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CPAP Machine Choices - CPAP for central apnea?
#1
CPAP Machine Choices - CPAP for central apnea?
I was just diagnosed (via ahome sleep study) with both central and obstructive sleep apnea. AHI = 36.5 

My insurance will not kick in until I spend my deducible. It will cost me about $1000 out of pocket and the DME wants to give me a  Respironics Dreamstation .

I read the Wiki page and found the following for sale online.

------------------------------
New, Open Box  ResMed S9 AutoSet  w/ Heated Humidifier

 
Notes:

Your Price

 
[Image: S9_Full_Small.jpg]
ClimateLine, and Slimline tubing included.

Number Available: 29 units
Retail Price New: $3700.00
Zero Hour, 2 Year Warranty.
$699.00

----------------------------------------------

Any advice before I buy it?
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#2
RE: CPAP Machine Choices - read this before you accept a new machine
(02-01-2018, 02:58 PM)Albercook Wrote: I was just diagnosed (via ahome sleep study) with both central and obstructive sleep apnea. AHI = 36.5 

My insurance will not kick in until I spend my deducible. It will cost me about $1000 out of pocket and the DME wants to give me a  Respironics Dreamstation .

I read the Wiki page and found the following for sale online.

------------------------------
New, Open Box  ResMed S9 AutoSet  w/ Heated Humidifier

 
Notes:

Your Price

 
[Image: S9_Full_Small.jpg]
ClimateLine, and Slimline tubing included.

Number Available: 29 units
Retail Price New: $3700.00
Zero Hour, 2 Year Warranty.
$699.00

----------------------------------------------

Any advice before I buy it?

Please search for Resmed Airsense 10 Autoset Sistemma on Amazon.  You will find a Resmed Airsense 10 Autoset for $647, and Airsense 10 Autoset for Her for $650.  Save your money. That includes free shipping.
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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#3
RE: CPAP Machine Choices - read this before you accept a new machine
My doc thought that treating the obstructive apnea the central may fix its self. Any thoughts?
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#4
RE: CPAP Machine Choices - read this before you accept a new machine
(02-01-2018, 05:33 PM)Albercook Wrote: My doc thought that treating the obstructive apnea the central may fix its self. Any thoughts?

Feel free to post your study.  In general, mixed apnea and centrals turn to central apnea and hypopnea with CPAP therapy, but we have seen some results here that treat all apnea to less than 5 AHI.  When dealing with that type of apnea, the trick is to keep pressure fairly low, constant and avoid pressure swings like EPR and Flex (different exhale and inhale pressures). 

Typically, a person is treated on CPAP before moving to more expensive machines.  The difference is significant.  An auto CPAP costs about $650, while an ASV cost over $2200...those are highly discounted non-insurance prices.  If you go through insurance, an ASV will easily reach $5000.
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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#5
RE: CPAP Machine Choices - read this before you accept a new machine
(02-01-2018, 02:58 PM)Albercook Wrote: I was just diagnosed (via ahome sleep study) with both central and obstructive sleep apnea. AHI = 36.5 

My insurance will not kick in until I spend my deducible. It will cost me about $1000 out of pocket and the DME wants to give me a  Respironics Dreamstation .

I read the Wiki page and found the following for sale online.

------------------------------
New, Open Box  ResMed S9 AutoSet  w/ Heated Humidifier

 
Notes:

Your Price

 
[Image: S9_Full_Small.jpg]
ClimateLine, and Slimline tubing included.

Number Available: 29 units
Retail Price New: $3700.00
Zero Hour, 2 Year Warranty.
$699.00

----------------------------------------------

Any advice before I buy it?
I would post your Sleep Study.  The Central Apnea may need a different machine.  Your Sleep Study should indicate some degree of Severity.  Seeing that we can better suggest what your future may hold.  It maybe APAP to BiPAP/BiLevel to ASV.

Fred
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#6
RE: [split] CPAP Machine Choices - CPAP for central apnea?
Depends how many CA, but if there were CA in the sleep study, the odds are there will be CA on CPAP, some need to move to a different machine. You may be better, spending the deductible $1,000 and perhaps have better care available? I don't know what other out of pocket you will have, you need to work this out.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#7
RE: [split] CPAP Machine Choices - CPAP for central apnea?
While the DreamStations (correct models) are good machines, I will state that many here prefer ResMed.  
Based on normal Medical Protocol.

Assuming Central Apnea needs to be addressed (Why to see your Sleep Studies)
Buy and Fail at CPAP (Auto CPAP preferred)   then
Buy and Fail at more expensive BiPAP/BiLevel CPAP Then
Buy and succeed with even more expensive ASV (Auto Servo Ventilator)  CPAP.

With 

Whichever way you choose we will help you to the best of our abilities.

Fred
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#8
RE: [split] CPAP Machine Choices - CPAP for central apnea?
You guys rock. I don't know if this is enough information. I only did an at home study. My doc will order an overnight stay sleep study if I want it. It will just take awhile because there is a waiting list. I will wait and do it but if the results are not likely to change the machine that I need I'm inclined to get the machine and make the adjustments (with this board's help). Seems like I will get to a good night's sleep sooner. I'm going to make adjustments either way.

Here is everything in my chart

<Redacted>

Thank you for anything you can conclude from it.

George
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#9
RE: [split] CPAP Machine Choices - CPAP for central apnea?
(02-02-2018, 02:58 PM)Albercook Wrote: You guys rock. I don't know if this is enough information. I only did an at home study. My doc will order an overnight stay sleep study if I want it. It will just take awhile because there is a waiting list. I will wait and do it but if the results are not likely to change the machine that I need I'm inclined to get the machine and make the adjustments (with this board's help). Seems like I will get to a good night's sleep sooner. I'm going to make adjustments either way.

Here is everything in my chart

<Redacted>

Thank you for anything you can conclude from it.

George

George, it is possible (but not probable IMO) that a CPAP/APAP solution could be found that provides satisfactory results. And the good folks here a great resource for optimizing settings.

A stronger probability exists that CPAP/APAP won't provide adequate therapy, Bi-Level/Bi-Pap would make it worse, and you arrive at the ASV solution.

If you had to purchase 3 machines in increasing levels of cost (roughly $1,200/$2,000/$5,000 at DME prices) it could get expensive quickly.

I failed on Bi-level almost immediately. The 5 nights of my trial were hell. I was glad I was able to borrow a machine from my sleep clinic.

High deductibles are tricky because DME prices are so much higher than purchasing out of pocket elsewhere. I'd just figure in the probability that the CPAP/APAP might not be the final solution. And I'd try not to purchase a Bi-level if they insist on a trial prior to ASV.

Would your sleep doctor be willing do to a split study, doing both CPAP and ASV in the same night?

Bill
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#10
RE: [split] CPAP Machine Choices - CPAP for central apnea?
Ask your Dr, about the Central Apneas which are roughly 50% of your Apneas if I'm reading the report correctly (the online copy is hard to read), and if you could be titrated for ASV at the night study.
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