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#11
(04-01-2015, 01:46 PM)retired_guy Wrote: I think you mentioned the Doc has an idea about what pressure to start you at. If it were me, I would set the machine to "Auto," with a minimum just a point or two lower than his idea of a good time, and a maximum of 4 or 5 points higher. You can decide about Ramp time, how much, or whether or not to use it at all. Same thing for EPR.

It would be nice if you were all tucked in comfy like with a sleep doc and a good DME. But if that's going to cost you a few grand, just so you can find out if CPAP therapy can address your issues?

Well that was what I was laughing about. He doesn't have a clue at this point. He wants me to run it on auto for 3 - 4 weeks and bring him the data so he can tell me about what to set the pressure. I am going to assume he means the upper and lower thresholds.
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#12
I like running these things on "Auto," but I really don't like running them wide open. I think that's a recipe for failure.

But without a benchmark, it's difficult to know where you should be.

I think if it was my cute little body, I would scarf up the S9, set it to Auto, Set the low pressure to 7 and the high end to 12. Then I'd run for a few days and monitor the results in Sleepyhead. Then I'd make decisions as to where to go next.

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#13
(04-01-2015, 12:24 PM)Sleepster Wrote:
(04-01-2015, 08:44 AM)clovett Wrote: Then I get a call from my Dr saying that he wants to look over the data collected in the first month and recommend a pressure setting.


I would make that appointment. He may be able to advise you about the pressure range. There's a lot more to it than just letting the machine pick the right pressure for you.

I agree with this completely. But do not be surprised if the doc uses the same workflow as those here on the forum do, which is to start for 30 days or more at wide open (5-20 or so) and then narrow the range based on the history of what the xPAP does in response to the patient. Or, they make adjustments based on another PSG study.

But the issue there is that while the data is more prolific, it is based on 5 or fewer hours of the patient in a foreign sleep environment, while machine data can be 8 hours times the number of days in the actual sleep environment, so the average of aggregate data can actually be much more accurate than the PSG.

It is true that the doc will know much more than anyone here, so yes, go see what they say. The ironic part is that they do not use what they know effectively, because as a patient you may be significantly more motivated to get the pressure right.

And you can do that. Get SleepyHead or something similar, and track what the APAP machine does. Once you understand how things work, you can use that info to narrow the range. While you may not know as much as the doc, you will know far more about your particular situation than they will.

For instance, if I followed my docs recommendations to the letter, my AHI would still be close to 3. But since I tinkered based on informed info, it has been averaging 1.5 for the last 100 days.
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#14
Caution buying a machine used if you need to have it repaired in the future may or may not be a problem. It is something that has to be considered.
For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/dire...onal/SHIP/
or here http://www.medicareinteractive.org/
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#15
(04-01-2015, 12:58 PM)clovett Wrote: How many times on this board has someone received an auto CPAP for straight recessed jaw blockage and had to get a totally different machine that is not a CPAP? What are my odds?

You did the home sleep study so you've never tried CPAP therapy? Here are the issues.

1. You may not be able to tolerate breathing out against the pressure and may need a bi-level machine that lowers the pressure when you exhale.

2. You may swallow a lot of air and need a bi-level machine to help with that.

3. You may find that CPAP therapy induces central apneas, and you would need a ASV machine.

I'm assuming your sleep study showed that you have only obstructive sleep apnea with no central apnea component. The reason I assume that is because they prescribed a CPAP machine. Had they detected central sleep apnea in your sleep study I presume they would have prescribed a ASV machine for you.

I don't know what the odds are, but just understand that you are taking this risk. It's not a huge risk, so getting that used machine is by no means a foolish choice, but just be aware that this could happen.

I urge you to tell the medical providers that you plan on buying a used machine. Tell them which machine and how much you're paying. When they realize this they may come down on their price.

I asked my provider for a replacement machine and they quoted me $1800. Then a couple months later they called said it would only be $1200. By that time I'd already bought one on craigslist for $200. Later I got a S9 VPAP Auto and a S9 Autoset on craigslist for $520, then sold the Autoset for $320.
Sleepster
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
The s9 autoset sounds like a good deal, but with it being your first machine I'd be weary of starting off used. A lot of DME's bill monthly as well for the rent to own machines, so it's not a huge chunk up front. In network DME's are worth looking at too, just to explore all of your options.
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#17
I picked up the machine but I could not see the hours. She did have the receipt for the machine and accessories and the machine is two months old. It's been on Craigslist for a month. She had the surgery right after and only one of the three masks was even used. The resmed quattro full mask. The P10 and N10 are still in the box.

The resevoir on the humidifier is the take apart one you can easily clean.

The only issues I have is not just the unit but the bag smells like...well...an old aunts purse. It was at her mothers house and she had scented soap everywhere. But the good news is no cigarettes so it should be fine. I'm cleaning everything now.

The other issue is I can't get into any menu. The only thing on the screen is the "Push Dial". The info and Setup buttons are not on the screen. Is there a way to reset the machine so it goes back to normal mode?
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#18
UPDATE*

I was able to get into setup, erase all data and reset the S9 to factory defaults. The S9 has 175 hours on it.

Thanks everyone. Now I am off to download software
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#19
Keep in mind that the cost of the machine should be compared with the same model from some of the vendors on the Supplier list linked at the top of the forum A new S9 Autoset should cost less than $900 new. The cost of used machines with warranty can be compared by looking at Supplier 2.

The cost through a DME is artificially high (about 2X) and does not reflect what they actually get paid by insurance. Most machines on Craigslist are overpriced because people only see the inflated DME invoice. It's like paying a car dealer his full asking price MSRP plus dealer markup.

It's a great machine and should serve you well.
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#20
Thanks for all the advice guys. I've cleaned the unit and let everything dry for 24 hours so tonight I will give it a shot and we will see how it works out. I'm going to try the full face Resmed Quattro Air mask first.



Thanks
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