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Cheap tools and the most capable CPAP machines
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #1
Cheap tools and the most capable CPAP machines
Reading here as fast and much as time permits.

Special thanks for archangel's workThanks

As I read my outlook is changing rapidly. I want to feel better as fast and much as I can.

I occasionally buy a budget tool thinking I will save money and usually regret it.

Tools are power. Knowledge is power. I am responsible for the quality of my health care.

So if money was no object (it is but for the sake of this discussion) and I wanted to maximize my chances of success with a CPAP in the shortest time frame should I not bite the bullet and and buy the most capable/adaptable machine available? From what I can comprehend at this time it looks like top of the line is about double but then when I consider how much of my life has been lost over this malady that seems irrelevant. I saw this (emphasis mine)

Quote:S9 VPAPTM Auto

The VPAP Auto is an auto-adjusting bilevel device designed to address the unique needs of noncompliant OSA patients while providing quiet and comfortable therapy.

and I hated my sleep studies and it resonated with me.

The vibe here (to me at least) is the whole industry is rather cynical and I don't want to ride the merry-go-round to find the cheapest machine that just barely does the job in the eyes of some bean counter. I wonder how many people give up on CPAP because they didn't get what they needed right away and just gave up? I can see that happening when one is already exhausted and doesn't have the strength to fight it out with the medical care providers. Lets say I was going to get on a boat and have no access to a more capable machine so it's gotta be as flexible/adaptable as possible what features do I want?

(shut up Mark. Focus. go take your amphetamines)

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
(This post was last modified: 04-10-2015 09:57 AM by Mark Douglas.)
04-10-2015 09:56 AM
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OMyMyOHellYes Online

Advisory Members

Posts: 915
Joined: Mar 2013

Machine: Respironics 560 Auto
Mask Type: Nasal mask
Mask Make & Model: Resmed Mirage FX
Humidifier: Respironics System One (no heated hose)
CPAP Pressure: 08.0-15.0 cm/H2O
CPAP Software: EncoreBasic

Other Comments:

Sex: Male
Location: Texas

Post: #2
RE: Cheap tools and the most capable CPAP machines
(04-10-2015 09:56 AM)Mark Douglas Wrote:  I wonder how many people give up on CPAP because they didn't get what they needed right away and just gave up?

According to the latest studies from the prestigous PIOOMA Instute in Bakersfield, the number approaches technical quantification of "a metric butt load".

OMMOHY
(This post was last modified: 04-10-2015 12:01 PM by OMyMyOHellYes.)
04-10-2015 12:00 PM
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trailrider Offline

Preferred Members-2

Posts: 304
Joined: Feb 2015

Machine: A10 Autoset for Her
Mask Type: Nasal mask
Mask Make & Model: Eson or P10
Humidifier: autoset
CPAP Pressure: 6-12 DME, 7-13 me
CPAP Software: SleepyHead

Other Comments: engineer. EPR at 3, unheated hose, humidity at 2. Routine hose entanglement.

Sex: Female
Location: Ontario

Post: #3
RE: Cheap tools and the most capable CPAP machines
Mark, I think we're kind of blind making any recommendations to you. You don't have a scrip (which would give pressure start points). You aren't using one now, so we can't use that as a baseline. I don't know about which would meet your needs in terms of battery operation, power supply.

I do know that I love my Autoset 10. It dynamically adjusts for my breathing/apneas as they occur. I tried holding my breath while awake to see what it does and how it behaves. I can hear the little 0.2s puffs it makes to break a CA. I can see from my readouts that pressure goes up when I need it, and down when I do not. I think having a data capable machine is important for you, since you are "self-medicating", and you need to be able to correctly interpret the results.

My loaner one (to confirm I needed xPAP thereapy) was a Resmed 9, and it was larger. Being at sea level, you probably don't need a humidifier. I do think that you should be aware that like any equipment, your machine may need calibration/servicing at some time. And don't forget to get the air filters for the intake.

The hardest part I found was finding and getting used to a mask that was right for me. We are all different, and it simply takes time and effort to get used to something so weird on your face.

Bottom-line: APAP, and data capable.

Wish I were out there on a boat too!
04-10-2015 12:19 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,292
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #4
RE: Cheap tools and the most capable CPAP machines
G'day Mark

It's not just a matter of buying the best machine you can afford, it's a matter of getting the best machine to treat your particular apnea regardless of price. If you have common or garden variety obstructive sleep apnea and don't need ultra-high pressures then something like the a Resmed Autoset is all the machine you need. There's no value in going higher unless you need it.

On the other hand if you have mainly Central apneas then you must have an ASV type machine, which tend to be the most expensive this side of hospital ventilators. And if you have a mixture of symptoms (eg COPD or asthma) then you might need one of the lower range bilevel machines.
It all depends on your own particular diagnosis.

While it's true that a lot of high end machines can emulate the lower grades, that is not a universal truth and you can get caught out. Get the machine which suits your needs. An analogy: a Mack truck will carry a wheelbarrow and a few buckets of sand but a one tonne ute will do a much better job of delivering that barrow and sand to your front garden.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
04-10-2015 12:26 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #5
RE: Cheap tools and the most capable CPAP machines
The truck analogy is on point. Thank you very much.


I'm chomping at the bit as I learn just how much I may have suffered over this.
If one is depressed and goes to a shrink they wanna give you a pill and hurry you out the door. If one has sinus problem and goes to an ENT you get steroid spray and eventually get your sinuses rotor rooted. Etc. To a man with a hammer everything is a nail. I am sick and tired of being sick and tired and I'm not gonna take it any more!

I made my living troubleshooting complex equipment. Not just my job but who I am at my core. Problem solver which turned out to be the perfect job for a guy with ADHD. Puzzles to hyper-focus .
So when I go to the sleep doctor in three weeks and DME provider I want to be armed for bear. Now I am smart enough to go uh huh uh huh and see if they try to give me the mushroom treatment Wink

I think this forum and its members may well extend and improve my life and I thank you all !

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-10-2015 01:00 PM
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #6
RE: Cheap tools and the most capable CPAP machines
Mark. I have a philips respironics auto machine. But over the course of first 100 days, I realized that the pressure changes were more disruptive to my sleep. So I essentially dumbed down the machine to a straight pressure cpap machine. And I sleep much better.

A VPAP or an ASV may have way too many settings to even dumb it down properly.

My 2 cents.

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.
04-10-2015 01:05 PM
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Sleeprider Online
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Advisory Members

Posts: 3,312
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #7
RE: Cheap tools and the most capable CPAP machines
I have a Philips Respironics 60 Series BiPAP Auto 760. It is capable of single pressure CPAP, auto CPAP, fixed bilevel, and auto bilevel. So anything short of adaptive servo ventilation needed for central apnea is available. It does not improve treatment efficacy very much over the PRS1 560 Auto CPAP I also have, and even that only improved my therapy a 1.5 AHI over the old M-Series Auto I had since 2008.

You can get more flexibility, but whether that gets you better treatment is up for debate.

If you were to invest in your own equipment, and auto bilevel machine in either Respironics or Resmed flavor would be very likely to be effective and comfortable, as long as you don't need ASV. It may or may not treat you better than a simple CPAP or APAP, but it won't be worse than whatever the insurance and DME provides, and you won't have to prove compliance. Personally, I don't need bilevel, but have found it does seem more comfortable. I was using 11-14 cm pressure in Auto, and have found 7.5 minimum EPAP with 4-7 pressure support is more comfortable, and eliminates OA. So far, the best results have been at EPAP minimum 9 maximum 14 with PS +2 to +6.

If you don't have the capability of auto bilevel, you will probably do fine, but just won't know.

______________________________________________
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04-10-2015 01:20 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #8
RE: Cheap tools and the most capable CPAP machines
Sleeprider I think you summed my dilemma perfectly.

Quote:Personally, I don't need bilevel, but have found it does seem more comfortable.

Quote:If you don't have the capability of auto bilevel, you will probably do fine, but just won't know.

As I alluded above. I am exhausted. My wife must be a saint because she is still with me. My ex just got up and left one night and honestly I cannot blame her. I am accomplishing little and the stack gets bigger every day. I just want to get better to the greatest extent possible with as little hassle as possible. If that means spending more just for the peace of mind of knowing I can try as many configurations as I reasonably can and therefore get the best results possible outcome I'm good with that idea.

Is about 1000' altitude change a factor? Call it the snowbird factor?

trailrider just a short while ago I retrieved previous sleep studies done a few years at about 10'msl. Currently at around 950'msl. My weight may have actually dropped a little. I will run the printed copies through OCR next few days and see if I get usable text. What data should I put up?

Thank you all for your interest. SmileSmile

PS I do have sleep Doc appointment in three weeks. Did I already say that? CRS sigh....

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
(This post was last modified: 04-10-2015 04:21 PM by Mark Douglas.)
04-10-2015 04:18 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #9
RE: Cheap tools and the most capable CPAP machines
Altitude is not an issue (at least the 1000' stuff).

So what you do now, while you wait, is go with what you know, and do the best you can:

1. If you must sleep in a bed instead of a nice "comfy chair," then make sure the head is elevated as much as you reasonably can. (If you go too far, you'll end up in a blob on the floor on top of the cat, and the cat will not like that.

2. Do whatever you need to do to make sure you do not sleep on your back. Sleep on your side, use pillows, tennis balls sewn into your t-shirt, a fish hook and line attached to your navel ---- whatever is required to avoid sleeping on your back for now.

3. Don't do weird drugs. They probably won't help. Don't eat weird food 30 minutes before bedtime. That won't help either. Do use "breath right" strips to help keep your sinuses open if you wish. They won't help much with the apnea, but maybe a little.

So that kind of stuff until you can get tested and prescribed.

You'll be fine. You've been this way for a long time so you only have a little further to go.
04-10-2015 06:01 PM
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Mark Douglas Offline

Advisory Members

Posts: 513
Joined: Apr 2015

Machine: Sys 1 (60) RemStar BiPAP Auto with Bi-Flex 760P Auto Bi-Level (Variabl
Mask Type: Nasal mask
Mask Make & Model: PR Wisp
Humidifier: PR Sys One heated
CPAP Pressure: RiseTime 3 Fxd E-9.0 / I-11.5
CPAP Software: SleepyHead EncoreBasic

Other Comments: Hashimoto's thyroiditis.

Sex: Male
Location: SW Ohio

Post: #10
RE: Cheap tools and the most capable CPAP machines
retired_guy Thanks

I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
04-10-2015 06:06 PM
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