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Dreamstation for UARS?
#1
Hi,

I'm new to the boards - finished my initial sleep study a couple weeks ago and received my results yesterday. As you'll see in the data below, I don't qualify for OSA as my AHI is too low. However, I'm seeing a ton of respiratory arousals, which is fragmenting my sleep (so UARS).

After talking with the doctor, we've decided that the best course of action for now is to try CPAP therapy. My titration is scheduled for tomorrow (Sunday) night. My question here is - given the differences between UARS and OSA, is there a CPAP that is going to be better at helping someone with this sort of profile?

The sleep center typically issues the Dreamstation Auto CPAP. If that's suitable, I can walk out with it Monday morning, which is appealing. They also made it clear that I can go elsewhere to get a CPAP of my choice. I've heard great things about the Dreamstation, but I want to make sure that it's the best choice for me and my profile. Thanks!

My main results:

Apnea Index: 0.4
Hypopnea Index: 2.2
Total AHI: 2.6
RDI: 12
RERAS: 46 (not sure if this is an hourly number or the total number)
Total Arousals: 73 (15/hr); 27 respiratory; 1 leg; 22 spontaneous, and 23 snore
The only other interesting thing they found is that I spend more time in N3 sleep than most (32%), which didn't seem to be that concerning.



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#2
Welcome to Apnea Board!

There is not a vast amount of information on UARS and its treatment. I suspect that I also suffer from that, but am waiting on an appointment with the sleep doc.

My understanding is that treatment is mostly a matter of trial and error, adjusting the pressure until the RERA events are suitably controlled. So the choice of machine depends on your pressure needs. The titration study will determine a first approximation of that pressure. As long as your pressure is not too high, the DreamStation Auto is a good machine. That is what I have and I am very happy with it. The Resmed AutoSense is another good choice. The difference comes down more to personal preference than therapy. I have not seen anything to suggest that one or the other is better at treating UARS.

If your pressure needs are too high, or if you have persistent difficulty with exhaling, you might need to move up to a Bi-level (Bipap) machine. Both Phillips (DreamStation) and Resmed (Airsense) make a model that has that function. I'd make sure when you get your machine that if it turns out you need a bi-level machine that you can exchange it. Unless the titration study shows you need a pressure near or above 20, they are unlikely to give you a bi-level machine until you fail to adapt to the CPAP machine.

Sleep-well
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#3
A slight correction to the information in Chill's post. Resmed's 10 series bilevel machines are called Aircurve.
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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#4
I would go for a ResMed AirSense 10 AutoSet For Her if I had only UARS. (I say "only" because I had around 30 OAs + hypopneas, plus ~20 RERAs/hr during my diagnostic sleep study, so I have a combo diagnosis.) The ResMed "For Her" has two auto algorithms in it (the "For Her" one & the regular Auto algorithm). The machine also gives you a readout for RERAs scored. And the flowers on it are kinda cute.

Here's the link to an article on the ResMed site about some differences in obstructive sleep apnea between men and women and how the AutoSet For Her algorithm takes those differences into account.

Tables 1 and 2 give you a quick look if you don't want to read the whole article.

If your sleep study results tell you if you had lots more events during REM sleep than during your other sleep stages, that would be another point in favor of the "For Her" machine to me. That part is definitely my personal opinion. I go to a sleep doctor who really likes Respironics machines. I have a fixed pressure Respironics last-generation CPAP. It can run in "auto-trial" mode, which is mostly how I've used it. In my opinion, it's too slow to respond when my pressure needs suddenly increase (like I go into REM sleep or shift from my side to my back) and then it's too quick to head back to the minimum pressure, usually before I'm done with the REM sleep or whatever.

I have not had the opportunity to try a ResMed machine, though, so my impressions of it are based on reading and looking at the events/pressure graphs that forum members post here.

I am not trying to say that the DreamStation won't work for you.

P.S. While we're talking Respironics vs. ResMed, if you are able to sleep without letting air escape through your mouth (you'll probably find out during your titration sleep study), I highly recommend the ResMed AirFit P10 nasal pillows.

They come in a regular and a "For Her" version. In the case of the nasal pillows, the "For Her" headgear is a little bit smaller, the "fit pack" comes with sizes XS, Small, & Medium nasal pillows to try, and it's purple/gray rather than blue/gray. It's really more of a sizing issue - I see plenty of women on this forum who use the regular P10s and some men use the "For Her".

The DME that I use does not even carry ResMed CPAP machines, but they do stock the P10 nasal pillows because they're so popular.

I'm glad that you are treating your UARS. I'm assuming you have symptoms/health problems resulting from it, since you ended up having a sleep study done.

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#5
Hi Art10630,
WELCOME! to the forum.!
I wish you good luck at your titration.
Hang in there for more responses to your post.
trish6hundred
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#6
Dreamstation Auto, set properly will do fine unless you need a bipap.
PR machines have for years recorded flow lmitation and RERA on all their data capable machines.

Resmed started recording that info with the "for her" version of their machines.
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#7
Thanks all!

That's really helpful. My tech tonight is supposed to have a ton of experience - 25+ years, so I will talk to her a little about some of the results from the titration to try to see what she thinks. I will also make sure I can return and get a different machine if need be.

Green Wings, I read that article a couple weeks ago. It was actually really helpful (though written by ResMed, so taking some of it with a grain of salt). While I have more apneas and hypopneas in NREM stages, almost all of my RERAs were during REM, so I will keep that in mind.

Ghost1958, To confirm, I will be able to see RERAs on the Dreamstation? Will it tell me on the machine itself or through software like Sleepyhead or the Repironics software?

If I'm not happy with the Dreamstation, I will check out the ResMed AirSense 10 For Her. Thanks, all!
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#8
(08-07-2016, 09:05 AM)Art10630 Wrote: Thanks all!

That's really helpful. My tech tonight is supposed to have a ton of experience - 25+ years, so I will talk to her a little about some of the results from the titration to try to see what she thinks. I will also make sure I can return and get a different machine if need be.

Green Wings, I read that article a couple weeks ago. It was actually really helpful (though written by ResMed, so taking some of it with a grain of salt). While I have more apneas and hypopneas in NREM stages, almost all of my RERAs were during REM, so I will keep that in mind.

Ghost1958, To confirm, I will be able to see RERAs on the Dreamstation? Will it tell me on the machine itself or through software like Sleepyhead or the Repironics software?

If I'm not happy with the Dreamstation, I will check out the ResMed AirSense 10 For Her. Thanks, all!

Youll see rera and flow on SH or Encore basic software.
On screen will show you AHI ,hrs slept, 90% pressure, if you had any periodic breathing, and large leak if any.
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