Another ResMed APAP brick just released

[Pugsy]

A short while back we discovered ResMed had released a basic/no frills/no data except compliance machine
viewtopic.php?f=1&t=113511&p=1096124&hi ... t#p1096124

The AirStart 10 CPAP and now they have added an auto adjusting pressure (APAP) model which is an apap but no data beyond hours of use.
I haven't looked deep into it but according to the product spec page at cpap.com it doesn't even offer the heated hose.
So it's a brick with no heated hose capability and no way to evaluate anything at all.
Doesn't appear to offer cpap mode either...big whoopie if it did.

God help the poor souls whose RX says "apap" with pressure settings of 4 to 20 and doesn't specify model name.

We can bitch ResMed out all we want but if DMEs (who Resmed really wants to please because don't think for one minute it is us the end users) wouldn't buy these POS bricks then ResMed wouldn't produce them.
It's about half the price of a full data machine..sigh...I don't need a working crystal ball to see where this is heading in terms of DMEs and their profit margins.

Gonna have to be real specific now when advising on which machine models to avoid in the ResMed "Air" model line.
AirStart......POS bricks...avoid anything with "Start" as part of the model name.
AirSense....there is the half assed POS "CPAP" model but at least it gives a tiny bit of useful data.

Not to mention that the heated hose can be a life saver for some people and not just in rain out prevention either.

[john5757]

Then it makes no sense for ResMed to make the AirSense CPAP only

[Hang Fire]

Is this the most pissed Pugsy ever?

[Pugsy]

Is this the most pissed Pugsy ever?

No. Not by a long shot.
You don't want to see this redhead really pissed off.

But...while I try to sugar coat a lot of things...a brick apap is never going to be on the sugar coating list.
Hell...this is worse than the S9 Escape Auto which at least gave a generic AHI and 95% pressure.

It's been a year now since the AirSense 10 release. I was so hoping the the half assed brick AirSense 10 CPAP was the worst of the lot. The reason for the AirStart.....DMEs wanted el cheapo to maximize profit margin.

They would make a good travel or back up machine I suppose. Certainly cheap enough but the lack of the heated hose would be a deal breaker for me even if I was happy with a brick otherwise.

[chunkyfrog]

Medicare competitive bidding, especially "Advantage"/Medicare part C.
I suppose they wanted to compete with the chinese #@%&.
These will be the standard for Medicaid patients, too--count on it.
No, thank you; I deserve better.

[avi123]

...

[Goofproof]

Did Resmed buy controlling interest in Black & Decker of China, prompting the sale of their leaf blower factory to Resmed. It's not going to effect me, there will never be a Resmed Product in my home, due to their heavy handed business pratcice. Jim

[island woman]

Hello Pugsy, I haven't been checking in most of the summer. This may be late but glad you are posting again. You helped me a lot when I was a newbie which will three years ago this November.
I agree totally about the ResMed brick. I was lucky to have a doctor who prescribed high end machines. I will be sure to request a Rx for a specific machine when eligible in two years. Hopefully Medicare will cooperate.

[palerider]

The AirStart 10 CPAP is available without prescription.

prove it.

[mibbim]

So which manufactory made cpap or bipap, or apap is better? Can all the bipap acting as cpap if need to? Is Apap better than bipap if AHI is 40? It seem Apap is more comfortable, but it takes time to kick in the prefer pressure when stopping breathing.

[chunkyfrog]

Mibbim, you request a book, or at least the contents of the cpap wiki, at the top of the page.
Just start reading, all your questions will be answered.

[Pugsy]

So which manufactory made cpap or bipap, or apap is better?

Depends on what you are treating and what you want or expect out of it.

Can all the bipap acting as cpap if need to?

Depends on the bipap/bilevel machine. There are plain bilevel machines that actually have cpap mode available.
Then there are specialty bilevel machines that may not have a special separate cpap mode available but can usually be dumbed down so that it works/functions like fixed cpap.

Is Apap better than bipap if AHI is 40?

AHI has nothing to do with it.

It seem Apap is more comfortable, but it takes time to kick in the prefer pressure when stopping breathing.

I think bilevel is more comfortable than APAP.

None of the regular machines will "kick in to the preferred pressure when you stop breathing". They actually don't do a think while you are having an apnea event. Instead they will try to figure out what is needed to best prevent the apnea event from happening again.
Now there is a specialty bilevel machine that will breathe for you when you simply don't breathe on your own (those are called central apneas where the airway is open and differ from obstructive apneas where you try to breathe but the airway is blocked) and they will jump in and give you a burst of pressure when central apneas are happening but that's a totally different type of bilevel machine.

If I remember your history correctly...you had more centrals than you did obstructive apneas and if that's the case apap would be NOT the best choice of machines for you. Most likely you would need one of those specialty high end bilevel machines to deal with the centrals.
Regular cpap/apap machines can't really deal with central apneas at all and aren't usually prescribed when someone has a high central apnea index on the diagnostic sleep study.
Regular bilevel will sometimes help but most of the time the specialty high end ASV type of bilevel machine is needed.
If you tried a regular bilevel machine and it didn't help....going down to apap is unlikely to help either.

[Grace~~~]

Sorry.
I am new and completely stunned by the medical system
(while trapped horribly in it's web ...)

The decision was made for me to not even look at bills and details and to
simply focus on trying to live.

...but now I am alive and feeling better and trying to understand?

This whole cpap thing is like a game unto itself?
I have no idea if it is representative of the whole.

(or maybe of a not so pretty coming future to all aspects of medicine?)



So with these bricks is it just the patient who has no feedback or data to attempt to optimize (or even follow) their treatment?

Do the doctors (or faux doc certificate holders) still get the same level of data as with the better machine?
Thus buying themselves a job as "holder of the data"?

...or have "they" (powersthatbe) just decided that the data was useless ... " it's the air pumping and mask selling that counts?"

[palerider]

no-data machines produce no data. period.

it doesn't matter what software anybody uses.

[Pugsy]

So with these bricks is it just the patient who has no feedback or data to attempt to optimize (or even follow) their treatment?

No data at all...no one gets any feedback except for hours of use.
If you go in to the doctor and tell him you are still feeling like crap all he gets is how many hours you used the machine and the standard reply is "give it time" "you just need to use it more"
No matter if you are leaking like a sieve or your pressures are allowing a truckload of apnea events to happen because they are too low or maybe you end up with complex sleep apnea with a truckload of centrals...but with no data there's zero way to even start to figure out what might be going wrong. Is it any wonder that half of the people who start on cpap end up with the machine in the closet because "it didn't help"?

Gripes my ass for sure because there's such a relatively easy way to make sure that people are at least getting optimal therapy.
Your insurance will pay for the "good" machine that can offer data just in case you aren't one of the overnight miracles (and those are really rare anyway) and you insurance pays the same no matter if you get a good machine or a POS brick. The DMEs who dispense the bricks only care about their bottom line profit margin.
And BTW....just because someone has an in lab sleep titration study doesn't guarantee that the pressure selected is optimal. It happened to me so I know for sure it happens out there. They got close but I need a LOT more pressure in REM and I just barely got 6 minutes of REM for them to even try to find an optimal pressure. Not near enough time to do a proper titration and this was with the entire night devoted to the titration.

If I had been given on of those bricks at the original RX pressure...it would have ended up in the closet too because it didn't help how I felt until I got those REM events dealt with effectively.
I would have joined the 50% of the cpap users who say "it didn't help" and delegate the machine to the closet or craigslist.
No amount of "give it time" or "you need to use it more" is going to fix something that simply needs more pressure in the first place.

So yeah...it does piss me off that people get substandard care all because the DME wants more profit margin.