Sierra

My suggestion would be to wash the hose and mask weekly with Dawn dishwashing liquid and water, followed by a water rinse, and then leave hang to dry for the day. One a month you could precede the Dawn wash with a vinegar wash. It will sterilize the equipment and also remove any mineral deposits. The vinegar trick should be done on the water reservoir as well. Keep in mind that the source of the bacteria in the hose and mask is you. One or two breaths of use will "recontaminate" the equipment anyway.

This is what Cheyne Stokes Respiration looks like when it is flagged by the AirSense 10. It is the green highlighted area.

As best as I understand it periodic breathing is technically a more general condition and includes a more specific type of periodic breathing called Cheyne Stokes respiration. Respironics likes to call it periodic breathing and ResMed calls it Cheyne Stokes Respiration (CSR). I think it is a worthwhile feature and both machines likely do about the same job. Some believe it is over reported by the machines causing unnecessary alarm. But, it does raise a flag if it is seen frequently and is something that should be investigated by a cardiologist. After 6 months using the AirSense 10 my machine reports I have had CSR about 0.1% of the time.

If you want some differences between the machines, the ResMed reports flow limitations continuously while the Respironics only flags it. The ResMed reports total time in apnea, but the Respironics machine does not seem to. Total time in apnea is a useful measure because AHI only counts incidents of apnea but does not consider the length of time each incident lasts.

The ResMed has a better method of controlling EPR (Expiratory Pressure Relief) than Respironics does with their similar A-Flex feature. EPR and A-Flex can reduce treatment effectiveness during sleep. However it does make the machine more comfortable by reducing expiratory pressure before you go to sleep. ResMed allows you to use EPR only during the Auto Ramp, and then have it shut off automatically when you go to sleep. Respironics can't do that. I also believe that EPR is more effective as it gives you the full pressure relief that it is set at, while the Respironics A-Flex more shapes the pressure instead of fully reducing it.

The two machines differ in how they respond in Auto mode. The Respironics is slow to increase pressure and quick to reduce it. It also ramps pressure up about every 10 minutes and then back down again just to see what it does. The ResMed is quicker to ramp pressure up and holds it up there in anticipation of more events longer. I believe that is more effective. ResMed on the For Her version of the machine offers two different response modes. The For Her is more suitable for those using lower pressures. You can set the machine to use either the Standard or For Her response mode.

Hope that helps some,

Based on these results the only change I would suggest is an increase in the minimum pressure to 11 cm. The maximum is fine at 15 cm. The hope would be that this pressure will normalize some of the OA and hypopnea events without initiating any CA events.

You also may want to expand some of that area highlighted in green and flagged as PB (Periodic Breathing) so that you can see the individuals breaths. The amount in total is not that high, but it can be an indicator of other issues.

The good news here is that OA is about 2/3 of the apnea and it usually can be fixed with a higher minimum pressure.

Yes, the government and private insurance systems are certainly not the most efficient when it comes to costs, and we know at the end of the day we are paying for it all. Seems to me that if the government just made necessary medical equipment 100% tax deductible, it would be a much more efficient system. When people are paying expenses out of their pocket they tend to be much more frugal about it.

I did a quick check of CPAP supply places located in BC. There are several, but none have any pricing. It appears they are all likely to be on the inflated insurance company pricing system.

If insurance is paying it may not make sense for you to buy on line. Here is a link to the machine I would recommend packaged along with a heated ClimateLine hose for $825. I have bought from them and they provide good service. This page also has the prices for replacement parts and consumables, except for the mask inserts. You will be able to find it under mask parts though.

A10 For Her

Welcome to the forum,

On the CPAP can you give more information such as the make and model, what are the pressures set at, and the masks you are using? Are there any specific issues which cause you to wake up while on the CPAP? Do you take it off in the night?

On the general sleeping without sleeping pills you may find this website at the link below helpful. They advocate the use of Cognitive Behavioural Therapy instead of pills, or CBTi. The information is not specific to CPAP use, but I have found some of their information quite helpful in my ability to get a good night's sleep.

SleepWell - It's No Dream

I believe SirRobin is located in British Columbia, Canada. To my knowledge we do not have the DME system here, although Ontario may have something similar. Health care in Canada is administered provincially although the Federal government supplies the money. For that reason each province is different. Where I am the provincial health care system pays for the sleep studies but not the machine or accessories. Many, and especially those who are working for a larger company may have a supplementary private insurance plan. But there are various levels of coverage and different companies that provide it (ManuLife, SunLife, etc). But in most cases they pick up the costs not covered by the provincial health care system up to a specific limit. How you spend up to that limit can be negotiable if you talk directly with the insurance company. It depends on the company and the coverage. The CPAP/Study provider of course likes to put themselves in the middle and will say they will bill the insurance company direct. And they do that often while charging very high prices. For example $2400 for a machine and mask, instead of the on line price of $875. It is not a very efficient system but it is what it is. I'm retired and no longer have a Cadillac insurance plan so everything I get is on my nickel. While this sounds bad, it is not really that bad. I can buy what I want, when I want, and do not have to dance to the tune of a government health cares system, or an insurance company. In the scheme of things the costs of a CPAP are not all that high when you are paying it all yourself, and shop around for the best prices.

For the AutoSet machine the initial cost on line for the machine, carrying case, slimline hose, mask, and heated hose is about $875. That is all you need to get started. A replacement mask insert is about $35 and is needed perhaps every year or so based on my wife's experience. Filters for the machine are about $3 each and probably need to be replaced every 6 months or so. My wife's machine is 4 years old and seems to be operating fine. Perhaps for budget purposes count on a replacement once every 5 years based on wear. No indication that hose life is an issue. The only real problem is that it seems ResMed thinks it needs to change the hose fittings with each new machine, so a new machine probably means new hoses too. And if you camp and want to run on 12V DC power supplies are about $130. They also seem to be specific to the current machine with ResMed,

You can buy parts wherever you want. You need a prescription for a machine but not parts. There are lots of CPAP machine and components on line stores in Canada. The good news is that prices in Canadian dollars are virtually the same as what the US folk pay in $US. Perhaps Trump has a 25% tariff on Australian imports?

I suspect the more practical issue is that you may want a new machine just to get the latest bells and whistles technology, not because it is worn out. The iPhone effect!

The wildcard cost is that of a mask that works for you. If you can get the mask type and model sorted out on somebody else's nickel, that is a big win. After that all you have to do is replace the insert once a year or so.

There is nothing simple about central apnea. About all I can suggest so far is that I do not see any recognizable patterns that can be easily associated with heart disease or other issues. Time will tell how persistent CA may be for you.

The maximum set pressure in auto mode is nothing to worry about. What you want to know now is how high does the machine want to take pressure, and even more important is there a pressure at which CA becomes more prominent. Down the road you may want to limit maximum pressure, but it is too early to think about that. I would be hoping that without any pressure support the machine will even use lower pressures. In an ideal situation pressure support may not even be necessary.