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how to get a script from cpap to apap
#1
how to get a script from cpap to apap
I had my sleep study done at the end of 2015 and it was a split night. The first part of the night AHI was 42. The second half of the night with cpap and a pressure of 4 to 6 was used. I was shocked I needed cpap and was very disturbed with the mask and only slept 90min but AHI went down to 4. 

My sleep dr wrote a script for- ResMed AirSense 10 AutoSet CPAP machine, CPAP pressure: 6 cm of water 

DME gave me a ResMed AirSense CPAP and said that I cannot have AutoSet because it's a set amount of 6 not a range. 

According to the MyAir site the cpap has kept my AHI below 1 every night since then, although I don't feel much better. 

Recently my daughter was prescribed a ResMed AirSense 10 AutoSet and I used it a few times. It seems that my pressure is all over the place. How can they say to have it set at 6 all night when I went from 6 all the way to 10 (the max pressure it was set for). 

I have an appointment with my sleep dr and I want to ask him to change the script with a pressure range so I can have the AutoSet machine. Which sleepyhead charts should I bring with me to convince him I need a pressure range? I don't think he's going to be too hard to convince since that's what his original script was for anyway. 

I'm always amazed that my AHI was 42 (and supine ahi was 72) and it's been under 1 consistently with only a pressure of 6. But I am wondering if I'd feel better if I had the autoset machine. 

           
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#2
RE: how to get a script from cpap to apap
(03-07-2019, 04:59 PM)blessedbylily Wrote: I had my sleep study done at the end of 2015 and it was a split night. The first part of the night AHI was 42. The second half of the night with cpap and a pressure of 4 to 6 was used. I was shocked I needed cpap and was very disturbed with the mask and only slept 90min but AHI went down to 4. 

My sleep dr wrote a script for- ResMed AirSense 10 AutoSet CPAP machine, CPAP pressure: 6 cm of water 

DME gave me a ResMed AirSense CPAP and said that I cannot have AutoSet because it's a set amount of 6 not a range

The DME ripped you off. The Autoset can be set to fixed pressure (CPAP) mode for your current settings and can later be set to autoset (APAP) mode if and when needed. A CPAP cannot. They should have dispensed as written. They get paid by insurance companies the *exact* same amount whether they deliver the cheapest fixed pressure machine or an autoset (it's the same insurance code), so they gave you the cheaper machine even though that wasn't what the script said and pocketed the extra money. Return it and tell them to dispense what the doctor prescribed. If they refuse, get your doctor's office involved to make the DME dispense as written. It won't cost your insurance a dime extra (though it costs cash pay patients a bit extra).

But, good to hear you are having such success even with a fixed pressure machine. That's an amazing result at such a low pressure, and lower pressures are less likely to cause side effects like swallowing air which can lead to acid reflux. But often Autoset machines can give better overall results because they deliver just the pressure needed, when its needed, which is important because as you've noted sleep apnea can change on variables like sleeping position.
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#3
RE: how to get a script from cpap to apap
I'm wondering what is the most important chart to show the sleep dr to prove I need a pressure range-  The overall pressure chart? It shows I went up and down from 6 to 10. Or the Time at Pressure? Should I zoom up on the Flow Rate chart somewhere and print that out? I'm just not sure what to show him. 

Thank you for your help.
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#4
RE: how to get a script from cpap to apap
The Resmed Autoset is responding to flow limitations. Try reformatting the charts to include flow limitations, and you will quickly see why pressure rises. Your Phiips is particularly ineffective in treating flow limitations, while the Resmed uses a bilevel pressure (EPR) which can actually reduce flow limits. Reading the wiki will help you understand http://www.apneaboard.com/wiki/index.php...Limitation

Your results are probably too good to make a compelling case for a change of machines, but the way to get it done is to focus on how your feel, and how the Autoset makes a positive difference. We know that it's really because of the auto pressure adjustment and bilevel IPAP/EPAP pressures that Resmed produces, but for your doctor it's going to be about comfort and tolerance. The use of the Autoset seems to confirm that a fixed pressure of 7.0 is okay, but I could see you at 8.0 as well. The big problem is your Resmed CPAP does not produce data, so no one can tell whether it is effective or not.
Sleeprider
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