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Best Machine for Mixed Apnea
#1
Hello everyone,

I have mixed apnea consisting of both Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). I am looking to buy a new machine and was wondering if anyone could recommend a machine that that can help me with my situation.

I don't mind spending a bit of extra money to get the proper machine that will help me but with so many options I'm confused.

I was originally thinking of getting a Resmed S9 AutoSet but I'm not sure if that will resolve my problem. I noticed Resmed also has a S9 VPAP ST-A and S9 VPAP Adapt... which they mention is designed to treat central sleep apnea (CSA) in all its forms but doesn't mention if it treats OSA. Also Respronics has their line of machines.

Any suggestions would be much appreciated and thanks in advance.
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#2
Hi cannotsleep,
WELCOME! to the forum.!
If I'm not mistaken, Resmed's adapt S V machine will treat all types of apnea, but hang in there and someone more knowledgeable about this subject will help you soon. I think you might find some threads here on the board about this also.
Best of luck on your decision and with therapy when you get set up.
trish6hundred
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#3
(10-27-2012, 08:23 AM)cannotsleep Wrote: I have mixed apnea consisting of both Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). I am looking to buy a new machine and was wondering if anyone could recommend a machine that that can help me with my situation.

Such a diagnosis requires a sleep study. In the US sleep studies have to be ordered by a doctor, and the results sent to that doctor before they are made known to the patient.

I would suggest you get a prescription for a machine from your doctor and let us know what it says. That will help us narrow down your options. As you say, there is a wide array of machines. But machines designed to treat CSA are really designed to treat mixed sleep apnea.
Sleepster
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#4
(10-27-2012, 08:23 AM)cannotsleep Wrote: Hello everyone,

I have mixed apnea consisting of both Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). I am looking to buy a new machine and was wondering if anyone could recommend a machine that that can help me with my situation.

Ah. I'm not the only one here with "mixed" sleep apnea.
There were no suggestions as to which may be better or more helpful. I have been trying out a Philips Respironics REMstar SE and it seems to be helpful. I'm not having the panic attacks I used to have when I had trouble breathing while trying to get to sleep so that's been a real plus. Yet I'm not waking up rested so I don't know if it's working well or not yet. I know the doctor never changed the pressure from what I had with my old machine.

Quote:I don't mind spending a bit of extra money to get the proper machine that will help me but with so many options I'm confused.

It was really weird since my old machine was 14 years old I haven't been aware of what's new or current until this past week. You can talk it over with your specialist or whoever you deal with for recommendations. I still find mine to be awkward but I'm sure it will get easier. The difference is because I'm on a disability income my CPAP was completely paid for and it didn't cost me anything.

Quote:I was originally thinking of getting a Resmed S9 AutoSet but I'm not sure if that will resolve my problem. I noticed Resmed also has a S9 VPAP ST-A and S9 VPAP Adapt... which they mention is designed to treat central sleep apnea (CSA) in all its forms but doesn't mention if it treats OSA. Also Respronics has their line of machines.

It almost sounds like we're a bizarre minority and most units seem to be for OSA *OR* CSA. I'm still trying to evaluate whether my new machine is helpful or not. Helpful in that I'm not having trouble breathing at night now. NOT helpful in that I still don't wake up rested. I'm quite exhausted still.

Quote:Any suggestions would be much appreciated and thanks in advance.

Good luck.
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#5
I think that the reason that there is a limited number of posted recommendations on here that would "suggest" which machine is best for you to treat combined central and obstructive apneas is because many of use feel that the first line of defense against any type of sleep disorder is a good comprensive sleep study in a controled enviornment and followed up by a board certified sleep physician knowledgeable and experienced in sleep disorders. Self dianosis and self prescribed CPAP therapy can do more damage then good.
Your post was void of any of your background knowledge or use of a CPAP even though you have some knowledge of your preference. Perhaps more personal info would encourage more responses.
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#6
(10-28-2012, 12:03 PM)JudgeMental Wrote: I think that the reason that there is a limited number of posted recommendations on here that would "suggest" which machine is best for you to treat combined central and obstructive apneas is because many of use feel that the first line of defense against any type of sleep disorder is a good comprensive sleep study in a controled enviornment and followed up by a board certified sleep physician knowledgeable and experienced in sleep disorders. Self dianosis and self prescribed CPAP therapy can do more damage then good.
Your post was void of any of your background knowledge or use of a CPAP even though you have some knowledge of your preference. Perhaps more personal info would encourage more responses.

Actually I would have benefit from such information. I mean, I was diagnosed in 1997 with mixed apnea. I had no insight as to who else to turn to, so I don't know about the original person who posted this thread but I was already diagnosed. I could always go for some insight as to what others think. The Resmed S9 AutoSet outshines the other S9 models in the Resmed comparison chart. Brief scouting around the internet suggests I would have to fork out $300 of my own money if I want to upgrade to the AutoSet, assuming that my sleep therapist will allow it. I mean I already traded in the Respironics "cheap" model for the S9 Escape as it was available at no cost. True, money talks, but I can't guarantee anything. I may be stuck with what I have. That's not so bad. It could have been worse. I could have been stuck with the REMstar SE. What a nightmare!
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#7
Central or mixed apnea is complicated.

Usually, a constant CPAP pressure won't fix it. In some people, a higher CPAP pressure causes central apneas.

In many people, as pressure goes up, obstructive apneas go down and centrals increase. Sometimes, you can find a good compromise pressure.

Central or mixed apena is one of the reasons it's absolutely critical to have a fully data capable machine for all patients. You may develop central or mixed apnea after starting CPAP and need to monitor for it.

Auto CPAP (APAP) doesn't necessarily help with central apnea. They may make it worse if the pressure range is set where the pressure can drift up to the point where you start having centrals. The manufacturers try to design their machines to detect centrals and not increase pressure if you start having them.

APAP only changes pressure slowly, it doesn't try to match your breaths.

Bilevel uses a different pressure on inhale and exhale. Also called BiPAP or VPAP. Sometimes this helps central apneas, sometimes it doesn't help or hurts.

A step above bilevel is a "Timed" or T mode bilevel machine that will attempt to start your breathing with higher pressure if you don't inhale after a certain time.

The next step up is an ASV (Adaptive Servo Ventilator) bilevel machine which does a much more complicated process and does go into more of a "force you to breathe" mode.

Throw in the complicating factor of Auto pressure adjustment on bilevels. Many CPAP/APAP machines have exhale relief/Flex/EPR, which is sort of like low level bilevel.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#8
I Have the same as you and use the Philips Respironics System One BiPAP autoSV Advanced (951P)

its a great machine fully data compatible my AHIApnea / Hypopnea Index is at 1.64 and most importantly feeling great again been using it around 3 weeks

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#9
Hello All,

First off... I'd like to sincerely THANK EVERYONE for taking the time to reply to my initial post.

I'm from Ontario, Canada and did do a sleep study in a sleep lab - that's how I found out that I have both OSA and CSA (honestly didn't even know CSA existed until the sleep doctor told me that my case is complicated because most people he's seen have either OSA or CSA but I have both. So @ Ugly, you're not alone my friend.

I'm currently borrowing a S9 Autoset with settings of 6min to 15max and and found that I wake up when the pressure gets to about 14 cmH20. The funny thing is I feel the same using (or not using) a machine. Although with my old machine (Resmed S8 Compact) I can't tolerate the pressure of 9 because that constant force gives me stomach & lung pain so I wasn't really using it.
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#10
If your in Ontario 75% cost is covered i believe 100 if on social assistance

just get a sleep study done and a prescription from the doc


http://www.health.gov.on.ca/en/public/pr.../cpap.aspx

the price of the machine are around 3500 to 5000

not cheap

check your work health plan if you have one too might cover the 25%
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