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BiPap not helping?
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Sleepster Offline
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Posts: 4,991
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: #11
RE: BiPap not helping?
Sometimes CPAP therapy can induce central apneas. Often, but not always, it subsides. You will just have to stay with it and see what happens. Meanwhile, it wouldn't hurt to get a second opinion.

Sleepster
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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.
03-14-2016 08:57 PM
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Sleeprider Online
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Advisory Members

Posts: 3,338
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #12
RE: BiPap not helping?
An AHI of 70 is not treated. You have complex apnea. About 15% of patients do have this form. A few can be treated with BiPAP, but most will fail CPAP and BiPAP and require ASV (Adaptive Servo Ventilation). Because the ASV machine costs more, most insurance companies require that the medical necessity of ASV be demonstrated by failing CPAP and BiPAP. That is where you are. You need to talk to your doctor and make him aware that bilevel therapy is not effective and you require a different approach (ASV). Call him now! Call him every day until he is sick of hearing about it. This therapy will work great for you once you have the right one.

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03-14-2016 09:16 PM
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PaytonA Online
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Posts: 3,006
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #13
RE: BiPap not helping?
Sounds to me like your doctor is trying to make sure that you fail with the Vauto in S mode to make it easier to justify the ASV. I would not let it go too long before I would start pushing my doc to go after the ASV.

Best Regards,

PaytonA
03-14-2016 09:20 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #14
RE: BiPap not helping?
You do not have to wait a month. Be nice, but push. AHI of 70 is not great, good or anything else. You are a long way from 5 and the chances of it going from 70 to 5 in a month just by getting used to it is almost zero. You have central apnea and an ASV machine is the only treatment for that. Be nice, but push.
03-14-2016 09:50 PM
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Gshell Offline

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Posts: 6
Joined: Mar 2016

Machine: ResMed AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: ResMed full face
Humidifier: Unsure
CPAP Pressure: 23
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #15
RE: BiPap not helping?
Y'all are great. Thanks for your comments and advice. Getting a new doc who will prescribe a servo is not a problem, my pulmonologist, not the neurologist who is currently treating me, has already said he thinks a servo may be what I need but MEDICARE- who knows - they won't budge on lots of issues and I don't know if this is an issue or not. My average events are 77.3 with 76.5 being central events. I am on some pretty heavy duty medication and I am sure that is a main contributor to the central apnea. The meds cannot be changed so I need the machine to work for me. It's a bit scary to still be having this many events while using a machine.
03-15-2016 07:56 PM
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richb Online

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Posts: 527
Joined: Jun 2015

Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Built in
CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #16
RE: BiPap not helping?
(03-15-2016 07:56 PM)Gshell Wrote:  Y'all are great. Thanks for your comments and advice. Getting a new doc who will prescribe a servo is not a problem, my pulmonologist, not the neurologist who is currently treating me, has already said he thinks a servo may be what I need but MEDICARE- who knows - they won't budge on lots of issues and I don't know if this is an issue or not. My average events are 77.3 with 76.5 being central events. I am on some pretty heavy duty medication and I am sure that is a main contributor to the central apnea. The meds cannot be changed so I need the machine to work for me. It's a bit scary to still be having this many events while using a machine.

With Medicare you have to jump through some hoops. Generally you need a sleep study with both a standard Cpap machine and an ASV machine. You have to fail with the standard machine and then succeed with the ASV machine. This can be done in a split study. The same machine can be set for both standard Cpap/Bi-pap and ASV. You then need a follow up visit with the sleep doc at 61 days where the doc certifies that your machine is providing therapeutic treatment. You already have data (and probably a sleep study) showing that standard Cpap does not work. Read as much as you can so that you can have a good conversation with your new Doc. Best of luck.

Rich
(This post was last modified: 03-15-2016 08:29 PM by richb.)
03-15-2016 08:28 PM
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justMongo Offline

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Posts: 3,845
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #17
RE: BiPap not helping?
(03-10-2016 08:52 AM)cpdaniel Wrote:  
(03-09-2016 10:37 PM)justMongo Wrote:  ... The ResMed AirCurve 10 VAUTO should have 3 pressure numbers.
IPAPmin, IPAPmax, and PS (Pressure Support.)

Minor correction- the settings on the AC 10 are >EPAPmin<, IPAPmax and PS.

Typo.

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.
03-15-2016 09:12 PM
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Ghost1958 Offline

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Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #18
RE: BiPap not helping?
As my medicare advisor provider says,
" A Dr can get done thru Medicare whatever he wants if willing to fill out a form to get it done".
Its finding a Doc willing to spend 10 minutes to fill out the form.
03-15-2016 10:30 PM
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Gshell Offline

Members

Posts: 6
Joined: Mar 2016

Machine: ResMed AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: ResMed full face
Humidifier: Unsure
CPAP Pressure: 23
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #19
RE: BiPap not helping?
I think you are right about the Medicare. Everyone's input has made me aware of what to ask and what I should expect. Thanks
03-16-2016 09:13 PM
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Gshell Offline

Members

Posts: 6
Joined: Mar 2016

Machine: ResMed AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: ResMed full face
Humidifier: Unsure
CPAP Pressure: 23
CPAP Software: Not using software

Other Comments:

Sex: Female
Location:

Post: #20
RE: BiPap not helping?
In an earlier comment to my post some suggested I share a waveform - just installed Sleepyhead and I can't find a waveform. the daily reports are great. Printing them out and taking to my doctor.
03-18-2016 12:17 AM
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