Post Reply 
APAP and central apnea
Author Message
CynthiaMueller Offline

Members

Posts: 9
Joined: Nov 2013

Machine: BiPAP AutoSV Advanced System One 60 Respironics
Mask Type: Nasal pillows
Mask Make & Model: Resmed Swift FX
Humidifier: Respironics System One
CPAP Pressure: EPAP Min 5 Max 15 PS 2-20
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: TX

Post: #21
RE: APAP and central apnea
Ghandi,
I have both central and obstructive events without therapy. The CPAP made the central worse, and didn't fix the obstructive enough. I switched to regular BiPAP and the obstructive got better but the central got even worse. I've had a prescription for a BiPAP ASV since the beginning of May but I haven't been able to get a DME to actually get a hold of one in order to sell one to me. (I have been through a few. I think that they have to get someone to invent it or refine the plastic used in it or something. ) Insurance has said "no problem" to coverage - they have the documentation.
It's amazing what the DME will try to tell us. BiPAP isn't used for apnea? You are lucky enough to have been treated successfully with the equipment they issued you. Next time you'll be more confident in dealing with the DME.
Cindy
08-16-2014 05:05 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #22
RE: APAP and central apnea
(08-16-2014 05:05 PM)CynthiaMueller Wrote:  I've had a prescription for a BiPAP ASV since the beginning of May but I haven't been able to get a DME to actually get a hold of one in order to sell one to me. (I have been through a few. I think that they have to get someone to invent it or refine the plastic used in it or something. ) Insurance has said "no problem" to coverage - they have the documentation.

Hi Cindy,

That's amazing. Maybe you can call your insurance company and ask them to identify a DME who can dispense the unit to you. Or ask if you can buy on line and be reimbursed at same rate as if using an in-network DME because you have been unable to locate a DME in your area which will supply the machine.

Hurry, or you may need to start all over again because pre-authorizations are only good for a few months, and then another ASV titration may be required or something like that.

Make sure you get either the newer S9 VPAP Adapt REF# 36037 (NOT older S9 VPAP Adapt REF# 36007 or 36017 if including Humidifier or 36027 if including Humidifier and heated hose, which had ASV mode but did not have the new ASVauto mode), or the PRS1 DS960 with heated humidifier AND HEATED HOSE).

Best of luck,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-16-2014 06:27 PM by vsheline.)
08-16-2014 06:24 PM
Find all posts by this user Post Reply Quote this message in a reply
vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #23
RE: APAP and central apnea
(08-16-2014 11:29 AM)Ghandi Wrote:  BiPAP with ASV (auto servo ventilation) seems to be marvellous. I'm just a little more irritated that it wasnt suggested to me at all.

Hi Ghandi,

In USA most insurance companies will not pay for the (much more expensive) ASV type of bi-level machine unless the patient is already being treated with CPAP or APAP or ordinary bi-level machine AND the nightly Central Apnea Index is both above 5 AND is higher than the Obstructive Apnea Index, AND a special ASV titration is done and shows ASV treatment works well for the patient. AND some US insurance companies require AHI to be greater than 5.0, others greater than 10.0, others greater than 15.0 when patient is using their present (non-ASV) machine.

Congratulations on your good success with CPAP + C-Flex.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-16-2014 07:00 PM by vsheline.)
08-16-2014 06:40 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #24
RE: APAP and central apnea
(08-13-2014 08:09 AM)Ghandi Wrote:  Oh god, i regret not paying that extra 150$ for the apap option. That way i could have asked to try apap at some point. Now it's too late Sad. At least for the next 5 years.

Not really. You can shop around for a good used machine, for example on craigslist. You'll find that a back up machine is a must-have because any machine can fail at any time and leave you stranded.

For example, that's how I found my VPAP Auto, and it's much better than the fixed pressure BiPAP prescribed by my doctor.

Just keep your eye on the advertisements, keep some cash on hand, and be ready to act fast. When a good deal comes up on craigslist it goes fast. On a Friday night I saw an ad that had been posted that afternoon. I called the seller and the next morning, after a 45-minute drive, I was at his house. As I was leaving he was texting someone else to tell him not to bother coming because he had sold both machines to me. An Autoset and the VPAP Auto. It was too good of a deal to pass up!

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-16-2014 07:03 PM
Find all posts by this user Post Reply Quote this message in a reply
archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #25
RE: APAP and central apnea
(08-16-2014 11:29 AM)Ghandi Wrote:  When i asked for bipap the DME told me they did't used it for sleep apnea. They reacted so strongly, like i was out of my mind to even mention the word bipap. So i backed off.

Your DME is trying to protect his profit margins.

Bilevel is mostly for people who have trouble exhaling against the CPAP pressure.

Bilevel may improve or worsen central apnea. It's cheaper than an ASV unit. ASV is also uncomfortable for many people to get used to. It's worth trying bilevel as long as you monitor the results and see whether centrals go up or go down.

Some people definitely need the ASV, though.

Ghandi, how high are your AHI and CAI numbers?

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-16-2014 09:17 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Ghandi Offline

Preferred Members-2

Posts: 137
Joined: Aug 2014

Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #26
RE: APAP and central apnea
CynthiaMueller well i hope you can get your asv machine and find a proper DME if that exists. I would call the insurrance like vsheline proposed

vsheline There is the medical mafia and the insurance is not any better Smile. my therapy is succefull but i wish i could eliminate the couple of long events that are probably causing desaturation.

Sleepster This is super idea and i have been thinking about it for an auto-pap. i cant get myself to sleep with used medical equipment. I may be a chicken but i'm really scared something bad could happen if the item is not working properply(and this could be the reason of the sale). The cpap shop is still a security blanket at this point for me. Maybe i will get more confident but for now i cant do it. Thx for the advice though. How is your Vpap therapy going? Do you have chronic obstructive pulmonary disease or just osa?
08-16-2014 09:24 PM
Find all posts by this user Post Reply Quote this message in a reply
Ghandi Offline

Preferred Members-2

Posts: 137
Joined: Aug 2014

Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #27
RE: APAP and central apnea
(08-16-2014 09:17 PM)archangle Wrote:  
(08-16-2014 11:29 AM)Ghandi Wrote:  When i asked for bipap the DME told me they did't used it for sleep apnea. They reacted so strongly, like i was out of my mind to even mention the word bipap. So i backed off.

Your DME is trying to protect his profit margins.

Bilevel is mostly for people who have trouble exhaling against the CPAP pressure.

Bilevel may improve or worsen central apnea. It's cheaper than an ASV unit. ASV is also uncomfortable for many people to get used to. It's worth trying bilevel as long as you monitor the results and see whether centrals go up or go down.

Some people definitely need the ASV, though.

Ghandi, how high are your AHI and CAI numbers?

Therapy Efficiacy
AHI 1.33
Obstructive Apnea Index 0.49
Hypopnea Index 0.68
Clear Airway Apnea Index 0.16

But when i sleep on with a backpack to prevent sleeping on my back it lowers AHI to .7 .8. I have more obstructive than central apneas.

i suffer from chronic rhinitis. So i have 20mg zyrtec and nasonex daily to be able to use the cpap.
08-16-2014 09:30 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #28
RE: APAP and central apnea
(08-16-2014 09:30 PM)Ghandi Wrote:  Therapy Efficiacy
AHI 1.33
Obstructive Apnea Index 0.49
Hypopnea Index 0.68
Clear Airway Apnea Index 0.16

But when i sleep on with a backpack to prevent sleeping on my back it lowers AHI to .7 .8. I have more obstructive than central apneas.

i suffer from chronic rhinitis. So i have 20mg zyrtec and nasonex daily to be able to use the cpap.

1.33 AHI is just fine as numbers go. Unless you're having other problems, be happy.

Centrals are not necessarily more harmful than obstructives, just harder to eliminate. Look at your data, and see what the apneas look like. Unless they're really long, be happy.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-17-2014 02:14 AM
Find all posts by this user Post Reply Quote this message in a reply
Ghandi Offline

Preferred Members-2

Posts: 137
Joined: Aug 2014

Machine: RemStar Pro with C-Flex+Philips Respironics System One
Mask Type: Nasal pillows
Mask Make & Model: airfit p10(resmed)
Humidifier: systeme one humidifier with humidity set at 3 and heat set at 1
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #29
RE: APAP and central apnea
(08-17-2014 02:14 AM)archangle Wrote:  
(08-16-2014 09:30 PM)Ghandi Wrote:  Therapy Efficiacy
AHI 1.33
Obstructive Apnea Index 0.49
Hypopnea Index 0.68
Clear Airway Apnea Index 0.16

But when i sleep on with a backpack to prevent sleeping on my back it lowers AHI to .7 .8. I have more obstructive than central apneas.

i suffer from chronic rhinitis. So i have 20mg zyrtec and nasonex daily to be able to use the cpap.

1.33 AHI is just fine as numbers go. Unless you're having other problems, be happy.

Centrals are not necessarily more harmful than obstructives, just harder to eliminate. Look at your data, and see what the apneas look like. Unless they're really long, be happy.

What do you consider really long ?
I may buy an oxineter to check desaturation.

Yesterday i had 1.78

Hypopnea 0.89
Obstructive Apnea 0.51
Clear Airway Apnea 0.38

The longest event was 26 seconds. But some nights i have 40 and 45 seconds apnea. so would that be too long?

My theory is that when i'm sleeping on my back the pressure is not high enough to treat some of the OAs.

I have ben using the cpap for over 3 months now. Overtime will it(number of envents and lenght)decreae with me getting used to get therapy?

The thing i'm happy about i that i have no problem sleeping with the machine. As a matter of fact i like it.
08-17-2014 10:35 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #30
RE: APAP and central apnea
(08-17-2014 10:35 AM)Ghandi Wrote:  What do you consider really long ?
I may buy an oxineter to check desaturation.

Yesterday i had 1.78

Hypopnea 0.89
Obstructive Apnea 0.51
Clear Airway Apnea 0.38

The longest event was 26 seconds. But some nights i have 40 and 45 seconds apnea. so would that be too long?

My theory is that when i'm sleeping on my back the pressure is not high enough to treat some of the OAs.

I have ben using the cpap for over 3 months now. Overtime will it(number of envents and lenght)decreae with me getting used to get therapy?

The thing i'm happy about i that i have no problem sleeping with the machine. As a matter of fact i like it.

30 or 40 is relatively long, but not enormously long. Some people go 120 seconds or longer. Do you stop breathing entirely or do you breathe a little?

Sit down, preferably in a recliner, or lay down. Get calm, relax, inhale and exhale regularly for a while. Take a normal breath in and hold it for that number of seconds if you can. See how hard it is to hold it for that long. Remember that it will be less stressful to do this in your sleep. Consider how many times a night you do this in various lengths of time.

I think most doctors will look at AHI<5 and say you're OK. I"m not sure I'd disagree unless your apneas were a lot longer.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-17-2014 04:25 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Medicare Advantage Coverage for APAP Evie 4 232 12-05-2016 09:49 PM
Last Post: Evie
  Upset about central apnea sleepytimegal 6 249 12-03-2016 11:54 AM
Last Post: PaulaO2
  ASV/ Central apena - Time for a second opinion? Feisty Folder 6 336 11-21-2016 04:14 AM
Last Post: DeepBreathing
  Central Sleep Apnea? wayne99 8 750 11-20-2016 06:39 AM
Last Post: wayne99
  cpap and apap not effictive Ezil71 109 3,129 11-05-2016 11:19 AM
Last Post: sonicboom
  Unable to clear throat while on APAP NorthernGuy 5 310 10-17-2016 08:18 PM
Last Post: Sleeprider
  Apap I_will_never_sleep_again 2 285 10-14-2016 02:58 PM
Last Post: trish6hundred

Forum Jump:

Who's Online (Complete List)