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Newbie questions
#1
I'm new to all this, and have some questions. I did a sleep study at my wife's insistence, as she said I stop breathing several times a night and snore loudly. The sleep study tech woke me in the middle of the night and put me on a CPAP, saying I easily failed the test. The rate of breathing it forced on me was WAY too fast! Hated it. In the morning he said I had Central Sleep Apnea. The doctor sent me to a local equipment provider who set me up with a ResMed Aircurve 10 ST. Here's the Rx information on my chart from the doctor... Instructions: Med name: bipap st at ipap=14 cwp, epap= 10 cwp, st=14, c-flex of 3 and heated humidoty with any comfortable mask. Last night was my first night and I could only stand having it on for 3 hours. Again the breathing rate seemed too fast and shallow. I question why I was given a ST instead of the ASV version. From my reading it seems that the ASV is made for Central while the ST is made for Obstructive. It would be much more comfortable if I controlled the breathing rate (and had assistance when needed). Is the forced breaths per minute (18) something I just need to get used to?

Also, they are charging $895 per month rent-to-own on this machine for 10 months. I have good insurance that covers 80% of the cost, but this still seems excessive. My out of pocket after the 10 months is $1790, insurance will pay $7160, (total of $9K) but the machine is available online (new) for $3-4K. Am I paying too much?

Thanks for any advice and help.
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#2
Well, the first question is would your insurance pay for purchase outright? If you have medicare it requires you to rent (I think). I would definitely purchase outright, if my insurance would let me. Mine won't authorize a purchase so, I am facing the same inflated outrageous pricing to rent for 13 months.
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#3
Hi Bendixen!

Welcome to the forum.

Failure to adhere to therapy is a BIG problem with xPAP treatment. For this reason it's very common for insurance companies and Medicare to require a rent-to-own scenario. As for the price; all I can say is they won't kiss you after you have paid for it.

Your other questions concerning the setup of your ASV ST will need to be answered by someone familiar with your equipment.

Good luck.
Statistics prove that people who have more birthdays live longer.
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#4
Gday Bendixon, welcome to Apnea Board.

I don't know the details of the American medical finance labyrinth but I have seen it written that you need to "fail" bilevel treatment before being considered for ASV. There's no reason for this, it's just policy. Wink

Although some patients with central apnea do respond to bilevel treatment, the majority require ASV, which is a big jump in cost. The cost difference is why they make you jump through these hoops.

I don't have access to the Aircurve 10 ST manual at the moment, but I would be pretty sure the breathing rate (termed "backup rate") can be adjusted to suit your own breathing pattern. 18 bpm seems far too fast - I'd want something around 10 but ymmv. You can either talk to your DME about getting the rate reduced or else take matters into your own hands and adjust it yourself.

At the top of every page in this forum is a link to CPAP Setup Manuals. Through this you can request a copy of the clinician manual for your machine, which will show you how to adjust the backup rate.

Good luck. Please don't hesitate to come back with any other questions or comments.
DeepBreathing
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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#5
Hi Bendixen,
WELCOME! to the forum.!
Hang in there for more suggestions and answers to your questions and much success to you with your CPAP therapy and getting it fine-tuned to meet your needs.
trish6hundred
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#6
OK, I've dug out the manual, and it seems there are a number of different modes for this machine, as follows:

S mode : In S mode, you may set two treatment pressures-–one for inspiration (IPAP) and one for expiration (EPAP). The device senses when the patient is inhaling and exhaling and supplies the pressures accordingly. The difference between IPAP and EPAP levels helps determine the tidal volume.

ST mode: In ST mode, the device augments any breath initiated by the patient, but will also supply additional breaths should the patient breath rate fall below the set "backup" breath rate.

T mode: In T mode, a fixed breath rate and a fixed inspiration/expiration time are supplied regardless of patient effort.

CPAP mode In CPAP mode, a fixed pressure is delivered.


Do you know which mode your machine is set in? That will obviously have a big effect on your experience.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#7
Thank you for the welcome and responses. I ordered the clinical manual from this forum and unlocked the machine. It is set to ST mode, but the backup Resp Rate was set too high and the Ti Max rate was set too low. I gave myself an extra second to inhale each time and it feels a little better. I'll try it out tonight and see if I need further tweaks tomorrow.
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