Sierra

As a comparison the fixed pressure AirSense Elite at this same outlet is $755 with the heated hose, and $25 discount. So you are getting an Auto machine for $30 more than the fixed pressure machine. Makes no sense to buy the fixed pressure model.

https://www.cpapmachines.ca/collections/cpap-machines-1/products/resmed-airsense-10-elite-with-humidair?variant=13682088837210

That is good news when you are buying a CPAP out of your own pocket. When you consider the $US exchange, we can get a ResMed Auto for the equivalent of $575 US. That is lower than you can get it for a new machine in the US.

On a quick look, the best price I can see on the AutoSet For Her package with a heated ClimateLine hose is $810 less a $25 with the discount code, or a total of $785 with no tax. Unfortunately the heated hose for the S9 does not fit the A10 machines, so you have to get the new A10 hose if you want that option. I have bought from this company and they are good to deal with. See this link:

https://www.cpapmachines.ca/collections/cpap-machines-1/products/resmed-airsense-10-for-her-with-humidair?variant=13682088968282

What country do you live in? The reason I ask is that in some countries there is a big difference in cost between a fixed pressure machine and an auto machine. In Canada the difference is low. For example at one on line store the fixed pressure ResMed AirSense Elite is $750 ($CDN), while the automatic AirSense AutoSet For Her is $780. At that low price difference it makes no sense in my opinion to buy the fixed pressure machine. The Auto machine can be easily set to fixed pressure mode. In fact that is what I am currently doing with my AirSense AutoSet. After running it in auto mode for 6 months or so and I determined what pressure works best for me, I have switched to fixed pressure CPAP mode. Now if you are living in a country where the difference in price is much larger, and you know what pressure works for you, then you might want to choose the AirSense Elite. It still captures detailed data on the SD card which can be viewed in SleepyHead. The more basic AirSense CPAP does not capture detailed data -- basically a brick.

If you are going Auto, my thoughts are that the ResMed machines have a few advantages over the DreamStation. The ResMed A10 machines have an auto ramp feature that maintains a constant go to sleep pressure and then ramps up to the minimum therapy pressure when you actually go to sleep. The ResMed machines also allow the option to use the EPR function in the ramp mode only. Your S9 does that too, but I don't believe the DreamStation allows that. You can often run lower pressure when you only use EPR during the ramp but not during sleep. And in the ResMed Auto machines there are two versions, the Standard and the For Her version. I would choose the For Her version. It does everything the standard machine does, but also can be set into the For Her auto mode. The For Her mode is more likely to work for someone using lower pressures. But the good part is that it is a selectable option. You can use it or not. The price is the same as the standard machine.

Hope that helps some. Any questions, just ask... My wife uses the S9 Auto, and I use the A10 AutoSet.

You could start with the make and model of machine you are using, the specific mask model, your pressure settings on the machine. For an auto machine there will be a minimum and a maximum pressure. Do you know what your AHI number was at diagnosis, and what it is now when using the CPAP?

For sure an AHI of 30+ is something to be concerned about. I can't help you with doctors in Florida. The first thing I would do is download SleepyHead and use it to find out in more detail what is going on. If you want you can post a screen shot of a typical day here for comments.

SleepyHead Download

SleepyHead Basic Manual

CPAP and even BiPAP machines often do not do a good job with central apnea. Often BiPAP machines are prescribed to fix it, but it actually makes it worse instead of better. The other options are going to a lower pressure - sometimes fixed, or an ASV machine.

My wife has the ResMed S9 and I have the newer A10. I think both are basically good machines, but the A10 does have a few advantages, and possibly one disadvantage. First with the disadvantage, I normally stand up to change the setup or check the data on my machine. I find the top display and controls on the S9 more convenient. My wife also likes the lower profile of the S9 because she can put it in the night table drawer and close it when not in use.

The advantages of the A10 are that it overall is smaller and a bit easier to travel with. The case has a loop to attach it to a travel bag that the S9 lacks. The data storage capability of the A10 is much better. The S9 only stores a limited amount of data and then starts to write over the old data. The A10 can hold months of data before it starts to overwrite. So, if you are a SleepyHead user you can slack off on transferring the data to your PC, without losing any data. But, the biggest advantage of the A10 is the Auto Ramp feature. While both the S9 and A10 can be set up to use EPR on ramp only (which is my preference), only the A10 has the auto ramp feature which goes to treatment mode when it detects you are asleep. I think that is far superior to the gradual ramp of the S9 or other machines, if you do have trouble going to sleep wearing this contraption. The gradual ramp up starts with a lower pressure and constantly increases it until it times out. Especially if you are a new or anxious user you can start thinking "I better get to sleep or the pressure is going to get too high and I will never sleep". The Auto Ramp is not really a ramp, but a pressure hold. It keeps the pressure constant until it detects you are asleep. It times out after 30 minutes, and goes to treatment mode, but I find I most often go to sleep in 10-20 minutes and I don't get to that point.

My last thought is that I think the Australians (ResMed) are ahead of the Americans (Phillips - DreamStation) when it comes to CPAPs. The unfortunate part is that the ResMed machines apparently are much cheaper in the US than in Australia (in $US). And they are even cheaper still in Canada. Why? Must be a government duty or tax thing, or a company strategy. Don't know. Now if you are thinking about upgrading your machine and are not in a hurry, keep in mind that ResMed is getting to the point where it is somewhat overdue to release a new model. Could happen anytime. I think the next major breakthrough in CPAP technology is the use of AI. It may be a little early to see that in commercial form though...

Here is a tool to determine your degree of Sleepiness. It is a standard in North America. Not so sure in the UK...

Epworth Sleepiness Scale

This link may be helpful to you. The way I read it is that the key is whether or not you have excessive sleepiness. I did not read all of this document, just the section 1.2.1.

Detailed DVLA Guidance for UK Drivers with Sleep Apnoea

SleepyHead gives you a lot more detail than MyAir if that is what you are currently using. Here is an example of the Daily Detail screenshot. There is a bar at the top that flags all of the events over the night. Below you can see what your pressures were along with other data. This lets you correlate the time of the event to the pressure it occurred at. It also lets you see how well the machine is responding to the events.

I am not familiar with the linkage of using a CPAP to the driver's licence issue. It would seem that if you are undergoing treatment, that there is some appreciation that you will not get immediate success. However, sometimes laws don't work that way.