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First steps ?
#1
Hello, 

I have just got my prescription to get a CPAP machine. Are there threads on the forum which list first steps for people beginning on therapy ? 
I was able to find a list of machines not recommended on the wiki, but wasn't able to find a list of machines recommended. I am probably not the first person looking for starter information - so am guessing someone has compiled noob info ? Could you please point me to where I can begin reading ? 

Cheers,
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#2
Welcome to the forums. If you can get the doc to write the prescription for a AUTO cpap. 2 machines come to mind...ResMed Airsense 10 and Phillips Resporonics Dream Station. These machines will allow you to use SleepyHead software and I'm sure the good folks here can help with setup. Good luck on your jjourney.
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#3
I'll write a more detailed response later, but for now I suggest you check very carefully before you commit yourself. As Maniac said, you are probably best served with an auto machine. Both the Resmed and Dreamstation lines have some excellent full data autos - but also some cut price crap which won't give you any useful data at all.

Assuming you have plain vanilla obstructive sleep apnea (and not central or complex apnea) then look for the Resmed Airsense 10 Autoset or the Philips Dreamstation Auto.
DeepBreathing
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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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#4
Thank you for your replies.

I am fairly green with where to go and what to do.

I read another thread where someone said they got a brick and the model was Philips Dreamstation. Are there specific models which I need to steer clear when finding what I want to buy ?

My titration study was done using a 'dreamstation' again and the dream wear nasal mask was an amazing fit, with a slight leak around the nostril. When I pointed this out to the tech, I was told 'it will leak till it can vacuum itself to your nostrils'. Whatever that meant, I was asleep and still found a slight leak around the nostrils when I woke up- I was told this is ok. Is a leak around the nostrils OK and expected ? Or should the nasal mask be a 'tight' fit ? I can call the folks who did the study for exact details of the model number.

So, I think I will be fairly happy with a dreamstation - but will need to trial masks. I wasn't woken up or had a disturbed sleep during the study, from the nasal mask. So, I think I may have gotten lucky with a good fit. But I don't know about the acceptable leak on a nasal mask.

These guys are selling one for USD 569 : secondwindcpap which is way cheaper than what the Australian retailers sell it for (~AUD $1800). Have people used this mob before ? Is this website reliable ?
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#5
Welcome!

See here for machine choices.  All major manufacturers make several models from the very basic to advanced, data capable machines.  You want one of the latter.  Phillips and Resmed are the top brands.

'it will leak till it can vacuum itself to your nostrils' -- hard to imagine a machine blowing air then developing a vacuum.  The pillow around your nose will inflate to make a seal. Having it too tight prevents this. You can lift and replace the mask and it should seal.  It can take a few tries.  Some people get leaks no matter what.  "mask liners" can help diffuse the leaks to make them less annoying.  Find the right mask for your face.

secondwindcpap is a reputable dealer which many here have used.  See the Supplier List at the top of the page.  You can trust all of them.
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#6
BHappy, please re-read the forum rules, especially the bit about commercial links. We don't allow people to post direct links to equipment suppliers. I have edited your post accordingly.

First thing to understand is the nature of your apnea. For most people here it is obstructive sleep apnea, where the upper airway gets physically blocked by the tongue or other tissues. The advice which follows relates to this obstructive apnea. If you have central, complex or mixed apnea, then a somewhat different approach will be required.

There are many brands of CPAP machinery on the market but as a general rule you should stick to either Dreamstation or Resmed. These are the market leaders. There is far more knowledge and support available for these brands, and they are compatible with SleepyHead software, which will become your friend. Other brands may be just as good, but they're not so widely used and fewer people will be able to advise you on them.

You must get a fully data capable machine. From the old project management adage: "If you can't measure it, you can't manage it". Don't be tempted to buy a non-data machine to save a few bucks - it's not worth it.

You should get an autoset machine. These will adjust your pressure up and down depending on your needs at any given time. It's a bit like having a little sleep study every night. Admittedly some people prefer a fixed pressure, but the auto machines can also be set to fixed pressure if that's what you need.

Dreamstation seem the come in three versions: CPAP, Pro and Auto. The CPAP is a POS which doesn't give you any data as to how your therapy is going. Avoid it like the plague. The Pro will give you 30 days in autoset mode then revert to fixed pressure. Why? What's the point? Avoid this machine also. Finally the Dreamstation Auto will give you an autoset machine with full data capability - this is what you want.

Resmed machines are made in Australia (if you buy locally) or Singapore (if you buy from the States). Personally I'd happily save a thousand bucks and buy the Singapore version. Like Dreamstation the base model Resmed CPAP is to be avoided. The Elite is a fully data capable fixed pressure machine. But the recommended version is the Autoset which is a fully data capable autosetting machine. There is also a "for her" version which has a gentler algorithm which some women (and many men) prefer. In the States there is a new Resmed model (can't remember the name) which is even more bare bones than the CPAP. Neither this machine nor the CPAP are sold in Australia any more.

As to which to get - I have a leaning towards Resmed machines, but others prefer Dreamstation. The Resmed has a more aggressive algorithm which reacts faster to head off apneas, but this does involve some fairly large pressure swings which disturb some people. The Dreamstation apparently gives you a more comfortable ride at the expense of a few more events slipping through. Different approaches with a similar outcome.

The mask is the hardest part of the whole exercise. I can offer no real advice except try as many as you can to see what suits you. A minor leak is no problem as far as therapy goes, but it can disturb your sleep (or your partner's). Some masks are notorious for blowing into the eyes (eg the Simplus) while many of them do "face farts" which are annoying. If you typically breathe through your mouth then a full face mask (eg Simplus, F10 or F20) would be the go. If you can breathe through your nose and not have air escaping out your mouth then a nasal or pillows type such as the P10 or DreamWear might suit. Personally I can't abide pillows type masks.

Quote:'it will leak till it can vacuum itself to your nostrils'.

BS! How is it supposed to vacuum itself to you when it's blowing air out? Even Mr Bernoulli wouldn't believe that. The fact is, though, that masks can be adjusted to reduce or eliminate leaking by repositioning them on your face and adjusting the straps. As a general rule the straps should be firm but not tight. They should never be so tight as to be painful. You can also get fabric liners which sit between the mask and your face, which can help control leaks and increase comfort - do a search for Remzz and pad-a-cheek.

OK, hope all that helps - don't hesitate to ask any more questions.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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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#7
Welcome! You're in the right place. This forum is such a great help. I'm 2 months ahead of you on this journey, but reading through threads here is how I got my intro to CPAPs.

I have a DreamStation Auto and the DreamWear mask, and I love them both!

Please do insist on a Auto (in whatever brand you end up getting). It's SO worth it, for the autonomy and ease it affords in finding the settings that are optimal for you.

I found the DreamWear mask to leak if the cushion is too large. I imagine the same applies for the silicone frame. If you go to a DME to get fitted, try the various sizes (while the machine is actually running) until you find the size that works for you and doesn't leak. Or if you buy one online, get the whole "kit", which comes with all the sizes, so you can really figure out what size you need.
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#8
@DeepBreathing : Thanks mate. That is a lot of well structured information that I can use straight off the bat. Thanks again for taking the time to type it out. It is very helpful. I didn't know about the commercial links bit. 


@Hydrangea : Thanks for the support and I do believe this is a good and a helpful forum. Thanks for the tip about the entire kit of masks. May cost a tick more but may be worth it.

Off to some more research Smile
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#9
(03-16-2017, 08:38 PM)DeepBreathing Wrote: The mask is the hardest part of the whole exercise. I can offer no real advice except try as many as you can to see what suits you. 

Is there a cost effective way to do this in Australia ? 
Other than ordering the dream wear nasal kit ? How do I find a good fit for the mask for Resmed machines ? Are the masks dependent on machine manufacturer ?

I don't even know if I breathe through my mouth. When I asked the specialist how I could be sure, all he said was if you are asking that question, you aren't a mouth breather. Usually, mouth breathers know they breathe through the mouth. is what I was told. I have asked my partner if I breathe through the mouth, but the partner has never noticed this.

I read this on the internet and wanted to know how true it is :
Quote:If you have been prescribed a CPAP setting of 10 cmh20 or higher, CPAP Nasal Pillows are not recommended. Experienced CPAP users agree a Nasal Mask is a more comfortable option.
I have been recommended a pressure of 10 and wore nasal pillows for my titration study and found them very comfortable. It will be a tough choice of masks if I need to rule nasal pillows out. Of course, I wanted to listen to the experienced folks here about the claim.
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#10
I don't know of any easy way to test out the various masks without aligning yourself with a clinic. I got a really good therapist who let me try several over a month or so till I found one I liked. (Which I later changed). I ended up getting my machine here in Oz as the VPAP Adapt was the same price here as in the States and it came with a 5 year warranty. But that's a special machine for treating central apnea.

If you have already used the pillows without problem then that's probably the way to go. That thing about pillows not being suitable over 10cm is rubbish. I know SleepRider (leader of the P10 cult) runs pressures in the high teens and apparently has no problems with them.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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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