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[Equipment] reviews of Resmed S9 AutoSet vs. DeVilbiss IntelliPap AutoAdjust
#1
My 13-year-old has been diagnosed with severe sleep apnea (by pre-adolescent criteria), which has really been making his life miserable. We're about to buy an Auto CPAP machine.

He gets chronic sinus infections, so we want a machine that he will tolerate even with his chronically irritated mucous membranes. It looks like we should pay attention to
  • the ramp-up feature
  • how well the machine follows his breathing and how quickly it is able to back off pressure on expiration
  • data collection
  • the waveforms in response to a hypopnea, apnea or central apnea
  • PLUS, for him, a humidification system that won't irritate his mucous membranes

His MD at Packard Children's Hospital wrote a script for the ResMed S9 AutoSet, which seems to be the most expensive one. Most expensive isn't always the best ... but it may be.

I've also seen a number of rave reviews for the DeVilbiss IntelliPap, but no detailed comparisons of it and the S9. I would love to hear the details of folks experience with both.
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#2
Hi cat_lover,
WELCOME! to the forum.!
Check out this link, there is a lot of helpful information: http://www.apneaboard.com/wiki/index.php...ne_Choices
Best of luck to you in your search for a good machine.
trish6hundred
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#3
(05-01-2013, 01:23 PM)cat_lover Wrote: His MD at Packard Children's Hospital wrote a script for the ResMed S9 AutoSet, which seems to be the most expensive one. Most expensive isn't always the best ... but it may be.

I've also seen a number of rave reviews for the DeVilbiss IntelliPap, but no detailed comparisons of it and the S9. I would love to hear the details of folks experience with both.

If you visit a few forums and read messages, you will find the S9 Autoset is pretty much the gold standard. I have one and like it a lot.


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#4
[quote='cat_lover' pid='35610' dateline='1367432607']
My 13-year-old has been diagnosed with severe sleep apnea (by pre-adolescent criteria), which has really been making his life miserable. We're about to buy an Auto CPAP machine.

He gets chronic sinus infections, so we want a machine that he will tolerate even with his chronically irritated mucous membranes.

cat_lover

My wife has an alergy to dogs, cats, horses and feathers. We live our life without going where they are or have been. She can get symptoms like you describe plus asthma if she is exposed. She had a dog when young but developed the alergy later. Are you sure your son does not have an alergy to your cat?

When my youngest daughter was in girl scouts I went on a father daughter campout and we slept in a tent with another father and girlscout. I could tell right away that the girl had severe sleep apnea so I discussed it with them in the morning. It turned out that she had bad tonsils and adenoids and they needed to be removed. They were infected and swollen causing her apnea. That is something else you might want to check if she still has tonsils.

GeneS
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#5
Actually...The S9 is not the most expensive. There are machines that cost thousands more, but
the S9 is like the Ford F-150, It does what it was made to do and does it well.
The big plus is that the onboard clock is easy to reset when needed and it generates data logs at night that can
help you and your child isolate and adverse trouble that may come up.
I dont think there are many machines out there that can do all those at once.
and ...it works with SleepyHead software. (free!)

The Respironics Auto CPAP is pretty good too but it wont let you set the onboard clock for some reason.
(weird)

You can't go wrong with either from what I hear.
(I own the S9)

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

Cool
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#6
(05-01-2013, 03:34 PM)genes Wrote:
(05-01-2013, 01:23 PM)cat_lover Wrote: My 13-year-old has been diagnosed with severe sleep apnea (by pre-adolescent criteria), which has really been making his life miserable. We're about to buy an Auto CPAP machine.

He also gets chronic sinus infections, so we need a machine that he will tolerate even with his chronically irritated mucous membranes.

cat_lover

My wife has an alergy to dogs, cats, horses and feathers. .... She can get symptoms like you describe plus asthma if she is exposed. ... Are you sure your son does not have an alergy to your cat?

Hi Gene,

I appreciate thinking beyond my original question, to see if there are other solve-able issues!
You're right, my son is the huge cat_loverSmile. For a decade we had not had cats due to my and my husband's cat allergies. But we discovered reputable research showing that about half of all Siberian cats express low levels of Fel d1, the protein that causes most allergies, and about 15% of the Siberians were exceptionally low Fel d1 . Being cautious, we adopted two cats at the low end of extremely low , their lowest category. We are lucky, and the cats do not trigger us nor our young cat_lover!

[As an aside: unfortunately for folks like your wife, on kittentesting dot com I read that about 25% of those who are allergic to horses react to one of the cats' secondary allergens, (for horses, typically Fel d4). ... Although the same research shows about 20% of those with even severe allergies to animals like horses, dogs, rabbits "have no reaction around a low Fel d1 cat"]

(05-01-2013, 03:34 PM)genes Wrote: ... I could tell right away that the girl had severe sleep apnea ... It turned out that she had bad tonsils and adenoids and they needed to be removed. They were infected and swollen causing her apnea. That is something else you might want to check if he still has tonsils.
GeneS

Good catch! And children can start showing ADHD symptoms as soon as their AHI > 1! But as far as my son, he already had his tonsils and adenoids removed in 2nd grade. (He had had pansinusitis all year, then pneumonia ... plus unDx apnea). Now his AHI = 19, and he's got delayed growth -- and we are told the apnea is likely to get a lot worse with puberty.

Provent is what we tried first, and it gave him his life back.

But not quite enough. He is not yawning all the time, and can focus in class, and is not falling asleep over homework. However he is till tired, with residual mood, organizational, etc. problems ...and has a residual AHI of ~ 9. So, even though he really likes the Provent, we're going to see if a CPAP can give us an AHI < 2, preferably AHI < 1.

Still, I know that kids often have more problems adjusting, so I would really like for his first CPAP experience to be the most positive it can be. Even if it means easing the transition by using Ambien for a few weeks, as I'd seen in a research trial. And by getting the best machine and mask we can.
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#7
Eplantz, Shastzi, thank you! Sounds like the S9 is really one to go with.

And thanks for the welcome, trish6hundred. Good to be in a forum with folks who "get it", how disabling severe apnea can be.

Question: can you dim or turn off the display at night? We're really trying to keep a dark bedroom, and blue light is the worst for suppressing melatonin.

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#8
(05-01-2013, 04:54 PM)cat_lover Wrote: Question: can you dim or turn off the display at night? We're really trying to keep a dark bedroom, and blue light is the worst for suppressing melatonin.

The display light on the S9 AutoSet turns off on it's own and doesn't come back on until you press a button.

+1 on the S9 AutoSet; but be absolutely certain the Durable Medical Equipment supplier dispenses an "AutoSet" and not an S9 Escape Auto. Some will ignore the Rx and foist the inferior machine on unsuspecting customers. Don't let them cheat you if they try. Make sure the machine is labeled "AutoSet" above the power button.

Best of luck to you and your son. CPAP is the absolute best treatment currently available for OSA. I would wager that it will be much more effective than Provent, but might be challenging for him to get used to. Finding the right mask is usually the hardest part - keep trying different ones until you find the best one for him.
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#9
(05-01-2013, 01:23 PM)cat_lover Wrote: My 13-year-old has been diagnosed with severe sleep apnea (by pre-adolescent criteria), which has really been making his life miserable. We're about to buy an Auto CPAP machine.

He gets chronic sinus infections, so we want a machine that he will tolerate even with his chronically irritated mucous membranes. It looks like we should pay attention to
  • the ramp-up feature
  • how well the machine follows his breathing and how quickly it is able to back off pressure on expiration
  • data collection
  • the waveforms in response to a hypopnea, apnea or central apnea
  • PLUS, for him, a humidification system that won't irritate his mucous membranes

His MD at Packard Children's Hospital wrote a script for the ResMed S9 AutoSet, which seems to be the most expensive one. Most expensive isn't always the best ... but it may be.

I've also seen a number of rave reviews for the DeVilbiss IntelliPap, but no detailed comparisons of it and the S9. I would love to hear the details of folks experience with both.

I'll give you my (evolving) experience. After being diagnosed with sleep apnea I began using an Intellipap auto. At the same time I started a dental appliance (easier for travel etc). The dental appliance won hands down. Recently I've needed to go back to the Intellipap and it did not give restful sleep at all in spite of the low reported AHIs (always less than 5). After learning about the algorithm Devilbiss uses to detect apnea, we (my doctor and I) changed the apnea definition parameters on the Devilbiss and increased the minimum pressure setting. My AHIs went up into the mid-30s, my NRIs (central apneas &....) shot up from ~ 1 to 10+, and the machine runs at max pressure all night AND I feel like I am sleeping SO much better. Hmmmmm?

Turns out that the Intellipap uses snoring to detect upcoming apnea events (as opposed to using air flow in the S9). Since I do not snore, we suspect the Intellipap was not able to predict upcoming apneas and thus it was always behind, playing catch-up. This could only be resolved by greatly increasing the sensitivity of the machine and running full out. In effect I now have a CPAP running at my max pressure (15cm) and I get a lot of central apneas thrown in for free!

So I (we) made the decision to switch to the ResMed S9 Autoset. Algorithms matter! After all the autopap is basically a computer dedicated to respond to your breathing signal. For some snoring is a reliable signal of upcoming breathing events - for me it's not and the Intellipap computer code doesn't (apparently) properly (adequately) respond to my breathing signal. If you (your son) is a snorer, then I would assume the Intellipap might work fine. I'm not a snorer and it didn't work well for me at all.

Waiting for the arrival of my S9.
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#10
S9 AutoSet over the IntelliPAP, no ifs ands, or buts. The S9 AutoSet is a great machine.

The IntelliPAP charges extra for the data module, and the data collection is better for the AutoSet.

As for masks, you might consider getting a nasal mask and a full face mask (FFM). The nasal mask is better in several ways if he can use it on most nights. Then you can use a FFM on nights when he's clogged up.

You'll probably have to pay out of pocket for the second mask, though.

Some of us find that a nasal mask will help clear up our sinuses.
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.
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