Email from Philips offering an "auto-adjusting CPAP" instead of the DS2

[frogger]

Basically I've been trying for months on end to help a poorly insured friend get a replacement for their ancient pre-Dreamstation CPAP.  They do qualify, but their doctor sucks, and has not responded to requests to send Philips their settings, and therefore Philips "can't" send it out.  Instead just now, they offered the following:

We are still missing your device therapy prescription. Because we are unable to fulfill your order without a prescription, we wanted to inform you of the option to receive a replacement device with automatic adjusted settings, more commonly known as Auto-adjusting CPAP. By choosing this option, we can ship you a replacement device without your prescription settings, which may help us process your order more efficiently. Below explains this setting and how you can provide your consent for this option within the Patient Portal.

I guess the real question is, is this just another attempt to screw someone over?  I don't trust Philips myself, so I'm wondering, is the "auto adjusting" portion just the same Dreamstation 2, but with settings that can easily be changed once you get it?  Does anyone know what this means?  I think my friend can probably get this sorted out in a couple months when they finally see the doctor for the prescription portion, but the sooner the better if it's all the same?

[Gideon]

Both the DS2 and the DS1 fit that description.

[frogger]

Both the DS2 and the DS1 fit that description.

OK, so basically , it would be the exact same machine, albeit without the prescription programmed in that we can then fix according to her settings?  I hope I understand before we seal the fate with this offer.

[Gideon]

Yes, and we on the forum can easily, with the use of OSCAR help you to tune it in.

[frogger]

Yes, and we on the forum can easily, with the use of OSCAR help you to tune it in.

I always just used the provider settings by holding down the button and swiping down...same thing?

[Gideon]

That is your call, without question it is a good place to start.

Likely you will find the new devices set to the device defaults of 4-20 which tend to work poorly in many cases with the Philips algorithm. These machine never optimize therapy, they just react to events and with Philips often too slow to significantly head off future events. We would be looking for a min Pressure higher than with other devices to use. We can't tell what these pressures need to be without viewing the daily charts.

[frogger]

That is your call, without question it is a good place to start.

Likely you will find the new devices set to the device defaults of 4-20 which tend to work poorly in many cases with the Philips algorithm.  These machine never optimize therapy, they just react to events and with Philips often too slow to significantly head off future events.  We would be looking for a min Pressure higher than with other devices to use.  We can't tell what these pressures need to be without viewing the daily charts.

Well I'm sure she can get a new sleep study done, but it's just the charity clinic she goes to is pretty awful about communicating outside of appointments, and the soonest appointment for her isn't until June at this point.  Philips said before that they couldn't ship it until the doctor sent the settings to them, but now apparently they've offered the alternate.  Thing is, she still knows her settings from her records, and probably not much has changed.  Looks like we may just go the immediate route and get the auto cpap

[Gideon]

I would then post her daily charts in a new thread, her thread, here and then we can suggest what to do from there.

[JshMD]

I was also confused by the reference to the "auto-adjusting" CPAP.  I thought that maybe it meant that the machine would evaluate the data and come up with a setting prescription per some algorithm.  I recently met with a doctor to evaluate my setting on the machine I have been using for the last 10 years on a System 1 (series 60), and on viewing the readout data, he advised that the settings remained appropriate for me.  My question is whether if I get a Dream Station 2 without a programmed setting, is it clear I be able to adjust the settings myself rather than rely on the auto-adjust feature?  There is a YouTube video that seems to say that all that needs to be done to program the settings is to open and use the provider controls by holding down the button down for 5 seconds and swiping down.  Philips' recently posted discussion of the alternative of getting an auto adjusting DS says that a replacement CPAP can be provided much faster if I consent to getting an auto adjusting CPAP.  [As a new member, i can't post the link to this on the Philips website - but you can find it under the discussion of "i-dont-have-my-prescription-yet-what-are-my-options".  The clear implication of their discussion is that I will be able to program my own settings if I want to (by saying "Philips Respironics recommends that you should not adjust your device settings without consulting your physician").  What do you think of their explanation for the delay of making this alternative available:  "In late 2022, as there continued to be a population of patients affected by the recall who had not yet provided to Philips Respironics their prescribed settings, Philips Respironics had to design and validate an alternative process that would help facilitate getting those particular patients a replacement device in a manner whereby those patients could then work with their physicians after the taking delivery to set their machine’s pressure settings." Is it possible that Philips is shipping replacements that have blocked the ability to program the settings myself as is shown in the YouTube video?

[Gideon]

DS2 has encrypted data.  This is, to my knowledge, the ONLY pap machine to date that has encrypted data.  OSCAR can read this data. At this time OSCAR is your only choice for complete and unfettered access to this data.

Via the CPAP Setup Manuals link in the black banner above you can request a copy of the manuals that describe how to access every setting your Philips, and other manufacturers, have in their pap devices.  This means that yes, you have the capability of changing any setting on your pap machine that you wish to do so.

Apnea Board has a long history of patient empowerment via education, knowledge and tools such as OSCAR to allow you to learn and change your CPAP settings.  Many of Apnea Boards members manage their own settings and are more than willing to share what they have learned .
Do not Dial Wing it.  Do not change settings without the knowledge of what to expect and why.  If you don't understand ask.  If you are uncomfortable making changes yourself then you have talking points to bring up with your doctor. 

Very few here have any formal medical training so despite any assumption you may have that someone may have, assume they don't.

Most doctor's are totally satisfied with any AHI that is 5 or less
  Most here would like to see at least half that.

One thing that sets Apnea Board apart from other internet based resources is that we pretty much insist on seeing data for any but the most basic of issues.  The data we prefer is the detailed data recorded to your data card and processed for viewing by OSCAR.

As I said in other posts, APAPs or Auto CPAPS, or Auto BiLevels for that matter are very capable of adjusting to your sleep status, your tossing around, and to leakage but very very few users are optimized when pro ided with default settings.