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ResMed Airsense 10 Autoset for Her
#1
ResMed Airsense 10 Autoset for Her
Hello everyone!  This is my first post.  
I had a sleep study on Feb 8, and I'm still waiting to get equipment - medicaid requires pre-authorization and the process is dragging on.
Thank you for all the information provided on this forum.  Thanks to all I learned, I was able to switch to a friendly DME and be assertive with the sleep doctor before anything was dispensed.

Yesterday, I managed to make it over hurdle 1: getting a copy of my prescription and sleep study.  It was a little confusing, although the sleep study showed pre-CPAP AHI of 50 and recommended 16cmH2O, the prescription said AHI 25 and a static pressure of 12cmH2O.  Also, there was no N3 sleep, 10% paradoxical breathing, and some alpha intrusion - not sure if any of that is important, but no centrals, just 6 awakenings, 20 OAs, 55 Hypopneas, and 30 Reras over 1h32m.  I'm not sure how they're adding up the numbers.

Today I made it over hurdle 2: contacted the DME and got them agree to dispensing an apap unit, despite the static pressure prescription.
I also hopefully convinced them to provide the ResMed AirSense 10 AutoSet instead of the Respironics; however, I requested the For Her version and got a lot of push back.

They said they weren't comfortable dispensing a "For Her" device for a male patient.  I explained that the model just had an additional algorithm that responded more quickly with more subtle changes and that it could be a benefit to any patient.  I explained that even though I would start in CPAP mode, I wanted to make sure the doctor would have as many features to adjust in the future, since I'm stuck with the unit for 5 years.  The response was, "But Sir, it says For Her, and you are not a her."  Nevertheless, they were nice enough to volunteer to contact my sleep doctor and ask if he would prescribe the For Her model, and if so, they would dispense it.  This is unlikely, however, because I asked the sleep doctor up front to prescribe the ResMed Airsense 10 AutoSet, and he refused to prescribe any specific model: "I don't get involved in what equipment is dispensed."  Even though the prescription specifies a ResMed AirTouch F20 Medium, and not - patient's choice.  I also noticed, insurance code A7031 Replacement Full Face Mask Cushion was not checked, so not sure if this will present a problem.

So my questions are: 
How useful is the For Her mode really?
Should I question starting with a static pressure of 12cmH2O, since I assume I shouldn't even consider adjusting the range until the compliance period is over?
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#2
RE: ResMed Airsense 10 Autoset for Her
.I have found the for-her mode to be of limited value for most members/ patients. It is faster to apply more pressure for flow limitation, and limits response to OA when pressure rise above 12 cm. Your pressure prescription is actually very high at 16 cm, and I think you will need the standard Autoset algorithm, and a minimum pressure over 10 cm. HCPS code E0601 is continuous airway pressure device (CPAP/APAP). This covers every thing from a CPAP brick to the Autoset For Her. Technically there is no difference as far as insurance is concerned, and CPAP is CPAP, even if it is APAP.

The best part about the Resmed Airsense 10 Autoset and for her variation is that you will have EPR. So even with a satic pressure of 12, you could be getting 12/9 (IPAP/EPAP) pressure. I think using the machine in Autoset mode is best, and would suggested a minimum pressure of 9.0 and maximum of 20.0. Exhale Pressure Relief (EPR) is suggested as a comfort feature, but in reality it is bilevel pressure.

Compliance means use for at least 4 hours per night for 21 of 30 days.. Compliance does not have anything to do with machine settings. It's fine to use prescribed settings, but I would not hesitate to use autoset mode within a reasonable range around the prescription. Is it 12 or 16?
Sleeprider
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#3
RE: ResMed Airsense 10 Autoset for Her
The difference is pretty close. The AutoSet is a very very good choice too.
Starting pressure, at this time there is no reason to not use your doctors prescription.

I suggest that you post a full copy of the sleep study.  Centrals may be hiding as different terms.  
And summaries frequently leave a lot out.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#4
RE: ResMed Airsense 10 Autoset for Her
Thank you.  Its good to know I probably won't miss the For Her mode.


The prescription says AHI 25; Pressure 12 cmH2O; Ramp 5/20; Flex/EPR (blank).

The Sleep Study summary says: "In summary, the patient is a pre-CPAP AHI of approximately 50 events per hour with moderate snoring and minimal hypoxemia, but with marked improvement in sleep continuity and a final AHI of 3.5 events per hour ...
The patient should wear CPAP at 16 cm of water pressure whenever taking nap and sleeping."

I understand compliance is not based on the settings, but I thought I had read in several posts that while the DME is monitoring usage during the compliance period, they are more likely to spot if I changed any setting and might override it remotely and get upset about it.  Because the sleep doctor and staff have been extremely hard to communicate with, I am not hopeful I will be able to get the doctor to work with me to prescribe new settings should I encounter difficulty.

I'm nervous about the process but excited to get started...
Thanks for your advice!
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#5
RE: ResMed Airsense 10 Autoset for Her
I think the conflict between the prescription of 12 and study recommendation of 16 is sufficient uncertainty to use auto pressure at 9-20. I would start with EPR 2 for comfort. We can help you more once you generate some data.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Optimizing Therapy
Organize your OSCAR Charts
How To Attach Images And Files to your posts
How To Deal With Equipment Supplier
Mask Primer
Beginner's Guide to Sleepyhead

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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#6
RE: ResMed Airsense 10 Autoset for Her
FWIW SR Your settings are about where I was going on night 2, right after the doctor's settings likely failed on night 1.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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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#7
RE: ResMed Airsense 10 Autoset for Her
I missed that. You and I are more often in agreement than chocolate on vanilla, so I'm not surprised.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Optimizing Therapy
Organize your OSCAR Charts
How To Attach Images And Files to your posts
How To Deal With Equipment Supplier
Mask Primer
Beginner's Guide to Sleepyhead

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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#8
My Sleep Study
Attached is my prescription and sleep study in case anyone can explain the difference between the sleep study AHI 50 Pressure 16 and the prescription AHI 25 Pressure 12.
And whether the prescription should have had A7031 checked.  Note: the sleep clinic wrote void across it before giving it to me.

Thank you for saving some initial discomfort.  I'll start at 9-20 EPR 2.


Attached Files Thumbnail(s)
                   
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#9
RE: My Sleep Study
(02-27-2019, 09:19 PM)snord Wrote: Attached is my prescription and sleep study in case anyone can explain the difference between the sleep study AHI 50 Pressure 16 and the prescription AHI 25 Pressure 12.
And whether the prescription should have had A7031 checked.  Note: the sleep clinic wrote void across it before giving it to me.

Thank you for saving some initial discomfort.  I'll start at 9-20 EPR 2.

I cannot see where your doc got AHI 25
Pressure 12 looks like it would work if you don't go into REM.
No Rx is needed for mask parts, only for a full mask so A7031 should not be a big deal.

I just wanted a reason to do it yourself thus looking for a failure at 12.  

No problem, it's just a different conversation with your doctor.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#10
RE: ResMed Airsense 10 Autoset for Her
Thank you for reviewing the prescription.  

I've finally got my FlashAir card working, so I can't wait to start getting some real sleep, and some sleepyhead-data-goodness.
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