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[Equipment] Need help finding machines to try
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RonWessels Offline

Preferred Members-2

Posts: 465
Joined: Jun 2013

Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #11
RE: Need help finding machines to try
Information on Respironics BiPAP machines (BiPAP Pro and BiPAP Auto) can be found at http://bipaps.respironics.com/. The same information for Respironics REMstar machines (REMstar Plus, REMstar Pro and REMstar Auto) is at http://respironicsremstars.respironics.com/.

To answer your questions based on the above information, there is also a Respironics BiPAP Auto. The autoSV Advanced you specified also has auto-servo, which is a mechanism by which breaths are delivered on a timed basis rather than solely on-demand. I would strongly recommend consultation with your doctor before getting an auto-servo machine.

I can't find any reference to setting the ramp time duration on any of the machine manuals listed on those pages, although I know for a fact that the REMstar Pro has that feature, since I have that machine. On my machine, I can set the ramp start pressure in 1 cmH2O increments from 4 to my CPAP pressure setting, and the ramp duration in 5 minute increments anywhere from 5 to 45 minutes.
06-21-2013 03:02 PM
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Zorki1c Offline

Preferred Members-2

Posts: 134
Joined: Jun 2013

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: H5i
CPAP Pressure: 6
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Pacific Northwest United States

Post: #12
RE: Need help finding machines to try
I have the F&P Icon Auto and like it a lot. It takes up less space than most of the others (the machine and humidifier are combined) and it is very quiet. It doesn't have a large a following as the ResMed but it does the job for me. My doctor specified the machine--maybe he gets a kickback--but I have no complaints--especially now that the latest version of Sleepyhead reads data from it.
06-21-2013 05:52 PM
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markrb Offline

Members

Posts: 19
Joined: Jun 2013

Machine: F&P Icon Auto
Mask Type: Full face mask
Mask Make & Model: Unsure
Humidifier: Built in
CPAP Pressure: Auto 13-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: New Hampshire

Post: #13
RE: Need help finding machines to try
I adjusted my request list to the doctor to be.

1. Philips BiPAP Auto
1a, ResMed VPAP Auto

If insurance won't cover the BiPAPs then will try.

2. ResMed S9 auto
2a F&P Icon Auto

All of these have the ramp feature, which I think will be the most important to me. Once asleep I think I will be OK.

Thanks for all the help,
Mark
06-22-2013 01:54 PM
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archangle Offline
Wiki Editor
Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #14
RE: Need help finding machines to try
Don't worry about ramp. If necessary, start at a lower pressure and increase it slowly over a few days. Wear the machine during the day while you're reading or watching TV to get used to the pressure. If necessary, start at a pressure that doesn't adequately treat your apnea, but you can stand wearing the machine. Then increase the pressure until your apnea is adequately treated.

After a few weeks, even at full pressure, you'll probably find you can't even feel the pressure and have to put your hand in the airstream or lift up the edge of the mask to tell it's on.

If you get an Auto machine, if the pressure bothers you, temporarily reduce the maximum pressure to a level you can live with and increase it bit by bit.

Doctors and DMEs are sometimes pigheaded about setting pressure. It's possible to change the pressure yourself if necessary.

By the way, sometimes ramp or a low pressure can make things worse because you get a feeling of not getting enough air.

Don't get the F&P Icon. The superior data collection offered by the PRS1 or S9 machines is important. With the PRS1 or S9 you can see every single breath and every single breathing problem for the whole night.

Here are some examples of the data you yourself can get from an S9 or PRS1 machine of the correct models. http://sourceforge.net/apps/mediawiki/sl...sers_Guide

The BiPAP/VPAP (generic term "bilevel") machines are not strictly "better" than the CPAP/APAP machines. They do allow more "exhale relief" where they reduce pressure on exhale. They generally go to a pressure of 25 vs. 20 for the CPAP.

A bilevel machine can help with difficulty exhaling, but I think most people will readily adapt to the pressure when exhaling

In particular, the ASV machine (ResMed VPAP Adapt or PRS1 AutoSV Advanced) is not necessarily an improvement unless you have some form of Central Sleep Apnea (CSA.) When used on a "normal" apneac, it may be "rough" on you because it decides when it wants you to inhale and you may feel it's forcing you to breathe on its schedule, not your own. If you have CSA, you need an ASV. Others should avoid it.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
06-22-2013 02:46 PM
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SuperSleeper Offline

Administrators

Posts: 9,973
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #15
RE: Need help finding machines to try
Yep, most patients can get used to the pressure over time and end up turning the ramp feature off completely. It's only a comfort feature, really. Not a necessity.

Smile

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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.

06-22-2013 08:07 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #16
RE: Need help finding machines to try
(06-21-2013 08:55 AM)markrb Wrote:  1. Is the BiPAP autoSV Advanced — System One the only auto BiPAP they currently sell?
2. What is the maximum time the ramp can be set to come to full pressure? All the manual says is 1,2,3. There is no explanation of what these relate to.

Hi Mark,

Below is attached the current Philips Respironics System One comparison guide.

From the comparison guide, it looks like the ramp time can be set as long as 45 minutes on all PRS1 models except maybe the BiPAP AVAPS and BiPAP S/T models.

By the way, the "1, 2, 3" in the BiPAP manual would be referring to Bi-Flex, which adjusts how abruptly or gradually the pressure transitions between the lower EPAP exhale pressure versus the higher IPAP inhale pressure. A Bi-Flex setting of 3 is the most gradual/smooth.

ResMed EPR and Philips Respironics A-Flex and C-Flex are used with APAP and CPAP machines, where the 1, 2 or 3 refer to approximately 1, 2 or 3 cmH2O drop in pressure during exhale.

ResMed EPR differs from Respironics C-Flex, which raises the pressure back to the high inhale pressure WELL BEFORE you have finished exhaling. This is not a bug, this is an (uncomfortable) feature: this is done to ensure that low pressure will not allow the throat to collapse during the beginning of inhalation, which is the time when it is easiest for the throat to collapse. ResMed EPR does not include that feature and is therefore more comfortable than C-Flex, but (at least for some people) EPR makes obstructive events more likely unless the normal CPAP set pressure is raised a little, to compensate. In fact, using EPR can actually decrease the number of obstructive events as long as the CPAP set pressure is not too low. If someone is using ResMed EPR on a CPAP machine (meaning a constant pressure rather than an Auto-adjusting APAP machine), unless the titration was done using the same or larger EPR setting, I would suggest it would be best to have the CPAP pressure raised by an equal amount as the EPR being used.

Take care,
--- Vaughn


.pdf  Respironics_ SystemOne_Comparision_Guide.pdf (Size: 59.32 KB / Downloads: 128)

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 06-23-2013 08:44 AM by vsheline.)
06-22-2013 08:55 PM
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markrb Offline

Members

Posts: 19
Joined: Jun 2013

Machine: F&P Icon Auto
Mask Type: Full face mask
Mask Make & Model: Unsure
Humidifier: Built in
CPAP Pressure: Auto 13-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: New Hampshire

Post: #17
RE: Need help finding machines to try
My Doctor has put in the request to insurance for the Philips BiPAP Auto, but does not think insurance will cover it.
She is really pushing the F&P Icon Auto as she says she has had success with that machine when people were not able to use other machines.
She insists it is the Sense Awake technology.

I have tried CPAP in the past and was not able to use it.

My thinking, right or wrong, is the BIPAP with a ramp would give me the best chance to get used to something and who knows maybe she is right about the F&P for me.
Data collection for me is a secondary concern. I need to be able to use a machine first and that will be a huge challenge given what my reaction to it was before.

At least the ball is rolling now. They say a decision takes about a week.

Thanks for all the help,
Mark
06-29-2013 08:46 PM
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