Sierra

Even though the machine is new, I would clean it thoroughly.

At the top of each post there should be a line beside the poster name that says how many days or hours old a post is.

I don't understand much of the German, but it would seem you have an AHI of 4.6 which is slightly less than the diagnosis standard of mild apnea (5-15 AHI). I also think I saw a minimum? saturated oxygen of 90%? That is a bit low but not worry some low. It does confirm there are some apnea events. I also think it says 78% of the events were obstructive, and 11% were central. Obstructive events where the airway closes can be corrected with air pressure. Central events are when you simply stop breathing with the airway open, and is not corrected with more pressure. I am not a medical professional, but I would suggest the sleep report indicates marginal apnea, and a cpap may or may not improve the situation. There is a certain amount of aggravation and sleep disruption from using a CPAP. In marginal cases this factor may outweigh the benefit from it.

What results are you getting for AHI and apnea types from the AirSense Elite? This machine should have a SD card that stores detailed data. You can download a freeware program called OSCAR to view this detailed data. It will tell you a lot more about what is happening during sleep and whether or not the machine is helping or not, or if there are some adjustments that could be made. The Elite machine is a fixed pressure device and does not adjust automatically, but the fixed pressure can be changed. OSCAR needs a PC or Mac and a SD card reader. If you need assistance with it, post back here.

My routine in cleaning my AirSense 10 is to rinse the water reservoir hose and mask with pure vinegar. I then add a bit of Dawn dishwashing detergent to the each component and continue to shake and rinse. Last I rinse out the parts with plain warm water until there is no more soap residue. Each night I turn on the pre warming cycle about 15 minutes before going to bed. The only time I have had a bad smell come out of the machine is when I let the reservoir run dry during the night. When that happens I wake up with a dry nose and thinking that something was on fire, or I was breathing out of a gym bag full of unwashed clothes. Not pleasant, but my fault.

You mean real bugs? I would expect the inlet air filter would not let bugs in?

Very nice graphs. There are two arguments for a BiPAP machine. One is that your APAP is maxxing out at 20 cm much of the time, and a BiPAP would be able to go as high as 25 cm in pressure. The second argument, which is a little harder to make is that your APAP can only provide 3 cm of pressure support (difference between IPAP and EPAP), while a BiPAP can provide up to 10 cm. I am not sure if you have any time where EPR was set at 0 cm or off? If there is and there is a difference in flow limitations between the zero setting and the 3 cm setting, it would support your case that more pressure support reduces your flow limitations. A pulmonologist should know that, but if you had some evidence to show that, it may be helpful. The other data you have is the shape of the flow chart which indicates flow restrictions on the inhale.

What is the situation in Quebec for coverage of machines? In Alberta our healthcare does not pay for any apnea machines. You either pay yourself or some may have private health insurance to pay for it. I recall someone saying that Quebec pays for an APAP. If that is the case the doctor may be under some obligations to show that a BiPAP is needed. I know in the US that when you deal with the DME system they have, there are criteria for each level of machine. You have to start with the basic machine and if that fails you can then move up a level.

One last thought is that if you are prepared to pay for a machine, there are no regulations that I am aware of preventing you from buying a used machine. My wife's S9 machine was on its last legs and there are no APAP machines to be purchased at one line stores. Our insurance does not cover them, so we pay out of pocket. All they seem to have now is a wait list which is months long. So, I started looking on Kijiji for a used machine. I found a virtually new A10 For Her machine where the seller was 10 minutes away. It had 94 hours on it. I bought it at half the price of a new one, thoroughly sanitized it, and my wife is very happy with it. I have read that about 1/3 of all apnea machines end up being not used and are sitting in a closet or drawer, essentially brand new. Many get them on insurance and are not out of pocket, so they don't care. That may have been the case in my wife's machine. All the seller said was that his wife could not tolerate it. So, of course, we have no warranty on the machine, and I am not sure ResMed would even take it in for repair. But, her S9 worked well for about 25,000 hours so I think the risk is low. The part about this option is that the relationship between you and your doctor may sour. They probably will not be willing to support you, and you would be on your own. We never had any support from a doctor, so that is a non issue for us.

The model name should be on the lower right front. See this link. If it has a SD card slot on the left side behind that blue tab it should be capable of saving data. But, if there has been no card in there, your history to date will not be recorded. It will start saving data when you put a card in.

The AirSense 10 CPAP model does not record detailed data. The AirSense 10 Elite does record data. The AirSense 10 AutoSet does record detailed data, along with the For Her version. Just click on the OSCAR hot link above to go to the site where you can download OSCAR. If you do not have an SD card, you only require a 4 GB, but it will accept the full size SD HC card up to 32 GB I believe. The data that gets sent via WiFi is extremely limited. It is just summary data like hours of use, and AHI.. The data recorded on the SD card is much more detailed. I can help you understand what the data displayed in OSCAR means.

It is too bad that your post got delayed. Did not see it until today. It was probably hung up in the spam filter due to the graphics included. In any case I think this is the key big of information:

"During my study I had 5 central apneas, 2 obstructive, 0 mixed and 80 hypopnea resulting in an AHI of 15"

Hypopnea is the biggest issue and after that it is central apnea. An APAP or BiPAP can effectively treat hypopnea with EPR or Pressure Support. EPR can give you 3 cm of pressure difference between inhale and exhale. Your AirCurve is giving you slightly more at 4 cm. It is not obvious that you really need a BiPAP. The problem is that while hypopnea is much improved, you now have a significant central apnea (CA) problem. Pressure can cause central apnea in some cases. The bottom line is that your AHI is now over the recommended maximum of 5 in North America. In the UK they do not treat apnea unless AHI is over 15. So, certainly one option is to not take any treatment.

I have experienced increased CA as the result of using an APAP. What I have found most helpful is keeping the pressure as low as possible. So one option you may have is to reduce your IPAP to say 7 cm, while leaving EPAP the same. Pressure support could stay at 4 cm. Similar settings on an APAP may work too with EPR set at 3 cm.

Hope that helps some, any questions just ask. Without graphics included, your posts should not get delayed.

Have you tried downloading your results to OSCAR and viewing them in detail? It requires a Mac or PC and a SD card reader. If you copy your daily report screen to a post here I can give you my thoughts on whether there is room for improvement.