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Moderate UARS about to start treatment
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Geniale Offline

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Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #1
Gross Moderate UARS about to start treatment
Hello, I've just been diagnosed with moderate Upper Airway Resistance Syndrome and it was recommended that I try a CPAP. I am meeting with a respiratory therapist in a few days in order to set me up with a rental device. As I have no insurance, so all costs are out of pocket for me (and we are fairly low income), I want to make sure I make the best choices for my situation, so any and all advice is appreciated!

Here are the results for my sleep study:

AHI -- 0.4 events/hour
RERAs -- 18.2 events/hour
Global index -- 18.6 events/hour

Desaturation index -- 0.2 events/hour
Average saturation -- 97%
Minimum saturation -- 94%
Snoring -- light

Impression -- Obstructive Sleep Apnea (Upper Airway Resistance Syndrome > 50% RERAS)
CPAP recommended pressure -- 5-20 cmH2O

Thanks
01-09-2016 01:50 PM
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OpalRose Offline

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Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Moderate UARS about to start treatment
Hi, Welcome to the forum Geniale,

How long is the rental period for? Just make sure your are trialing an APAP machine.

Before you purchase anything, do your research as to the machines available.

Here is a link that can help you know which machines to avoid.
http://www.apneaboard.com/wiki/index.php...ne_Choices

Another thing, you may be better off "not" buying through your DME because they will probably over charge you.

Don't know what your budget is, but you can check out the suppliers list above. Supplier #2 offers gently used and also open box new machines.

Also, the Phillips Respironics 60 Series machines are discounted to around $400.00 on some of the suppliers lists.

Good luck and let us know how you are doing during the trial.

Just noticed you are from Canada, and I know they have different rules than the US.
There are many members here from Canada and are not able to qualify for an APAP machine, but if you are paying out of pocket, then you should be able to get what you want.

OpalRose
(This post was last modified: 01-09-2016 02:07 PM by OpalRose.)
01-09-2016 02:04 PM
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Sleepster Offline
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Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #3
RE: Moderate UARS about to start treatment
(01-09-2016 01:50 PM)Geniale Wrote:  CPAP recommended pressure -- 5-20 cmH2O

That indicates an auto-adjusting CPAP machine (APAP) which is good. If it turns out that that works for you you can eventually buy a new or used one from an online provider, or even on craigslist. Best to make sure it does work for you first, though.

You will need to install free software and monitor your therapy yourself, so I do not recommend renting a DreamStation because meaningful and free software is currently unavailable.

Sleepster
Apnea Board Moderator
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.
01-09-2016 06:03 PM
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vsheline Offline

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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: #4
RE: Moderate UARS about to start treatment
(01-09-2016 02:04 PM)OpalRose Wrote:  Just make sure your are trialing an APAP machine.

Actually, if you are paying out-of-pocket then I strongly suggest skipping the trial (saving a lot of money) and simply buying a bilevel Auto machine. Because a bilevel Auto machine can be set up to operate like an APAP or even a fixed-pressure CPAP machine, a new prescription is not strictly needed. You can buy a bilevel Auto from [url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #2[/url] using your present prescription, and the machine will auto-adjust itself, and for further improvement you can tweek the settings with help from fellow members.

Bilevel Auto machines are the optimal machine for treating UARS.

Specifically, an APAP machine is not able to optimally treat UARS.

Certainly, if you decide to go forward with a rental trial (a waste of money in my view) do please at least completely refuse to accept any machine on trial that is not a bilevel Auto.

I recommend the economical Philips Respironics System One BiPAP Auto (DS760 in USA or DS761 in Canada).

On Philips bilevel Auto machines Pressure Support is self-adjusting (in addition to EPAP, the pressure during exhalation, being self-adjusting), which is a neat feature which the others lack. Pressure Support is the amount the pressure is boosted during inhalation to help overcome UARS. On bilevel Auto machines from other manufacturers EPAP self-adjusts (to automatically minimize how many obstructive apneas are occurring) and Pressure Support is fixed (manually adjusted).

Quote:[url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #2[/url] offers gently used and also open box new machines.

Right. For example, from website of [url=http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List]Supplier #2[/url]:

Gently Used Respironics System One DS760 BIPAP Auto Machine
Your Price $649.00
Low hour, gently used, 6 month warranty.
Heated Tubing Optional.

By the way, it is worth it to include the heated hose option (the option includes the heated hose, an upgraded power supply and different humidifier lid) and pay a little more up front.

Take care,
--- Vaughn

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: 01-09-2016 08:23 PM by vsheline.)
01-09-2016 07:11 PM
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Sleeprider Online
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Posts: 3,353
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
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CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #5
RE: Moderate UARS about to start treatment
UARS is best treated with bilevel therapy, with a low exhale pressure and higher inhale pressure. This takes a lot of effort off of you and results in the best result. So, I'm in agreement with Vsheline. With limited funds and no insurance, you really need to steer clear of local brick and mortsr DMEs. I'm guessing you could own a machine, for the price of rental in short order.

Getting a mask that fits and is comfortable to you is the biggest challenge. Best of luck.

______________________________________________
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01-09-2016 07:42 PM
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trish6hundred Offline

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Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #6
RE: Moderate UARS about to start treatment
Hi Geniale,
WELCOME! to the forum.!
I wish you much success as you start your CPAP journey.
Hang in there for more responses to your post.

trish6hundred
01-09-2016 07:57 PM
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Sleepster Offline
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Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #7
RE: Moderate UARS about to start treatment
Why is auto-bilevel therapy better than auto-CPAP therapy for treating UARS?

Sleepster
Apnea Board Moderator
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.
01-09-2016 10:13 PM
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vsheline Offline

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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: #8
RE: Moderate UARS about to start treatment
(01-09-2016 10:13 PM)Sleepster Wrote:  Why is auto-bilevel therapy better than auto-CPAP therapy for treating UARS?

Because with bilevel the Pressure Support (the difference between the inhalation pressure "IPAP" and the exhalation pressure "EPAP") can be much larger than 3 cm H2O. Some prefer 5 or more.

With ResMed EPR (the exhalation pressure relief available with ResMed APAP) the max pressure increase during inhalation is about 3; with A-Flex (the exhalation pressure relief available with Philips APAP) the pressure increase during inhalation is about 2.

UARS is caused by difficulty while breathing in. The larger the Pressure Support is, the easier it is both to breathe in and to breathe out. When PS is about 5, PS is doing for us about half the work of breathing.

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: 01-10-2016 03:31 AM by vsheline.)
01-10-2016 02:54 AM
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Sleeprider Online
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Posts: 3,353
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #9
RE: Moderate UARS about to start treatment
The effect vsheline talks about is not only something you feel as easier breathing, it is measurable as increased minute vent and tidal volume. As pressure support increases, the tidal volume of most people will increase. This improved ventilation is important to UARS patients, just as it can actually lead to centrals by CO2 washout, if the pressure support is raised too high.

I personally enjoy a PS between 4 and 6 cm. If I use a PS higher than that, I will record centrals through the roof. Everyone is different, and patients with UARS or COPD or other restrictive lung disease, need higher PS just to ventilate normally.

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01-10-2016 11:02 AM
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DariaVader Offline
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Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

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Location: Oregon

Post: #10
RE: Moderate UARS about to start treatment
UARS question for you experts.... is UARS correlated at all with Asthma? What about UARS in a person with a naturally high TV - is it mutually exclusive? or would that make it harder to detect?

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
01-10-2016 01:14 PM
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