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[CPAP] I want to buy a bi-level or AVS machine and am in need of advice.
#11
RE: I want to buy a bi-level or AVS machine and am in need of advice.
I'll make a minor correction to the above, it does not change the intent.

"The only way you qualify for a Vauto/bilevel on medicare/insurance is if you first fail CPAP/APAP"
to
The "typical" way you qualify for a Vauto/bilevel on medicare/insurance is if you first fail CPAP/APAP

since it depends on the doctor and the medical condition being treated. It is certainly the common way.
Absolutes, "only", are rarely correct.
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#12
RE: I want to buy a bi-level or AVS machine and am in need of advice.
Sure it can happen but doctor needs to convince medicare/insurance, they need to say you are not suited for CPAP/APAP which most doctors usually won't do without first failing it and some of the medicare/insurance clauses require it to have been tried. If the OP had obvious central apnea and an ASV was indicated things might be a bit different but with only moderate level hypopneas, no apnea and minimal oxygen desaturation you would have to have a very rare doctor for him to go to bat against medicare/insurance and sign off on bilevel instead of CPAP/APAP. Feel free to ask, just don't be surprised if doctor rejects it, lots if not most doctors believe bilevel is only required for severe cases.
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#13
RE: I want to buy a bi-level or AVS machine and am in need of advice.
   
   
   

If the allergy season in combination with my COPD is to blame for my worsened condition I'm not certain. I'm having higher AHI, ranging from 7 to 26. Some nights recently my CA's have been as high as my OA's. I've ordered a new cervical collar, but it is delayed in shipping. I primarily sleep on my back and use no pillow, but elevate my head somewhat. Three days ago I reduced IPAP from 13.6 to 13.0. This helped with AHI, but not high percentage of CA's. 
Attachments added to next post, Thanks to all!
Larry
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#14
RE: I want to buy a bi-level or AVS machine and am in need of advice.
   
   
   

The rest of the graphs. My chart heights are too great so 5 do not appear on one page.
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#15
RE: I want to buy a bi-level or AVS machine and am in need of advice.
Chart heights are adjustable, Just hover your cursor along the top or bottom border of a chart, and it will change shape allowing you to drag to a new size. You can also use the menu options under File/Preferences/Appearance to set graph height defaults for your needs.

Your events seem highly clustered, and this is likely to be a result of chin-tucking or positional apnea. Read these wiki articles on this common problem and try the experiment where it is suggested you relax and let your chin sag to your chest while observing airway resistance. The tendency for positional apnea will be very quickly apparent.
Positional Apnea: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneaboard.com/wiki/index.php...cal_Collar
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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.
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#16
RE: I want to buy a bi-level or AVS machine and am in need of advice.
Hi Sleeprider,  thanks for the help with sizing charts and especially the two articles that dealt with chin tucking. I came down with covid a day after I posted. Having COPD, receiving monoclonal antibodies was a great help in recovering. At the time I posted I had pretty well worn out my Coreflex Ultra collar as well as the regular Core collar before it. I have serious sinus blockage and must have been forcing my mouth open frequently at night to breathe. After a week's use I could feel and see how the foam had broken down. Five days ago I received a hard collar I thought might be worth a try. It is a Velpeau "silicone" neck brace cervical collar. Amazon seems to be the only way to order at this time. The current cost is $23.99. The hard plastic has a foam collar around it. It is not as comfortable as a foam collar and I did not expect it would be. The large size has a 3.3" width. The best thing is it supports my jaw on both sides about 2" from my chin. This collar will not collapse. Adjusting the collar will take practice to perfect, I think. The first night it bothered my back, but hasn't since. Once my AHI settles down post covid, I will be back seeking more of your good advice. 

Thanks
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#17
RE: I want to buy a bi-level or AVS machine and am in need of advice.
            I don't have noticeable after effects after receiving monoclonal antibodies for covid 3 weekes ago. I have used an allergy nasal spray the last 5 nights and it does help. My ACH has ranged between 21 and 27 the last 5 nights. I have lots of hours on my current machine so am looking to replace it. Medicare advantage and local doctors have only given an ok for a CPAP. I haven't gotten one but instead to continue to use the old Aircurve vauto that was gifted to me. I will buy a used machine out of pocket.  

I am needing help with the settings. I found an article on here about EERS. It sounded promising. I'm willing to try anything.

   
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#18
RE: I want to buy a bi-level or AVS machine and am in need of advice.
I really don't know what is going on here, but with apnea this persistently high, I think you need professional medical attention. It's clear you need a higher minimum pressure than 6.4 to deal with obstruction, and the advise to use a collar may still be valid. As far as I can tell, your minimum pressure needs to be 9.0, max pressure 18.0 and I have no idea if that will help or not.
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.
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#19
RE: I want to buy a bi-level or AVS machine and am in need of advice.
   

I gave a prayer of thanks when I saw today's chart! 

Your pressure recommendations were right on in bring down the apnea, Sleeprider! 

Wink  Wink  Wink  Wink  Wink  Thanks  Thanks  Thanks  Thanks

The reminder about the collar was good. I am going to try to wrap tape around the Velpeau silicone neck brace collar to raise my chin more. I have the large size which has a width of 3.3 inches and I believe more might be beneficial. 

What do you recommend from next? 
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#20
RE: I want to buy a bi-level or AVS machine and am in need of advice.
That is pretty remarkable progress. It sure looks like the pressure was just off so far that the machine never caught up. Let's go with the same pressure but change Trigger Sensitivity from normal to High.
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.
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