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[Equipment] PR System One replaced with Löwenstein Prisma 25S
#11
RE: PR System One replaced with Löwenstein Prisma 25S
Have we ever discussed positional apnea and use of a soft cervical collar? It would probably stop the clusters of obstructive apnea and numerous leaks. http://www.apneaboard.com/wiki/index.php...cal_Collar
Sleeprider
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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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#12
RE: PR System One replaced with Löwenstein Prisma 25S
(02-26-2022, 08:44 AM)Sleeprider Wrote: Have we ever discussed positional apnea and use of a soft cervical collar?  It would probably stop the clusters of obstructive apnea and numerous leaks. http://www.apneaboard.com/wiki/index.php...cal_Collar

Yes, we did. Unfortunately I couldn't find one which he can tolerate. That's why I'm trying the rolled towel under his chin. It is obviously less effective, but he can sleep with it. I'm still searching though.
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#13
RE: PR System One replaced with Löwenstein Prisma 25S
Try a travel neck pillow, and use a piece of Velcro to connect at the front. It will at least support the jaw and help alignment. I realize the styles available in Hungary will be different, but something not too thick behind the neck that can still provide some jaw support would be ideal. Consider this an idea: https://www.amazon.com/Memory-Travel-Pil...WNrPXRydWU=

[Image: 81Ah56ih4RL._AC_SL1500_.jpg]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#14
RE: PR System One replaced with Löwenstein Prisma 25S
The pressure on the Prisma is set to a much lower range than the Philips - your median/max delivered pressure on Philips is 12.4/17.7cm while the Prisma max is 12cm. Why not give the Prisma similar settings to allow it to raise pressure as required?
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#15
RE: PR System One replaced with Löwenstein Prisma 25S
(02-26-2022, 08:17 PM)kappa Wrote: The pressure on the Prisma is set to a much lower range than the Philips - your median/max delivered pressure on Philips is 12.4/17.7cm while the Prisma max is 12cm. Why not give the Prisma similar settings to allow it to raise pressure as required?

Somehow the mouthleak is worse with prisma.
Also prisma is increasing the pressure more quickly.

I'm afraid he will just sleep the whole night on max pressure with fully opened mouth.

I will try tonight with Pmax 18.

Thanks
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#16
RE: PR System One replaced with Löwenstein Prisma 25S
Quote:Try a travel neck pillow, and use a piece of Velcro to connect at the front. It will at least support the jaw and help alignment. I realize the styles available in Hungary will be different, but something not too thick behind the neck that can still provide some jaw support would be ideal. Consider this an idea: https://www.amazon.com/Memory-Travel-Pil...WNrPXRydWU=

I ordered some of these, I can try it in a couple of days, thanks.
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#17
RE: PR System One replaced with Löwenstein Prisma 25S
I still didn't have the chance to try the neck pillow (unfortunately my father is against it, I have to convience him to at least try it for a couple of hours)

In the last nights we tried to sleep with prisma.
Almost all nights we ended up switching back to philips either because of enourmus leaking or higher number of apneas.

It's just always worse than the old machine even with the same settings.
We have leaking with the old one too, but he is actively managing it better (closing his mouth after a while and leak rate is generally lower)
Also AHI is roughly half with the old one.

I'm actually quite fed up with prisma.
It's hard to find any information because very few people are using it.
I struggle to assess the data properly. The unreleased version of OSCAR (which barely works with prisma) and PrismaTS (which runs slowly in a VM on a mac) is not too helpful.
And even the results are worse.

I still thinking about buying Resmed which would at least solve the first two problem.
Now that he is on APAP, I could buy airsense 10 out of pocket relatively easily.
Aircurve VAUTO would be a much bigger hit to my wallet.

What do you think about it? Would you replace the machine at this point?
Are we 100 percent sure that APAP is the best mode for him? I see convincing results with APAP, but before buying a new machine I have to think twice.

Sorry for venting out, at this point I'm quite desperate trying to get him a good therapy without the recalled machine since two months. My sleep schedule is also sacrificed to the goal.


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#18
RE: PR System One replaced with Löwenstein Prisma 25S
Unfortunatelly we had not much success with the travel pillows.
He just couldn't stand wearing anything around his neck for more than 5 minutes and I can't force it.

We have the normal yearly appointment to the sleep doctor on monday, so I decided I can try prisma for a few more nights.

Yesterday was not too bad, but what worries me the most is his oxygen levels are still not as stable as with philips.
For example from 3:21 to 3:30 there are no apneas, nor hypopneas, yet the spo2 is oscillating between 90 and 95. Also generally the min/med levels are lower.

I still have the plan to replace it with the aircurve 10, I'm actually just a few clicks away from ordering it.


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#19
RE: PR System One replaced with Löwenstein Prisma 25S
I was finally able to get the Aircurve 10 VAUTO from Supplier #24 for my father. After 3 nights I'm mostly satisfied with the machine.
AHI is roughly the same, and o2 levels are even better than with Philips in the last few weeks.
I think the old machine can finally retire as a good reliable backup device. Löwenstein will be probably sold in the family.

I am surprised that this machine seems to be even more quiet than Löwenstein, not to mention the old Philips of course.

I tried all the three machines for a few minutes just to compare and we both agree that breathing is certainly the most comfortable with Resmed.

Unfortunatelly, mouthleaking is still something I need to solve. He is wearing a chinstrap, this the only thing he is able to wear for mostly the whole night.
I saw a white chinstrap somewhere which is allegedly pushes upwards not backwards.

I think with this machine, it is more visible on the graphs, that he would benefit from the cervical collar, but he still hates it.

I'm attaching last night's screenshot, if there is anything new visible, I'm always happy to take any advices.


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