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New Member: New User, Which Machine? Totally confused
#1
Hello all:

I was just diagnosed with moderate sleep apnea and am searching for a machine that has auto features, a humidifier and is quiet.

I've done a bit of homework, but I have to say all of this is a mystery to me.

So what does the group recommend? My research suggests I want a machine with auto features and one that makes as little noise as possible. The candidates thus far are:

1. Phillips Dreamstation, either the Pro or Auto model.

2. Resmed Airsense, either the A10 Elite or the Autoset model.

3. Resmed Aircurve 10.

4. Apex Medical icH Auto.

I have no reason why I picked these, except that they seemed to provide auto features and are quiet.

Any recommendations or input would be much appreciated. I've done some searching on this site, but some of the shorthand input doesn't register with me, and I'm not a techno person.

Thanks for your help.
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#2
Hi Spunky, welcome here. I just wanted to tell you that the Dreamstation Pro is not a full APAP, you would need to choose the auto model instead. I bought the Dreamstation Pro because I also didn't know any better and I am stuck with the fixed pressure CPAP, not that it's not working well, but if you have the Auto feature you can run it in either auto or fixed pressure, so there's no need to choose the Pro model, and it's only marginally cheaper. Other than that I like the machine and it's quiet.
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#3
Likewise the Resmed A10 Elite, also a constant pressure model. You would want the Autoset or Autoset for Her model; the Aircurve models are more specialized and more expensive.

The Dreamstation Auto and the Autosets are all very quiet, although there have been some complaints against all of them - a bedroom after midnight can be a _very_ quiet place, especially when you can't sleep.
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#4
Spunky, if you have simple obstructive apnea and don't have any unusual pressure needs, either the Resmed Airsense 10 Autoset, or the Philips Respironics Dreamstation auto are your go-to machines. The Apex (made in Taiwan) is a distant choice IMO. The Aircurve 10 vAuto is a bilevel equal to the Philips BiPAP auto. In choosing between Philips and Resmed, the main difference is the rate at which the machines increase and decrease pressure in response to apnea cues, and the manner in which inhale/exhale pressure transition is delivered.

Resmed is much faster to increase pressure in response to events and is therefore able to operate over a wide pressure range. Philips is slower and needs a higher minimum pressure in order to be "ready" to stop events. Either machine works equally well once optimized, but if you want a player that intercepts the ball from across the field, that is Resmed. Resmed offers up to 3 cm pressure relief during exhale using EPR, and is set from 0-3 in settings. Philips offers either C-Flex or A-Flex which provides up to 2-cm exhale relief at the beginning of exhale and inhale. While EPR is more like bilevel, EPR maintains pressure to support the airway better for some people. Purely preference, I prefer Resmed's implementation, but I am also a bilevel user.
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#5
Another thing, you might want to consider is choosing a heated tube to go with your machine, it will add to your comfort level and you get less condensation in the tube.
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#6
Hi Spunky8
I am new at all this (3 months in).
If you can get the opportunity to trial the machines, then do so.
In Australia you can rent machines and masks for a week or month.
I started with the DreamStation Auto and then tried the AirSense 10 Auto For Her.
Trialed the DreamStation for 6 weeks and the AirSense for 2 weeks.
In the end I chose the AirSense as it suited me better.
I can now sleep 7 hours straight without knowing I am hooked up.
Also, my AHI's were lower using the AirSense.
Another issue to solve is mask types.
Some masks I trialed were uncomfortable and kept me awake.
The correct mask will make it all more comfortable.

Very best of luck.
JD


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#7
Resmed or Philips Respironics are the 2 main brands. Their better machines do very detailed analysis and reporting on your breathing, pressure, apneas, and more. Note: Not all machines/models do reporting. The non reporting units are next to useless and are called "bricks". Don't get a brick.

There is a free program called Sleepyhead that you can download. It will give you all the info you need to monitor your progress. You take the SD card out of the machine and Sleepyhead pulls the data onto your PC through a card reader. Once you get going and sorted out periodical checks are all you need.

At least one supplier online allows mask trials (returns) for a small additional fee. Well worth it to figure out what mask works for you.

I bought the Resmed Airsense Auto For Her. The new Philips was not out then. It has been good. The unit is louder than it was when I bought it, but not very loud. The For Her model has an extra mode. I cannot be 100% sure but that mode may be available in the for him model now.
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#8
Resmed offers up to 3 cm pressure relief during exhale using EPR, and is set from 0-3 in settings. Philips offers either C-Flex or A-Flex which provides up to 2-cm exhale relief at the beginning of exhale and inhale. While EPR is more like bilevel, EPR maintains pressure to support the airway better for some people. Purely preference, I prefer Resmed's implementation, but I am also a bilevel user.
[/quote]

If you can, I'd appreciate a bit more explanation of this. Does the amount of exhale relief affect comfort?

And, what is "bilevel"? And what is "EPR"?

All of this is new to me.

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#9
Bi-Level Positive Airway Pressure (Bi-level or BiPAP) - See CPAP. A CPAP device providing two measured pressure levels of continuous airflow: one level for inhalation and a lower level for exhalation. http://www.apneaboard.com/wiki/index.php?title=Bilevel

EPR = Exhale pressure relief. Exhalation pressure relief is a CPAP feature that lowers the pressure on a CPAP machine when the patient exhales in an effort to make breathing more comfortable. CPAP machines provide continuous positive airway pressure, making it easier for the patient to inhale, but harder to exhale. Exhalation pressure relief generally offers three possible settings: 1, 2 or 3, with each number signifying the degree of pressure reduction. (A setting of 1 provides the least pressure relief; a setting of 3 provides the greatest relief).

There are several brand-specific terms for exhalation pressure relief. ResMed uses the term EPR. Philips-Respironics uses the term A-Flex for its APAP machines, Bi-Flex for its BiPAP machines, and C-Flex for its CPAP machines.

Some people fine exhaling against pressure to be difficult or uncomfortable and even intolerable. Others may even prefer no pressure fluctuation between inhale or exhale. Pressure differences between inhale and exhale pressure are a comfort feature of most CPAP machines, and can be adjusted in intensity.

All terms and acronyms can be looked up in the Apneaboard Wiki. http://www.apneaboard.com/wiki/index.php...=Wiki_Home
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#10
The members of this board are extraordinarily helpful.

Kudos to the board and its members.

And sincere thanks to all!!

I've learned a lot here and very much appreciate it.
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