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[Equipment] Another Newbie - ? on machine
#1
I'm new so please excuse me if I use the wrong terminology.

I had an at-home sleep study done and I was diagnosed with severe sleep apnea. Then I had an in-lab sleep study with a machine using a nasal mask. Tech said it went well. I see the doctor for the follow up and to discuss the next step next week.

I mentioned to the doctor and the tech that I was interested in the ResMed S9 Autoset and they both disagreed with the "autoset" feature. The titration study I just had will let the doctor set the pressure so I don't need the auto setting.

They both said the "auto" machines force you to experience an "episode" before changing the setting so you still don't sleep normally straight through.

1) Are they correct that I should avoid the autoset machines?

2) Which none autoset machine should I ask for?

Thanks.
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#2
Doesn't make sense to me what you have been told. I would insist on an auto set. I know ResMed S9 auto set can be used as straight CPAP and to me, it is beneficial to have the auto set to have a minimum and maximum setting capability.

You definitely do NOT want the Resmed Escape as it only shows compliance data and you want a data capable machine where you can monitor your AHI's, leaks, etc. etc.

I don't know where your doctor is coming from. I am sure other members will be able to help you more.

Welcome.
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#3
JohnNJ, welcome, they are right what they are saying but the pressure increases as soon as an apnea is detected and stays at the pressure you require and then drops down again and the cycle continues, so you will have some apneas that last 10 secs or more but not enough to wake you up or cause any problems. I would say thee majority of people on this site use an Auto CPAP, it's advantages are that it has a low pressure and high pressure versus a constant pressure. If you have servere sleep apnea, your high pressure may need to be fairly high, personally I couldn't take that all night. A disadvantage is the cost, obviously you get what you pay for.
Some Drs and techs try to save money by giving you the cheapest machine possible and quite a few still don't want patients taking their therapy into their own hands. Both major brands Resmed and Phillips have auto machines, the Resmed which I use is called the Resmed S9 Autoset. I would not use any other machine and pay 10 times the amount I did if I had to to get the right machine as this is my life I am talking about, good luck and please ask any other questions you have.
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#4
(11-13-2013, 01:30 AM)JohnNJ Wrote: They both said the "auto" machines force you to experience an "episode" before changing the setting so you still don't sleep normally straight through.
This doctor is a spin doctor, no machine whether CPAP or APAP can prevent all apnea/hypopnea all night every night but at least correctly set APAP ... preempt apnea events by responding to snore and flow limitation which are the early signs of airways collapse.
APAP require doctors to review/interpret the data download and trouble shooting during the followup period. Lazy doctors don,t have the time, just send the patient for another sleep study when the patient complain that leaks under control and AHI always below 5 but they don,t feel any better

Lab titration is only one night, APAP titartion is every night in your own bed.

S9 Autoset and S9 Elite both are data capable machines but the AutoSet only cost few dollars more. If you happen to in US and insurance paying for the machine, your insurance pay the same amount of either machine but your DME make extra profit by not giving you the AutoSet. The AutoSet is better investment ... two machines in one ... CPAP and APAP











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#5
(11-13-2013, 01:30 AM)JohnNJ Wrote: They both said the "auto" machines force you to experience an "episode" before changing the setting so you still don't sleep normally straight through.
There's a bit of truth to this if the Auto machine is left running wide open---as in with a pressure range of 4-20cm. If the Auto is set to a much smaller range centered around your titrated pressure, there typically will be no more events than using a straight pressure machine and there may (or may not) be a bit more comfort.

The thing is a few events are going to get through even if you use a single pressure machine set correctly. That's because our sleep varies from night to night and no therapy is [i]perfect
night after night after night.

That said: Some people are more comfortable with the varying pressures of a well set Auto because it reduces the overall pressure needed and on a bad night it can respond with a bit more pressure in an attempt to smooth things out. Other people are more comfortable with a well set CPAP because even small pressure changes tend to disturb their sleep, and the well set CPAP stops almost all their events while providing a "constant" sleeping environment.

Quote:1) Are they correct that I should avoid the autoset machines?
Any Auto CPAP can be set to straight CPAP mode (i.e. be set to run as a single pressure machine.) No plain CPAP can be set to run in Auto mode. That's probably the biggest reason for trying to get an S9 AutoSet or a PR System One Auto---it's like getting two machines in one. (But do NOT settle for the S9 Escape Auto, it is a crippled auto in terms of the data it records)

Quote:2) Which none autoset machine should I ask for?
The Resmed S9 Elite and the PR System One Pro CPAP are both top of the line plain CPAP machines that record full efficacy data. You get as much data from the S9 Elite as you do from the S9 AutoSet. You get almost as much data from the System One Pro as you do from the System One Auto. If the doc absolutely insists on a straight pressure machine, try to get the S9 Elite or the System One Pro.


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#6
What everyone else has said.

If it were me, I would find a doctor willing to write a script for an auto set rather than straight cpap. They are not that much more expensive but gives the option to set the machine in a range of pressure should it be beneficial to you and you can still use it as straight CPAP. In this case, more is better.
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#7
Hi JohnNJ,
WELCOME! to the forum.!
What everyone has said so far.
Good luck to you and hang in there for more responses to your post.
trish6hundred
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#8
Sticky question. A straight cpap machine may solve your apnea more simply and elegantly than an auto machine. The advantage to the auto is only the versatility of the machine. They can generally be programmed to run in straight cpap mode. The longer I do this I believe the simplest answer/machine is the best one. If you find cpap does not fix the problems you were having- the reasons you had a sleep study to begin with- you can always advance to a BiLevel or auto machine. Keep track of your symptoms and progress and keep up with the doc. If you find all is well, great. If not, changes to your therapy can be made.
There are so many different brands of machines it's hard to make a recommendation for one. If you want to keep track of your "numbers"- leaks, ahi, etc., ask for a data capable machine.
Good luck. I understand how conventional cpap wisdom encourages us to get the most bang for our buck when getting a new machine, but the more variables there are to control, the more difficult it can be. Please keep us posted.
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#9
I have used both straight CPAP and AutoSet.
The Auto rules big time. This is because you can find the best pressure profile that works best for YOU.
If something changes during the night *the machine compensates*
This is the huge feature about it.
It is much more comfortable to sleep with since it always delivers minimum pressure to get the job done without
waking you up needlessly.

Oh yes, don't let the doctor sell you any wooden nickles.

Cheers & good luck!

=^.^=
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#10
Snort. The others have 'splained it well but I'll do it too, just so you got more ammo.

Quote:They both said the "auto" machines force you to experience an "episode" before changing the setting so you still don't sleep normally straight through.

Okay, you are driving down the road with your foot on the gas pedal. Not on cruise. You don't move your foot on the pedal one bit. Up hill, down hill, don't matter, you don't move it. You fly down the hills, you crawl up them. Same pressure on the gas.

On cruise, the car's computer may hesitate at first going up a hill then realize, hey, we slowed down, need to increase the gas. It does, you maintain the set speed. You start down the hill. Car's computer realizes hey, we sped up, lets go the gas and lets just the car's weight carry it down.

This is the same with regular CPAP and APAPs. Regular CPAPs carry the same pressure no matter what. Events happen, don't happen, don't matter, it maintains the same pressure. For the the majority of folks, this is just fine and they do well. But for others, an APAP is better. It can adjust to whatever happens. Change in medication, to sleep position, to whatever.

Like the others have said, an APAP is the best machine for a good reason: it is two machines in one. You can use it in auto mode to help figure out what is your best pressure then switch to CPAP mode and use that pressure. You then have the option of the APAP mode if something changes or for regular "check ups".
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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