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Machine failure; advice for replacement
#1
Machine failure; advice for replacement
Hello again.  I have been complacent for the last couple of years, fairly comfortable with my complex sleep apnea finally fairly well managed with a PR BiPAP Auto SV Advanced.  I have been forced, kicking and screaming, to use Encore Pro since Phillip's Dream Mapper is a cruel joke and last time I checked Sleepy Head does not work with this machine.  My CA's and OA's have been well under 5 although my Hypopneas remain usually in the low teens.  Subjectively I feel well although do have frequent sleep interruption partly due to various arthritic problems and partly due to mask leaks with my relatively high pressures.  My sleep doc feels this is probably as good as I'll get due primarily to my morbid obesity.  (BTW, I prefer the term "pre-morbid obesity"; I ain't quite dead yet.)  I have titrated to these settings: Max Press 30; Min EPAP 15; Max EPAP 20; Min PS 10; Max PS 18; Breath rate Auto.  My hypopneas don't seem to decrease with further increases in PS.  I'll try to insert recent data summaries from EncorePro.  

Anyhow, I tried to summarize all that because my PR BiPAP Auto SV seems to have died overnight.  (I dug out my old BiPAP Auto Biflex  System One to tide me over.)   I understand this Auto SV Advanced model is no longer available.  I anticipate a long battle with my local medical equipment supplier whose mantra is "lowest bidder (meaning near-obsolete Phillips gear)" and "you'll use Dream Mapper and like it" and "we'll try to find you a loaner."  It took them over a month to find my original Auto SV.  I see by cursory scan that prices in general seem to have come down from 2-3 years ago and I am tempted to buy out of pocket from Supplier #1. [Commercial Link Removed] hoping for advice/recommendations since I have really neglected to stay informed over the last couple of years.  

Would the ResMed Aircurve 10 VAuto BiLevel be a reasonable choice?  


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#2
RE: Machine failure; advice for replacement
J.Mayer, if you are looking for a good machine, my top recommendation is the Resmed Aircurve 10 ASV which is compatible with Sleepyhead software and is more responsive than your old System One. Supplier #2 and Supplier #33 both offer very good prices on new and lightly used models. You should not have to tolerate a DME that will not fulfill a prescription with appropriate current equipment...why do you continue to use them?

An Aircurve 10 Vauto has no backup rate and will not resolve hypoventilation or central apnea. Given your persistently high pressure support, you might need a ST-A machine, which is more appropriate for obesity related hypoventilation, and can also pickup the CA events.
Sleeprider
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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: Machine failure; advice for replacement
(01-23-2019, 11:30 AM)Sleeprider Wrote: J.Mayer, if you are looking for a good machine, my top recommendation is the Resmed Aircurve 10 ASV which is compatible with Sleepyhead software and is more responsive than your old System One.  Supplier #2 and Supplier #33 both offer very good prices on new and lightly used models.  You should not have to tolerate a DME that will not fulfill a prescription with appropriate current equipment...why do you continue to use them?

An Aircurve 10 Vauto has no backup rate and will not resolve hypoventilation or central apnea.  Given your persistently high pressure support, you might need a ST-A machine, which is more appropriate for obesity related hypoventilation, and can also pickup the CA events.

Thanks again, Sleeprider, for your prompt and helpful reply.  Mea culpa …. In my original post I unwittingly mentioned the name of a commercial vendor (No.1) and had my ears boxed and my post deleted.  Sorry 'bout that.  

Reference local DME (I'll certainly NOT name names!) it comes from a lack of competition.  I started with another DME who a week after I first started RX closed their local office and moved 50 miles away.  Then they essentially stopped home visits.  Now there is but the one within a 50+ mile radius.  I live near the edge of nowhere.  For me, a 50 mile drive is significant especially if into a metro area.
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#4
RE: Machine failure; advice for replacement
Jmayer, have you tried the newest version of Sleepyhead? http://www.apneaboard.com/forums/Thread-...stallation I know you supplied data in support getting your machine included.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

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: Machine failure; advice for replacement
(01-23-2019, 05:35 PM)Sleeprider Wrote: Jmayer, have you tried the newest version of Sleepyhead? http://www.apneaboard.com/forums/Thread-...stallation  I know you supplied data in support getting your machine included.

Hello Sleeprider,  Since I started with the PR BiPAP Auto SV Advanced two years ago, and at the time was forced to use EncorePro I got numbed up to the Encore Pro and did not recheck for new Sleepyhead capabilities.  I just now reinstalled the new Sleepyhead and was overjoyed to find that it not only reported my data with the PR BiPAP Auto SV Advanced with near perfect correlation with Encore Pro, but when I offered the one night's data from my back-up BiPAP Auto Biflex System One it flawlessly imported that machine's settings and the expected worsening in my numbers.  I have placed my order with #2  for a refurbished ResMed AirCurve 10 ASV.  Such a pleasure compared to my prior dealings with that DME.  Thanks again, until you are better paid.
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#6
RE: Machine failure; advice for replacement
(01-23-2019, 11:14 AM)jmayer180 Wrote: ... My sleep doc feels this is probably as good as I'll get due primarily to my morbid obesity.  (BTW, I prefer the term "pre-morbid obesity"; I ain't quite dead yet.) 

Sorry to get all trivial, but I did a belated double-take on that just now. "Morbid" doesn't mean dead or dying; that's "mortal". "Morbid" means diseased, not necessarily fatally.
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#7
RE: Machine failure; advice for replacement
I DO learn things from this list!  Thank you Fats Drywaller.  It does bother me when I find a word that I've always thought meant one thing, and then I find actually means something different.  And I do not think you are at all "devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  
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