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CPAP Machine Choices - read this before you accept a new machine
#61
Thanks for the tips.
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#62
Idea 
Dont-know  Forgive me if I missed it, but I didn't see among the criteria for machine selection the availability of affordable battery options.  

Smile For years I had a unit that could run from 12VDC via the usual electronics barrel plug, which meant I could use anything from a car battery to gel cells to those wonderful lithium ion (LiPO) batteries that pack a lot of runtime into a compact lightweight easily rechargeable long-life package.  It was easy to run the CPAP from the battery fed from a charger; if the power went off in the night, I never knew it.

Thinking-about It didn't even occur to me that anyone would make such a health-critical device that wouldn't be easy to run from a battery in a pinch.  But the ResMed S9 makes it really hard and you have to plan and purchase well ahead.  It requires 24VDC so forget plugging it into the 12V accessory socket in your car.
  Oh-jeez But that's not the worst of it: what I find really egregious is that the S9 won't work with anything other than a ResMed brand power supply (they do a digital handshake that is impractical to imitate.)  If it weren't for this, you could run the S9 from a pair of generic 12V batteries with a $10 connector.  ResMed makes you spend $129 to do the same thing, and if you buy their LiPO batteries, you'll spend upwards of $2000 just to run for one night. 


Annoyed-and-disappointed  I'm not in a position to research all the brands and models and make a table of ps options and keep it up to date, or I would do it.  But the next time I'm in the market for a new machine, you can bet that among the units that are a good match for my needs, I'll be looking at the battery options.  

PS  like I am totally a fan of ApneaBoard and thank those who keep it going.  I recently sent another contribution and hope others will as well.
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#63
(10-13-2017, 11:45 PM)cookedj Wrote: The more I read on this board, the more I learn.  After much troubles, the VA issued me a good Cpap (ResMed S9) but I have had a time getting the supplies.  Went to my PCP requesting supplies for the machine I have, and they are going to set me up with a brand new machine and supplies.  I told them I just needed supplies, but I guess we'll see what happens when they come out.  Thanks for all the good info!

I got my machine from the VA also in Orlando and it was a Resmed Air Sense 10 Auto Set.

Ive been using it for a month, im having some issues with leaking but have nothing to compare my data too.

Good luck to you

Semper Fi

Jarhead
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#64
(01-15-2018, 07:30 PM)MadMonty Wrote: Forgive me if I missed it, but I didn't see among the criteria for machine selection the availability of affordable battery options.  

The Philips Respironics machines, including the current DreamStation and its predecessor the PRS1, run natively on 12 volts DC. It is not recommended, though, that you connect it directly to a battery without the proper surge protection and fuse. The cable that connects to a cigarette lighter socket costs about $20. An additional cable that costs about $25 is needed if you want to connect directly to battery terminals.

The ResMed DC adapter will allow you to run the 24-volt ResMed machines on a 12-volt battery. It costs about $70 US.
Sleepster
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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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#65
I have mixed apnea, but very mild compared to your situation.
I am writing because I understand that CPAP treatment can increase central apnea.  I opted for Aircurve s10 ST Bipap with backup breath rate.  If you look deep on the net several online suppliers offer waranteed new machines for under 1700.  

In addition I purchased a CMS50-I SPO2 wrist band monitor which I wear if I lie down for abit off my machine, to warn me of low SPO2.  However, given your high AHI that might be too disruptive.

The point is, one needs to be aware that cumulative brain damage can occur over a long time, anytime you are sleeping off the machine.
https://www.whywesnore.com/sleep-apnea-leads-to-early-onset-dementia/
In other words, meeting a four hour compliance is insufficient to prevent this, if you are napping at other times during the day.
   
BTW, I have been able to drop my AHI significantly by finding a lower optimal pressure, than the Sleep Med shop prescribed.  It showed up in their titration, but they did not recognize it, because the tech only stayed at the pressure interval for 9 min, which calculated an artificially high events/hour as a result.
...Finding this saved my bacon as I could not keep any kind of a mask on for long at 21 cmH20.

The 13 month rental before purchase strikes me as collusion between the sleep and insurance industries.  It appears such a waste of our medical premiums.  Perhaps it was the high monthly charges that I ran into with a specific company, that would have resulted in paying $10K or more for a 1700-3500 machine. 

Good luck
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#66
To go fishing on a remote trout pond last year, I purchased the Resmed 12V (to 24V) battery adapter power supply for my Aircurve S10; and ran it off a light 25lb 35AH golf cart battery.  I recharged the battery during the day with a small solar panel approx 16x24in which I just set in a window of the cabin.  I checked the charge with an inexpensive digital mulitimeter...  

I brought bottled water for the humidifier.

Everything worked well...plus I had power for keeping cell phones charged...although that is what I wanted to minimize in that situation.  : )
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#67
THANKS FOR THE TIPS.
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#68
(01-21-2017, 08:04 PM)Sleeprider Wrote:
(01-18-2017, 04:00 PM)kraz1660 Wrote: i do not agree with you 100%. In my research, different machines have different algorithms and I feel that although all machines will treat your OSA all machines are not created equal. if you buy into all the propaganda out there you can buy the machine that is not necessarily the best for you or was not prescribed for you. All this to say that your home care provider has a trained health care specialist who should choose the best machine for you regardless of its styling or looks or potential revenue production. Remember anybody can buy a cpap, however what you are really buying is long term after care. Follow up visits and regular contact with your provider. DO NOT buy on the net, you will be sorry.

Kraz, let me put this delicately... Most DMEs, or their employees, do not have the patient's best interest at heart since they have a financial interest in the transaction, which pays the same whether a basic "brick" or a premium full-efficacy data machine is dispensed.  Meeting the minimum requirement of the prescription is the only mandate for a DME, and the uninformed patient who goes in to receive a machine will receive the machine that best serves the DME financially, while meeting the minimum requirements of a prescription.  Data is important.  Patients should control their own therapy, and most suppliers fail to help them to do this. The "trained health care specialists" are constrained by the prescription from a short and typically inaccurate sleep study, titration study, or the default settings of an auto machine.  I am telling you here and now that in 5 minutes, that patient will get better advice on this forum than struggling for weeks with most providers, and I can offer you the threads to prove it.

Significant numbers of patients are prescribed the WRONG machine until they "prove" they are intolerant of the CPAP therapy, in spite of the fact their sleep study demonstrated a central or mixed apnea problem; and they are not given any guidance whatsoever from the RT or prescribing physician when their machines indicate extraordinary AHI problems.  I am aware of several congestive heart failure patients prescribed CPAP, and failing with events over 30 AHI, that received no assistance or incorrect advice from their RT, and even prescribing physicians.

Many people have very high deductibles and copays, or no insurance at all.  DMEs routinely sell at highly inflated prices compared to the "net".  Even with insurance, it is possible to be charged multiples of the fair price the same equipment is available for on the Net.  The "trained health care specialists" are constrained by the prescription from a short and typically inaccurate sleep study, titration study, or the default settings of an auto machine.  I am telling you here and now that in 5 minutes, that patient will get better advice on this forum than struggling for weeks with most providers, and I can offer you the threads to prove it.  As far as recognizing different machines use different algorithms, it's my opinion that maybe 1% of health care providers are even remotely aware of the faster/slower auto CPAP algorithms, and especially the influence of EPR/Flex on them.  When we get to more sophisticated bilevel ST and ASV machines, we're dealing with such esoteric knowledge that you'd think it was a State secret. There are huge differences, and very few of the DMEs have a clue.

Nice try.

FWIW, my last contact with a DME 3-weeks ago, my wife was offered a discontinued PRS1 60 Series Auto, and I requested a Resmed Airsense 10 Autoset for her and got it.  She was prescribed at 8-cmH2O CPAP mode at CFlex 3, and she is now in Autoset standard mode at 7.5-12 cm with EPR at 2, and getting less than 1 AHI after her prescription resulted in greater than 3 AHI.  Please tell me again why the pros should have done this.

What is "Central or Mized Apnea"? Is there a way to tell if I have that or not? I didn't know there were different types (if there is information about this on the forum ... just link it, I just couldn't find it)
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#69
astraith, Hope these articles help.

http://www.apneaboard.com/wiki/index.php...leep_apnea

http://www.apneaboard.com/wiki/index.php...pnea_(CSA)
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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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#70
Is a Phillips Respironics System One 560PBT a “brick”?
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