Airsense 10 CPAP vs...Elite or...?

[vsheline]

While there's no excuse for prescribing an AirSense 10 CPAP for anyone instead of an Elite, it DOES record nightly averages of AHI and some other info. I believe it will give an AHI and CAI nightly average

The Clinician Guide (set-up manual) for AirSense 10 series specifically lists which AirSense 10 models distinguish obstructive versus central apneas, and the list includes all models except the base "CPAP" model.

[vsheline]

Does anyone have any advice on the best way to approach this?

Hi slumberdog

I think most insurance companies in U.S. are like U.S. Medicare, which requires an overnight sleep lab "ASV Titration" which will verify that ASV therapy reduces your AHI to acceptable levels.

So, call up your medical insurance company and ask whether an ASV machine wi be covered based on the diagnosis made during your sleep study, or whether an ASV titration will be required by insurance company before coverage will be provided.

I strongly suggest returning the CPAP base model machine to the DME but not making an appointment to pick up a new machine until you know which model the DME will be charging you (and your insurance) for.

If you truly do have Complex Sleep Apnea, an ASV machine would be able to treat both the obstructve and the central Apneas and Hypopneas.

Take care,
--- Vaughn

[slumberdog]

...I strongly suggest returning the CPAP base model machine to the DME...

All good advice.

I had 3 nights in the lab. I think returning the device to the DME should be the 1st priority. I was trying to orchestrate an exchange, but that may not work out. Returning it now would give me time to work it out without the deadline (since I'm out of pocket for the $500 deductible).

It's been about 3 weeks and I used the device for about 1 1/2 weeks. Is the DME required to refund me even though I used it (and before the situation is straightened out?)? Can they refuse?

Thanks : )

[vsheline]

It's been about 3 weeks and I used the device for about 1 1/2 weeks. Is the DME required to refund me even though I used it (and before the situation is straightened out?)? Can they refuse?

Not sure. May depend on individual DME rules/policies and insurance company's rules/policies, and may depend on whether DME wants to turn you into a long term and satisfied customer.

But in any case, I suspect the less hours it has been used and the sooner it is returned, may make a difference.

[slumberdog]

Thanks for the input. I'll be trying to deal with it this week.

[tedburnsIII]

Point of inquiry- Is ASV generally considered a sub-type of bi-level (BPAP) machine or is it an entirely separate creature?

If the former, fair to assume that it's a more refined version of BPAP?

[vsheline]

Point of inquiry- Is ASV generally considered a sub-type of bi-level (BPAP) machine or is it an entirely separate creature?

If the former, fair to assume that it's a more refined version of BPAP?

Hi Ted,

Bilevels come in two main types, those without a backup respiration rate and those with a backup rate.

Not more refined. Just with an additional feature.

[tedburnsIII]

Point of inquiry- Is ASV generally considered a sub-type of bi-level (BPAP) machine or is it an entirely separate creature?

If the former, fair to assume that it's a more refined version of BPAP?

Hi Ted,

Bilevels come in two main types, those without a backup respiration rate and those with a backup rate.

Not more refined. Just with an additional feature.

vsheline-

So, ASV is considered to be a bi-level machine and can be distinguished as you stated.

Would it be accurate to then state that a bi-level machine that has a so-called 'backup respiration' feature is necessarily ASV-classified?
The 'v' in ASV is the ventilator part that breathes for you when necessary? Is it similar to being in the hospital on a ventilator?

[Sleeprider]

Ted, ASV stands for "Adaptive Servo Ventilator". It is built onto an auto or standard BPAP. The machine is programs for EPAP and pressure support, or EPAP/IPAP just like other bilevels, however when it detects a cessation of breathing, it can induce a breath by using a higher pressure than the IPAP, up to 25 cm. For someone with an open airway that experiences a central apnea, this pressure rise is sufficient to cause a breath. The machine default is to allow patient to spontaneously breath, but when a breath does not occur in a given time, the machine will initiate it with a pressure rise.

The machines also deal with periodic breathing by monitoring flow on a breath by breath basis. The bilevels do this as well, but the ASV is able to increase IPAP to maintain volume. Auto bilevels can change EPAP and IPAP over time in response to events, while the ASV capability can do it on a breath by breath basis, otherwise it is essentially the same hardware but different software.

[tedburnsIII]

vsheline-

Thank your for your most informative post, above! Do really appreciate your posts!

I do know that I tired holding my breath one or two times to see what my APAP would do. There may not have been an increase in inhalation pressure beyond the max set, but I almost felt as if machine were kind of 'breathing' for me. Also noticed on a couple of occasions that machine would supply inhalation pressure BEFORE I was ready for it- IOW, I felt the need to inhale at a given interval otherwise the machine would provide inhalation pressure anyway.

Comments?