked about not continuing treatment.

" "If" I choose to continue treatment "

So, don't be surprised that we assumed you were serious about going untreated. Of course, we are going to try to convince you to keep being treated, especially since you posted the report with serious issues in it.

You are correct. If cost were going to be $4k I would seriously consider no treatment as an option. Right or wrong it’s my choice. As you all know this Isn’t a one time expense and I’m frustrated that I haven’t felt little if any benefit in treatment.

Now having said that other good options have been brought up and I will look into them but not until I know more on which device is right and I have a script for it.

Does ASV have backup rate or encourage a breath in another way? I thought the guy at second wind yesterday said it didn’t have backup

tsduke wrote: ↑

Tue Sep 10, 2019 4:50 am

You are correct. If cost were going to be $4k I would seriously consider no treatment as an option. Right or wrong it’s my choice. As you all know this Isn’t a one time expense and I’m frustrated that I haven’t felt little if any benefit in treatment.

Now having said that other good options have been brought up and I will look into them but not until I know more on which device is right and I have a script for it.

Does ASV have backup rate or encourage a breath in another way? I thought the guy at second wind yesterday said it didn’t have backup

The ASV has an automatic backup rate that is designed to provide a breath .


The Resmed Algorithm looks as the breaths of the last 3 minutes and the Minute Volume i t increases PS to encourage a breath take a look at this link and have a read

https://www.resmed.com/us/dam/documents ... er_eng.pdf

Thanks Jas!

TropicalDiver wrote: ↑

Mon Sep 09, 2019 10:42 pm

tsduke wrote: ↑

Mon Sep 09, 2019 10:36 pm

Yikes. Not sure how why I typed that. 83% was my lowest if I recall correctly. I don’t think I got enough sleep in the tests to get any lower.

You didn't type it -- it was a pasted image from the actual report.

My report does indeed say 66% min in the titration testing which seems odd. Hmmm. Looks like I hit the low right after a time of wake. Kind of annoyed at myself and Doctor for not seeing that to discuss it. He only talked about the 83% I dropped to in the first test that was testing only and I don’t know how I missed that. I really need to get my notes and questions in order.

tsduke wrote: ↑

Tue Sep 10, 2019 4:50 am

I’m frustrated that I haven’t felt little if any benefit in treatment.

I am only going to address this above. I have seen you say it a few times and I hear your frustrations.
You really can't expect to feel much benefit when the treatment isn't even optimal in the first place. It's hard enough when the therapy is optimal.
Right now your therapy isn't optimal. It's half assed.
Damn impossible to feel any better with half assed treatment.

I agree. I find it odd that a doctor doesn’t want to change anything until 6 weeks out. Is that normal? He almost seemed annoyed when I called asking if we could make some adjustments at 2-3 weeks in.

I know I can change things myself but didn’t want to mess with it before getting professional guidance. Plus I wouldn’t know what to change anyway.

No...not unusual for a doctor to want to wait a period of time to give the patient time to adjust to the therapy.
Different doctors have different time frames.
A month is probably the minimum time frame for a doctor....they tend to work on different schedules than most patients work off of.
They aren't the ones who aren't feeling any better and we are and we typically are rather short in the patience department.
They can afford to have lots of patience since they aren't the ones using this stuff.

Some docs are simply more aggressive than other docs and willing to do something sooner than later. There's a big YMMV sticker on doctors too. Dr Krakow is probably the most aggressive sleep doc that I know of. He puts people on ASV for the least little reason.

If those hyponeas you see are obstructive in nature (and the chances are that they are obstructive) you need more EPAP on the ST machine. Going by the odds (and of course there are always outliers who don't fall within the odds) probably not a lot more EPAP to hold the airway open and prevent the obstructive stuff from happening. Obstructive hyponeas are usually fairly easy to kill with just a little more EPAP.

Pugsy wrote: ↑

Tue Sep 10, 2019 7:32 am

If those hyponeas you see are obstructive in nature (and the chances are that they are obstructive) you need more EPAP on the ST machine. Going by the odds (and of course there are always outliers who don't fall within the odds) probably not a lot more EPAP to hold the airway open and prevent the obstructive stuff from happening. Obstructive hyponeas are usually fairly easy to kill with just a little more EPAP.

But if the Hypopnoeas are Central in nature then more Pressure support will be needed to clear them and with a ST that gets very uncomfortable fast


Could you provide a zoomed flow of about two minutes duration when your having the Hypopnoeas and maybe we can see by the flow if its central or obstructive based

Jas_williams wrote: ↑

Tue Sep 10, 2019 11:23 am

Pugsy wrote: ↑

Tue Sep 10, 2019 7:32 am

If those hyponeas you see are obstructive in nature (and the chances are that they are obstructive) you need more EPAP on the ST machine. Going by the odds (and of course there are always outliers who don't fall within the odds) probably not a lot more EPAP to hold the airway open and prevent the obstructive stuff from happening. Obstructive hyponeas are usually fairly easy to kill with just a little more EPAP.

But if the Hypopnoeas are Central in nature then more Pressure support will be needed to clear them and with a ST that gets very uncomfortable fast


Could you provide a zoomed flow of about two minutes duration when your having the Hypopnoeas and maybe we can see by the flow if its central or obstructive based

Yeah....I know that they could be central in nature and have already gone through that discussion about it with the OP in a different thread.
I won't even guess as to central vs obstructive on a hyponea just from looking at the flow rate. I am not comfortable doing it especially on a Respironics flow rate graph. I won't even go there.

Since OP didn't want to mess with anything in terms of settings.....wasn't much sense in suggesting a 1 night experiment that might rule in or out what those hyponeas were made of.

There's nothing about using the ST machine for complex sleep apnea that I like. I hate that damn machine and I am just about to the point that when someone comes here complaining of feeling like crap and nothing is working and they are using an ST machine that I am going to just send my condolences and move on. It's just too difficult to tweak it to cover all bases without being horribly uncomfortable assuming someone is willing to do try the tweaking which in the OP's situation here he isn't comfortable doing at this time.

Pugsy wrote: ↑

Tue Sep 10, 2019 11:53 am

Jas_williams wrote: ↑

Tue Sep 10, 2019 11:23 am

Pugsy wrote: ↑

Tue Sep 10, 2019 7:32 am

If those hyponeas you see are obstructive in nature (and the chances are that they are obstructive) you need more EPAP on the ST machine. Going by the odds (and of course there are always outliers who don't fall within the odds) probably not a lot more EPAP to hold the airway open and prevent the obstructive stuff from happening. Obstructive hyponeas are usually fairly easy to kill with just a little more EPAP.

But if the Hypopnoeas are Central in nature then more Pressure support will be needed to clear them and with a ST that gets very uncomfortable fast


Could you provide a zoomed flow of about two minutes duration when your having the Hypopnoeas and maybe we can see by the flow if its central or obstructive based

Yeah....I know that they could be central in nature and have already gone through that discussion about it with the OP in a different thread.
I won't even guess as to central vs obstructive on a hyponea just from looking at the flow rate. I am not comfortable doing it especially on a Respironics flow rate graph. I won't even go there.

Since OP didn't want to mess with anything in terms of settings.....wasn't much sense in suggesting a 1 night experiment that might rule in or out what those hyponeas were made of.

There's nothing about using the ST machine for complex sleep apnea that I like. I hate that damn machine and I am just about to the point that when someone comes here complaining of feeling like crap and nothing is working and they are using an ST machine that I am going to just send my condolences and move on. It's just too difficult to tweak it to cover all bases without being horribly uncomfortable assuming someone is willing to do try the tweaking which in the OP's situation here he isn't comfortable doing at this time.

Noted and I agree