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[CPAP] Just got a DeVilbiss DV54 AutoAdjust
#1
I had been using a ResMed old style CPAP (no data collection except hours on) for the 10 years since my sleep study. It had started to act wonky recently, so I decided to get a new one. THANK YOU to all of you here who post your experiences, it made it easy for me to decide I wanted a auto-adjust model. Yeah, I know, 10 years of daily use, I got my money's worth.

I did not want to go through another sleep study and my GP was happy to give me a script, so that part was easy. I called my insurance and got referenced to their preferred providers. The two I called were horrible - very restricted in the info they would provide or how the selection and delivery process would work. I simply did not want to do business with either of them.

So, I ordered from one of the online providers - DeVibiss was not offered by either of the DME suppliers "preferred" by my insurance. The good news is that my reimbursement (at 60% for non-preferred providers) will likely result in a lower out-of-pocket for me than the 80% for the high-markup-low-options of the preferred providers.

I have been using my new machine for 2 nights and have gathered the "smartcode" data from each. I know the first two nights will not be typical, but here is what I got:

AHI: 5 (1st night), 4 (second)
95% pressure: 18, 16
90% pressure: 17, 15
High leak: 0%, 0%
Non-responding event index: 0.5, 0.0
Pressure plateau time: 2.0%, 0.0%

In the middle of the first night I awoke with my full-face mask unsealed from my face with air blowing out all over. I looked down and saw the pressure was 18.4 or something around there. My old CPAP was set at 9, so that was quite a surprise. The second night I used a different style full face mask and had no issues.

So now the questions:

I did not get the data report option, so I do not have the SD card to load into SleepyHead. I am not much of one to analyze my processes much once they are established (remember I was using a 10 year old machine until 2 days ago). Is the above data collected by the daily, weekly, month and quarterly smartcode process enough for me to make sure I am headed in the right direction?

Is it common for my pressure to have gone up that much in 10 years (essentially doubled)? I have gotten older but not much else has changed. Should I be looking a different masks if my pressure stays that high?

Any other advice for adjusting to the autoCPAP?

Thanks again for all the good posts - this forum has been a huge help and reassurance!
Thanks

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#2
You might do better with a higher minimum pressure. You're running wide open at 4-20 and that can cause the machine to get into a pressure increase/feedback cycle due to initial pressure being too low. I would set the minimum to about what your old CPAP pressure was at and see if it helps lower your 90% pressure.

Someone more familiar with that machine may be able to provide better input on what data can be retrieved from it. With your interest in data, I'm surprised you didin't go with the PRS1 60 Series Auto or Resmed Airsense 10 Autoset. Not a huge price difference.
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#3
Thank you for the suggestion Sleeprider. I will try increasing the minimum pressure - the feedback cycle certainly sounds possible.

I selected this machine for several reasons. I travel a lot and the separate power pack is one of my pet peeves - I hate them. I also wanted a humidifier that can be left behind as I do not use it most nights. Finally, this machine fell just under the price threshold for advance insurance authorization.

I misunderstood the optional data pack. I thought it just included the software and was for therapist use. I now see that it is primarily the card reader and the software is also included. As I do not have compliance reporting requirements, I had no need to buy something to provide the therapist reports. This unit does generate a code daily (also weekly, monthly and quarterly) that shows many of the the stats that SH uses - I thought I would be able to get them into the software on my own but now I know there is no card slot on the unit itself. Live and learn. I can still buy the data kit if I decide it has enough benefit.
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#4
I have an alternative suggestion. Why don't you put the devilbiss in straight pressure mode equal to your old machine pressure. Evaluate for 10 days and go from there.

Auto has variable pressure which may or may not be good for you. If the old straight pressure or a new straight pressure is doing the job (AHI good, restful sleep), then why change it.

My 2 cents. Ymmv.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#5
I really like the DeVillbiss units a lot. It is not my primary, but I use one a couple hours a day, a couple of days each week. I got it really really cheap with almost zero hours on it. It has some great features that others lack. You're right. It does not require an external brick, and one of those neato cool features is that if you hook it up to a battery and AC power at the same time (since it has two inputs), it will automatically switch to 12 V DC if primary AC power gets interrupted, and switch back to the AC main when that is restored. All while you sleep blissfully through the power interruption, unaware that anything happened.

To be honest, I think the data reporting for the PR System 1 and the ResMed machines is overkill for most folks most of the time. In the six years I used my original S-8 Elite, I never once looked at any data.

When I got an S-9 a couple years ago, I looked at the data weekly for a couple of months. Pretty colors!

Since getting the PR1 early this year, I think I pulled the card to look at data like, what? Once?

If you're having problems, the data is cool to have to be able to see and try to map relationships. What you get from the Intellipap is probably good enough to let you know how you are doing. I would be more than happy with its reporting features, better than probably 98% of the time. If you really need the details there is always the data module you could get.

OMMOHY
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#6
Thank you for the responses!

AshSF - I wanted to try a different pressure as I had a sneaking suspicion that it needed to be increased. I am not having any issues adjusting to the auto adjust except that it is so quiet when I first put it on that I think it is not running (no ramp but the 4cm is not much to my ear). Last night was my 3rd good night's sleep with the new machine - AHI was 2. Since I did not have any data recording with my old machine, I am not sure if that is better than it was before. It might be fun to try a constant 9.0 pressure for a few days and see what happens. I need to order the clinician's manual by email before I can change those settings, but I need to have that in hand anyways.

OMMOHY - nice to hear a good report! I did not know about the battery / AC switching. I will have to look into that. The battery is a big plus to me - I like to go camping but with my old machine I always had to find a place with electric outlets. For places with unreliable electric power, the battery backup would be great. I agree with you about the data. I doubt I will be looking at it closely for long. And with the smartcode decoder on DeVilbiss's website, I get a lot more data than I ever had before!
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#7
Hi Kookaburra,
WELCOME! to the forum.!
CONGRATULATIONS! on your new machine.
Much success to you as you continue your CPAP therapy.
trish6hundred
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#8
Follow-up report Smile

I tried the CPAP setting at fixed 9.0 (setting on my old machine) and had the worst night of sleep since I got the new machine. My AHI was 5.5 - not terrible but definitely higher than the nights since I switched to auto-adjust. That lasted just one night as it was clearly not as restful as the variable rate.

Next night I went back to auto-adjust but raised the lowest pressure from 4 to 6. That definitely dropped my 90% and 95% pressure marks and the other statistics are quite nice. I am feeling well rested now. With that change my AHI is running 1.5 to 2.0, max pressure has dropped to about 14 (from about 17 with the 4-20 range).

After a full week's data, I will increase the rate to 6.5 and see how it goes. If it is even better, I will test ever increasing levels until I see a negative turn in the results. I never would have thought of this on my own, so thank you for the suggestion Sleeprider!
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#9
(08-22-2015, 10:16 PM)Kookaburra Wrote: I misunderstood the optional data pack. I thought it just included the software and was for therapist use. I now see that it is primarily the card reader and the software is also included. As I do not have compliance reporting requirements, I had no need to buy something to provide the therapist reports. This unit does generate a code daily (also weekly, monthly and quarterly) that shows many of the the stats that SH uses - I thought I would be able to get them into the software on my own but now I know there is no card slot on the unit itself. Live and learn. I can still buy the data kit if I decide it has enough benefit.
If your DME is like mine, the cost of the card reader and software is tripled if you buy it separately from the machine. (For me, one week ago, that meant $50 US vs. $150 US.) However, after just a few days I realized that the SmartCode data was not going to be enough for me so I called my DME to find out if they would make an exception since I was purchasing the card reader within one week of the machine ... and they agreed!

Long story short, if you are thinking you might like the software and card reader sometime, you might want to try getting it now at a lower price rather than wait and pay triple.

Good luck!

Coffee

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#10
Sleepover I as well are having problems with the intellipap dv54 after 2 or 3 hours of sleep I'm woke up with machine trying to blow me and the mask up I've tried pressures from 6 and 18 thru 6L 9h and even set it on CPAP mode at 11 still trying to blow wide open any help would be appreciated.
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