Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

BIPAP machine stops blowing when I stop breathing
#21
RE: BIPAP machine stops blowing when I stop breathing
Sometimes you can find a deal on a used ASV or one that was not tolerated. Craigslist, FB Marketplace and Offerup have been sources for others and a seller on the CPAP Talk forum occasionally has them. Those deals have gotten more scarce. Probably the best way to approach it is to discuss how you have a worse AHI with your Vauto than untreated and discuss your awareness of the correct therapy being ASV. Request a clinical titration to evaluate the efficacy of ASV for your condition. This study usually opens the door for insurance to reimburse once it has been adequately demonstrated bilevel without backup has failed to treat your condition. That looks pretty obvious at this point.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#22
RE: BIPAP machine stops blowing when I stop breathing
Thank you.
I have sent messages to my PCP with quotes from these consults and references to articles on this issue. Apparently, within my insurance system, any change in my prescription would have to come from him and then sent to the Medical Equipment Department for approval. Actually, I don't mind paying for one out of pocket if it is really determined to be the correct machine for me. The assessment you mention would reveal that. I don't know  they are willing to provide that. I thought the Sleep Study was supposed to cover that. 

I see that ASV is counter-indicated for individuals with heart failure or even moderate to severe CSA so I also messaged my Cardiologist to check on whether I fall into that category. My Sleep Study indicated only mild CSA. I do have Afib but echo cardiograms and other tests indicated no other underlying heart disease. I had an ablation in March which, along with a medication helped control it pretty well.
Post Reply Post Reply
#23
RE: BIPAP machine stops blowing when I stop breathing
Read this article for an update on the SERVE-HF and ADVENT-HF studies. While a risk of sudden death from an unknown cause was statistically verified in the 2015 SERVE HF study, the patient cohort was not properly titrated or monitored for compliance with ASV therapy. The subsequent study has not replicated this risk and suggests that the benefits of ASV therapy outweigh the risks. The whole thing is moot without severe congestive heart failure with left ventricular ejection fraction less than 45%. If you were part of that risk group, you would not be unaware of it. Because the risk factor ended the SERVE-HF study, ASV was basically removed as a therapy for some of the people that needed it most. Hopefully the medical community will get this sorted out sooner than later. http://www.apneaboard.com/wiki/index.php...nd_Summary

The Resmed Aircurve 10 ASV is an amazing machine and many members use it. I have never seen an individual that presented with your CSA symptoms that did not fully resolve the central apnea problem with AHI less than 2, and generally near zero.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#24
RE: BIPAP machine stops blowing when I stop breathing
Heads-up. There is a Resmed Aircurve 10 ASV for sale on Facebook Marketplace for $449. Seller Mike Thruman seems to have sold a number of PAP machines.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#25
RE: BIPAP machine stops blowing when I stop breathing
Thank you for being so attentive to my situation. 

I see that there are 3 different Facebook Marketplace pages on Facebook. I ran a search in them and nothing came up for "Res Med Air Curve 10 ASV."

I'm probably missing something.
Post Reply Post Reply
#26
RE: BIPAP machine stops blowing when I stop breathing
I presented all of this information along with several articles, etc. to my doctor. He submitted it to Pulmonology and then responded to me with this message:

"Thanks for the updated information. I asked Pulmonology to take a look at the information you sent as well as the ASV.

 
According to Pulmonology, ASV is only approved for certain conditions COPD, neuromuscular disease, obesity hypoventilation, and you do not appear to meet these criteria and or appear to have been on BiPAP for very long based on the date of your most recent sleep study. They suggest you try the BiPAP as much as possible even for a few minutes to get acclimated to it, for example while watch TV or earlier in the night for desensitization.
 
If you still continue have issues however, they suggest to let me know and I can ask your pulmonologist to schedule a follow up visit with you to discuss this more and review the information in more detail with you."

I agreed to try the machine a bit more but, as I told him, I can tolerate the pressure and do fall asleep so pressure is not the issue. I tried to convey to him that when I stop breathing and then try to re-breathe, the machine doesn't respond so I'm gasping into a vacuum which scares me and wakes me up dozens of times within just an hour or two making me exhausted. So I just go off the machine and get much better sleep without it for the rest of the night. 

So, my options and plan for now is to try it again though I refuse to let it make my Central Apnea worse. If they won't help me with this, I will simply buy a ASV machine on my own either new online or used and see if they or someone else will do the settings.
Thank you.
Post Reply Post Reply
#27
RE: BIPAP machine stops blowing when I stop breathing
If you read the Resmed Titration Guide, you will see that the doctor's office is wrong. They defined the uses approved for ST and iVAPS, but let's review:
ASV Page 28:
This extensively studied therapy provides demonstrated results across the spectrum of central breathing disorders including:
• Periodic breathing, both normocapnic and hypocapnic
• Other forms of central and concomitant obstructive events 1 (mixed sleep apnea)
• Complex sleep apnea (CompSA) 2
ResMed’s ASV should also be considered for central sleep apnea (CSA) and ataxic breathing, which is sometimes seen in patients on opioids, 3 and neurological patients
ResMed ASV therapy is contraindicated in patients with chronic, symptomatic heart failure (NYHA 2-4) with reduced left ventricular ejection fraction (LVEF ≤ 45%) and moderate
to severe predominant central sleep apnea.

iVAPS including ST Page 34:

iVAPS is suitable for adults with respiratory insufficiency It is ideal for patients whose condition is likely to change and is characterized by hypoventilation (day/night hypercapnia)
Patient conditions may include:
• Neuromuscular disease and restrictive conditions – iVAPS can maintain stable ventilation when respiratory effort fluctuates1
• Obesity hypoventilation – Unlike standard Pressure Support therapy, iVAPS can compensate for changes in respiratory mechanics, such as during nocturnal changes in the patient’s body position 1
• Chronic obstructive pulmonary disease – iVAPS may reduce the risk of hyperinflation associated with increased respiratory rate and can compensate for changes in a
patient’s chronic airflow limitation.

You have not received your first typical misinformation and misdirection from your doctor's office showing they have limited expertise in CSA.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#28
RE: BIPAP machine stops blowing when I stop breathing
Insurance codes (HCPCS codes) are also worth knowing:
E0470 is a respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device).
E0471 is a respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device).

You are in need of a RAD E0471 because you fail to develop spontaneous effort to maintain a normal respiratory rate or volume do to what we assume is idiopathic central sleep apnea. CMS is the insurance approval process for Medicare and many other insurance programs. Here is the CMS template for qualifying for an E0571 device: https://www.cms.gov/Research-Statistics-...vice-Order- Template-Draft-20180412-R10b.pdf What your doctor's office failed to see or report was:
"Central sleep apnea, i.e., apnea not due to airway obstruction"

Yes it's covered, but you have to be somewhat knowledgeable in the area of sleep disordered breathing to find it or be aware of it. It may be time to request a referral to a specialist knowledgeable in CSA.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#29
RE: BIPAP machine stops blowing when I stop breathing
Something I forgot to suggest you do, it to change the setting for "Trigger Sensitivity" to Very High on your machine. This makes the Vauto trigger IPAP with less inspiratory flow, which sometimes improves CSA results, especially with therapy onset CA. Anyway, do give this a try, and change your profile to show the correct machine since the Airsense 10 CPAPs do not have this capability. You can edit your profile in the User Control Panel http://www.apneaboard.com/forums/usercp.php
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#30
RE: BIPAP machine stops blowing when I stop breathing
Again, thank you for your reply and this information. I will be armed with it when I finally have a consult with the pulmonologist
1.) The pulmonologist, through my doctor, suggests I try the BiPAP a little longer, even if only a few minutes at a time during the day. I've already tried with my longest tolerance being two hours during sleep with one hour another night. Last night I tried again and only made it about 10 minutes. He says if I do that, he will agree to a consult.
2.) Something else I haven't mentioned yet. Having Afib, I noticed during the two hour session that I didn't go into Afib but my heart started getting out of rhythm which was the deal breaker making me stop therapy.
3.) I am seeing a rebuilt Res Med Air Curve 10 CSA online for $1600 and a new, out-of-box one for $2599. I don't mind paying for a machine if it's really the one I need. I am considering buying one of these but trying to hold back until I see how this works out with my healthcare providers.
4.) The "Trigger" was set at Medium when I started. I did try it with High but will move it to Very High and see how that works.
5.) The problem with HMO insurances, as you probably know, the patient is blocked from direct consults with specialists, everything having to go through the PCP. It's kind of demeaning and insulting, in my opinion although I have a great PCP who doesn't mind receiving and responding to my messages almost daily.
Thank you.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Does Pressure (Air) Stop or (OSCAR) Data Issue? VAuto issue? KeepSmiling 2 116 11-19-2022, 04:13 PM
Last Post: KeepSmiling
  [Diagnosis] What is this breathing/mask/machine problem? peterporker 3 336 11-18-2022, 02:35 PM
Last Post: KeepSmiling
  BiPAP not working for CA PSlebow 24 697 11-12-2022, 03:55 PM
Last Post: PSlebow
  Noobie UARS, pls help me fix my breathing :/ newuser1002 10 463 11-10-2022, 10:56 AM
Last Post: jcoleman
  Bipap Pressure Suggestions supyasieve 6 304 11-09-2022, 05:50 PM
Last Post: KeepSmiling
  Finally got the BiPAP! RainbowFish 6 524 10-25-2022, 01:56 PM
Last Post: RainbowFish
  Mystery Awakenings With BiPap SBDhelp 13 470 10-25-2022, 10:19 AM
Last Post: SBDhelp


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.