Need help converting AirSense 10 into BIPAP in UK

Hi everyone,

I'm someone with UARS who is desperately looking to convert his ResMed AirSense 10 into a BIPAP machine via the Airbreak modification (https://airbreak.dev/).
Unfortunately I lack the technical knowledge to carry this out myself, and by now my sleep deprivation is severe to the point that I don't feel capable enough to avoid 'bricking' the machine.

Is anyone here based in the UK and would be willing (for a fee) to do this modification? I live in Berkshire.

Any help or advice would mean the world to me as by now this condition has cost me my main job, and now I'm barely getting by financially — it would take forever to save up the thousands needed to buy a BIPAP properly, so this conversion is my best shot at getting treated.

P.S. I'm new to the forum, so I apologies in advance if I've posted this wrong.

Hi Humancyclone7,

While I sympathize with you – and with anyone who is not getting enough of the right kind of sleep – you need to be aware, in my opinion, of the legal position.

As I understand from your quoting of the linked piece, you want to take the ResMed Airsense 10 APAP that you have, and turn it into some kind of BiPAP (but not a full-on ventilator) – because you think that is what you need.

For one thing, do you own this APAP machine? Or has it been issued to you by someone – say, the NHS?

For another, even if you own it, please note: there are quite strong laws in the UK against anyone doing what this article suggests. Liability and all that.

And – as I understand you – you don't know yet if a BiPAP will help you, because you haven't experienced a BiPAP yet. So, is It something you hope will help you? Or know will help you?

Where to go for a trial use ...

You may already know this, but the average NHS sleep medicine clinic is unlikely to recognise UARS as a condition. And in any event, they won't have anything to do with modifying an APAP machine, regardless of who owns it. Getting the staff at the sleep medicine clinic to trial you on BiPAP will take a lot of push.

You could 'go private' and look to find a UK sleep-specialist doctor who is willing to 'trial' you on a BiPAP. But that will typically cost £200 for the appointment, and another £300 for the doctor's nurse to administer the trial – and for the doctor to review the results. And then – if the trial shows that BiPAP is your-long-term treatment path – there'd be the cost of that.

If you were to buy a BiPAP machine direct from ResMed UK, the cost would be something like £1300.

And, btw, they would insist on a scrip.

The alternative to that is the 'second user' market – which is not very extensive in the UK, because the majority of UK patients don't own the machine they use – they get it on long-term loan from the NHS, meaning it's not theirs to sell.

However, the second-user market in the US is well-established. So you could enquire from traders in it about a BiPAP* – but your search, I would say, is for a machine that is already a BiPAP, not an APAP that is to be given modification.

But before that, and if you haven't done so already, find some way of doing a trial with a BiPAP. Confirm that is in fact what your UARS responds to.

* The leading US dealers in 'second user' machines are very experienced in providing paperwork that will satisfy UK Customs.

Hi Rick,

Thanks for replying.

Yes, I own the machine (bought from FB marketplace).

You're right, I don't know for a fact that BIPAP will help me, but then as I understand, most people (that get it) don't know that either — correct me if I'm wrong, but some of them require ASV if the pressure support required to treat FLs is too high.

I can only hope it will help me because I have read many anecdotes and some online articles that testify that BIPAP is effective for UARS. Many of the anecdotes share similarities with my experience using CPAP i.e. unrefreshing sleep despite no mask leaks and trying higher pressures, flow graph in OSCAR isn't sinusoidal but jagged, Fitbit still showing fragmented sleep and reduced nightly HRV averages.
I understand that BIPAP may not work for me and may damage my health if it causes TECSA, but I still wish to proceed.

Yes, unfortunately I know first-hand how hard it is to even be diagnosed with UARS in this country, let alone treated. I have asked the NHS twice for a BIPAP trial and was refused.

I do like the idea of seeing a private somnologist for a BIPAP trial/prescription, however my prime concern is cost. I'm bedridden most days and struggle to work even 16hrs/week at minimum wage i.e. around £700/month, most of which goes on staying afloat.

I prefer your 2nd idea. I have spoken with another UK UARS patient who just started using BIPAP (his initial experience is also promising) and he got his BIPAP from the USA off SecondWind CPAP without a prescription in just a few days.
I have checked and they are selling an AirCurve 10 S, ST and VAuto for £475, £711 and £711 respectively (VAT and delivery not included) — this seems much more feasible.

It's wrong to buy a BIPAP out of desperation, but I honestly see no alternatives at this point. I have zero faith in getting treated by Vik Veer at UCLH in less than 3 years. And I am sick and tired of watching helplessly as the best years of my life are thrown away — time that could be spent earning money, socialising/dating, and pursuing hobbies, rather than drifting in and out of consciousness due to exhaustion all day.

Hello again, Humancyclone7,

If you go the second-user route, some information:

1. Second Wind has a good reputation.

2. In the UK, there is no VAT (value-added tax) chargeable on sleep apnea equipment, and there should be no import duty charged either.

Describing a CPAP device with commodity code 90 19 20 20 00 makes it duty exempt – because said equipment is "a medical device for your personal use".

3. To repeat, VAT should not be charged on any CPAP machine, whether bought in the UK or imported. But somewhat cruelly, I've known HMRC apply both duty and VAT to the carrier cost (ie, 'shipping'). If that happens, you can and should dispute it.

To register yourself as VAT exempt wrt CPAP, you need to complete the form at:

https://www.gov.uk/government/publicati ... led-person

and send this to your shipper. This form, along with the commodity code, tells your shipper (a) to not charge you for the VAT and duty and (b) then not pass the sum from these on to HMRC.

And if the vendor is experienced in shipping overseas, they will know what paperwork and stickers to attach to the package.

Another UK voice here. I was in a similar.position and ended up just buying a BMC BIPAP from AliExpress. Cost for a brand new machine with warranty was about £600 and it was "pay on delivery" with free returns so the risk was very low. I have been very pleased with the quality of the machine and the buying experience.

As to the air break option, I am intrigued and did look at this but I wasn't confident in going about it and it would have relied on a second hand machine. With an unknown history etc. I have been tempted to look out for a cheap airsense 10 CPAP and attempt to do the air break to gain a spare machine but I wouldn't consider it (or recommend it) if it was on a sole machine I was relying on.

I really get your desperation....I went round in circles with NHS Scotland who wouldn't refer me to UCLH despite me seeing Mr Veer privately and him recommending this....I looked at a few of the CPAP hire / trial options and soon realised that the cost of a month's trial was most of the cost of the machine and less than the cost of another private consultation / sleep test so just decided to "do my own thing"

I have found the BIPAP helps a lot....I had loads of other sleep issues that I've been working through but it has made a real difference. Whilst im in the fortunate position that I could afford to "take a punt" I'm glad I did. It sounds like you have made your.mind up that you want to try BIPAP so you will only know one way or the other when you have tried it. If you are going to all the hassle of importing them it's well worth looking at a new machine.

More than happy to share more details / links etc if you want me to

Humancyclone7 wrote: ↑

Mon Feb 26, 2024 9:47 am

Hi everyone,

I'm someone with UARS who is desperately looking to convert his ResMed AirSense 10 into a BIPAP machine via the Airbreak modification (https://airbreak.dev/).
Unfortunately I lack the technical knowledge to carry this out myself, and by now my sleep deprivation is severe to the point that I don't feel capable enough to avoid 'bricking' the machine.

Is anyone here based in the UK and would be willing (for a fee) to do this modification? I live in Berkshire.

Any help or advice would mean the world to me as by now this condition has cost me my main job, and now I'm barely getting by financially — it would take forever to save up the thousands needed to buy a BIPAP properly, so this conversion is my best shot at getting treated.

P.S. I'm new to the forum, so I apologies in advance if I've posted this wrong.

Dig way deep into github/airbreak... you'll find folks sharing vAuto firmware. That and 40$ worth of programming electronics turns your AS10 into an AC10 vAuto (or ASV, or whatever). You have the absolute right to hack your machine folks... the fact that Resmed did not lock this down is interesting in itself. Airbreak was a failed attempt at creating an ad-hoc ventilator for Covid19 shortages... much progress was made, but the effort petered out. Sorry to hear your sad tale, wish I could help more.

rick blaine wrote: ↑

Thu Feb 29, 2024 10:22 am

Hello again, Humancyclone7,

If you go the second-user route, some information:

1. Second Wind has a good reputation.

2. In the UK, there is no VAT (value-added tax) chargeable on sleep apnea equipment, and there should be no import duty charged either.

Describing a CPAP device with commodity code 90 19 20 20 00 makes it duty exempt – because said equipment is "a medical device for your personal use".

3. To repeat, VAT should not be charged on any CPAP machine, whether bought in the UK or imported. But somewhat cruelly, I've known HMRC apply both duty and VAT to the carrier cost (ie, 'shipping'). If that happens, you can and should dispute it.

To register yourself as VAT exempt wrt CPAP, you need to complete the form at:

https://www.gov.uk/government/publicati ... led-person

and send this to your shipper. This form, along with the commodity code, tells your shipper (a) to not charge you for the VAT and duty and (b) then not pass the sum from these on to HMRC.

And if the vendor is experienced in shipping overseas, they will know what paperwork and stickers to attach to the package.

Thank you for sharing this Rick, I'll definitely keep it in mind when I make my purchase from Second Wind — super useful to know!

Garethep wrote: ↑

Fri Mar 01, 2024 10:18 am

Another UK voice here. I was in a similar.position and ended up just buying a BMC BIPAP from AliExpress. Cost for a brand new machine with warranty was about £600 and it was "pay on delivery" with free returns so the risk was very low. I have been very pleased with the quality of the machine and the buying experience.

As to the air break option, I am intrigued and did look at this but I wasn't confident in going about it and it would have relied on a second hand machine. With an unknown history etc. I have been tempted to look out for a cheap airsense 10 CPAP and attempt to do the air break to gain a spare machine but I wouldn't consider it (or recommend it) if it was on a sole machine I was relying on.

I really get your desperation....I went round in circles with NHS Scotland who wouldn't refer me to UCLH despite me seeing Mr Veer privately and him recommending this....I looked at a few of the CPAP hire / trial options and soon realised that the cost of a month's trial was most of the cost of the machine and less than the cost of another private consultation / sleep test so just decided to "do my own thing"

I have found the BIPAP helps a lot....I had loads of other sleep issues that I've been working through but it has made a real difference. Whilst im in the fortunate position that I could afford to "take a punt" I'm glad I did. It sounds like you have made your.mind up that you want to try BIPAP so you will only know one way or the other when you have tried it. If you are going to all the hassle of importing them it's well worth looking at a new machine.

More than happy to share more details / links etc if you want me to

Hey Garethep,


Appreciate you sharing your experience. I take it you have UARS too?


As luck would have it I actually managed to find someone who was able/willing to do the Airbreak (for free as well!). Unfortunately it doesn't have Ti min/max, trigger and cycle settings available, and based on my one night using it I feel I'll need those settings so may have to purchase one from Second Wind after all.

The same person who did the modification also has UARS, and he recommends that I ditch UCLH and switch to Guy's and St Thomas' — he says the waiting times are non-existent in comparison (e.g. he got a sleep study in just 3 weeks, took me over a year at UCLH), that they respond quickly to messages, and that one of the doctors (Dr Oliver Bernath) was trained by the discoverer of UARS (Prof. Christian Guilleminault). I'll probably take his advice because UCLH have stopped responding to me since November (despite me reaching out to them via my GP, telephone, email), and I currently have no appointments scheduled with them.

Are you effectively treated by your BIPAP then?

And out of curiosity, do you experience any tightness in your throat that affects your breathing even during the daytime (like me)?