[Equipment] Aircurve vs Dreamstation Data Recording question

[bfry]

I have searched the forums for information on this, but can't find where anyone has mentioned the data points that are recorded by the newer machines. Since early 2015 I have been on a ResMED Airsense 10 CPAP, however I was recently re-evaluated and told I needed a BiPAP. 
My Dr. aggressively pushed for a PR Dreamstation, and every reason I mentioned for the Aircurve was met with a reasonable answer, so I acquiesced. I HATE the Dreamstation. I looked into returning the device & going to the Aircurve, but my Dr's latest objection is the following:

"The decision to not use RESMED devices is across the board in our practice even when patient's use outside DME due to insufficient clinical data that comes out of the RESMED device that does not allow us to give the best clinical management to the patient. As you have regular follow ups throughout your life we will be looking at clinical data to ascertain effectiveness of treatment and fine tuning will be performed. The Respironics devices are the most effective in achieving these goals."

Here are the problems I am having:

• The way the pressure functions now has created a problem where my mouth is opening & I have now had to start adding a chin strap. Not fun with a beard.
  
• Bright light when I turn it off in the morning, so when I want to look at the night's info real quick, my wife is bothered... etc. you get the point.
  
• The water chamber is not really visible from the outside, so you have to open the system up just to check it. In my case, with a small nightstand, it means moving my table lamp, just to open the dang thing. That's ended up with a couple of nights where it went dry. ( Dr.'s office says I should be emptying the water every day anyway, so forgetting and going dry or whatever shouldn't be an issue. I just need to re-position my system for better use they say.)
  
• My AHI has gotten very marginally better, though I attribute that more to the medications for the RLS that were added at the same time, than the BiPAP (maybe actually in spite of the BiPAP).
  

So. My question is primarily in relation to the above quote. Does the PR Dreamstation record more data than the Aircurve? Or is that just pure BS?
I already use SleepyHead and Encore. (I was using the ResMED software before.), but I can't see that it's providing any different data with the exception of a "Periodic Breathing" data point. Is that one data point Respironics specific or BiPAP v CPAP specific. 

If anyone knows the answer, I would appreciate the information. I would prefer not to have to change doctors, and I don't want to challenge him on the information without knowing for sure. That said, I'm ready to toss the Dreamstation in the trash & go back to the Airsense until I can afford to buy my own Aircurve somehow.

Blessings to all,

Bill.

[Walla Walla]

Your Doctor is full of BS. Buy the Resmed VAUTO. Tell the Doctor he's free to use the Dreamstation all he wants but your going to use the VAUTO since your paying the bill. Tell him you'll supply him a copy of your SD card and he can join Apnea Board and download ResScan to get all the data he needs.

[Sleep2Snore]

He is just pushing the Dreamstation as he has more money coming in from sales or hire of them.
You are the patient, if you want a ResMed, tell him you will not accept anything else.
Tell him you have spare tanks and power supplies for the ResMed, so why would you want to change to another machine.

[SarcasticDave94]

Short and simple: YOU are the patient, Also Known As the person using the CPAP, so the device brand is your choice.

The doctor wants to choose Philips Respironics DreamStation, well OK great but he's not using it. He's not the one that has to meet compliance. I have nothing against PR products as I had the DreamStation BiPAP one year ago, and it was a nice product, but BiPAP was not what I needed. When I failed compliance due to the wrong tool for the therapy situation, I decided I am getting a ResMed for the ASV machine that was/is the correct device. I told the doctor I choose ResMed's ASV. I couldn't get him to name it specifically, but I did try to do so. OK plan B: I chose a new DME that would supply my choice of ResMed as that is what they carry. I forced the decision on them to dispense the brand I wanted.

Be ready to change something if you want and/or need ResMed. It sounds like the PR DreamStation isn't all dreamy for you, so make the change happen. After all, you are the patient, and you are deserving of a proper level of input into what device you are issued.

[Sleeprider]

You might want to look up your doctor at this link and see who pays him. https://projects.propublica.org/docdollars/

So. My question is primarily in relation to the above quote. Does the PR Dreamstation record more data than the Aircurve? Or is that just pure BS?
I already use SleepyHead and Encore. (I was using the ResMED software before.), but I can't see that it's providing any different data with the exception of a "Periodic Breathing" data point. Is that one data point Respironics specific or BiPAP v CPAP specific.

If anyone knows the answer, I would appreciate the information. I would prefer not to have to change doctors, and I don't want to challenge him on the information without knowing for sure. That said, I'm ready to toss the Dreamstation in the trash & go back to the Airsense until I can afford to buy my own Aircurve somehow.

In answer to your questions, the data collected by both Respironics BiPAP auto and the Resmed Aircurve 10 Vauto are about the same. Resmed actually provides much higher resolution data for flow limitation and mask pressure, while the Respironics flags RERA events. The two machines operate the same in BiPAP-S or VPAP-S mode which is fixed bilevel pressure. That appears to be what you are using with fixed pressure of 14/9 at PS 5.0. In Bauto mode the machines operate a bit differently. Both let you set a minimum and maximum EPAP pressure and pressure support (PS). The Respironics allows a range of PS, so you could use a range of 3.0 to 5.0 for pressure support, while the Resmed only offers a fixed pressure support. Let's say you set EPAP min at 8.0 and EPAP max at 12.0 on both machines, but set a range of 3.0 to 5.0 on the Respironics and 4.0 on the Resmed. Both machines would increase EPAP pressure to prevent obstructive apnea events, and during hypopnea. The Respironics would start at PS of 3.0 (11/8) but would increase PS to respond to hypopnea and flow limitation. The Resmed would maintain a constant PS and move from 12/8 to 16/12 as needed.

Both are good machines, but you have an autocratic doctor who has set you up on fixed bilevel pressure, so regardless of which machine you use, you don't get an individual or changing response. This is similar to using CPAP mode on an auto CPAP. I think you could get good results on either machine, but your doctor's controlling attitude is the main limitation. A doctor may prefer that all of his patients use the same machine because it makes it easier for the office staff to obtain data and produce reports. Using only one software to evaluate patient data is a lot easier than running two different software platforms, and I suspect that is the main consideration here. The bottom line is, you sound like you're prepared to do your own optimization and the doctor wants to control your therapy. That's not a very good fit. If you are feeling lucky, change your settings as suggested above in Bauto mode, with EPAP 8-12 and PS 3-5 and see how it goes.

[bfry]

Thank you to all who have responded so quickly. Especially @Sleeprider for your detailed response on the data. My doctor is pretty much an expert and has been pretty controlling. To his credit, he is detailed and very thorough. As I mentioned, he had a logical and well thought out answer for everything I presented. The problems are more lifestyle & personality fit than therapy effectiveness, but they are problems nonetheless.
My problem now, is getting him/DME to take back the current device & acquire a replacement (hopefully still getting coverage by the insurance company, which is Tricare (military). I called Tricare, and all they would tell me is to work with my DME to get authorization for another device after returning my current one. Who knows.

[Walla Walla]

Right now your on a rent to own with Tricare. I would look for another DME that uses ResMed and return the Dreamstation. You'll need to get a copy of your prescription from the Doctor which your entitled to. The downside of this is you have to start all over on the rent to own payments. Of course you could just buy one on Amazon without the prescription and return the Dreamstation. That's what I did.

The nice thing about not having to worry about the DME and insurance is you have all the power.

[Sleeprider]

bfry, it would be interesting if you posted a graph of your detail results from Sleepyhead. I bet we could give you some talking points.

[bfry]

Here's the statistics page in Monthly mode from Sleepyhead:

And the standard stats:


Here's a detail page from just the other night:


And one from back in November, just before I redeployed home from Afghanistan:


I can pull more, or include the overview page, but hopefully this is a good start.

blessings,

Bill.

[Walla Walla]

I have no idea why your Doctor put you on a Bipap???