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Newbie getting equipment tomorrow and some questions
#1
I have asked previously about the comparisons between the Aircurve V10 and the Dreamstation Bipap pro. Most advice was to try both of them and choose the most comfortable machine.  My DME will not let me trail the machines and have to make a choice while in their retail location.  I was hoping that someone that has experience with both machines could give me the pros and cons.  Also, I am meeting the doctor tomorrow to pick up my prescription for the equipment.  I have had advice on this forum that I need to ask the doctor to spell out the type of machine, fully data recording, etc.  Is there anything else that I need to make sure that he adds to the prescription?  Is there any advice or method with dealing with the DME to simplify or advance the chances of a successful start to treatment?  Any advice that you guys have would be most welcomed.  I am keeping my fingers crossed that things will go well.  Oh, one other question, can anyone comment on the PR Nuance Mask vs. a traditional FFM?

I have attached my sleep study report in case that helps!!
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#2
Just to clarify, are you referring to the aircurve 10 vauto or S?  The BiPap pro is not an auto machine, but the vauto is.  I have not tried the dreamstation BiPap, but I find the vAuto incredibly comfortable.  It matches perfectly with my breath, and I sleep much longer than I did on APAP.   It's virtually silent, and never wakes my wife up (thank god).  It has provided me with generally excellent therapy (with exception to a problem that has recently started occurring) and I probably would stick with Resmed again.

I would definitely go for an auto machine if you can.   Auto's will provide you with effective therapy despite changing needs day-by-day.  You can always set the auto devices to straight BiPap if you don't want to use the auto feature, but better to have it.  

Probably the biggest differences are the algorithm and variable pressure support on the respironics. I don't know the value of variable pressure support enough to speak to it but I'm sure others will.  

Either way you'll get good therapy if your settings are correct.  I can't imagine you can really go wrong with Resmed or respironics.
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#3
Silversnore, I think both machines produce roughly the same results and will serve you well. The suggestion I would make is to get Auto BiPAP or Auto Bilevel on your prescription. This makes adapting to the therapy much easier, and lets the machine adjust to any changes that occur, just like the difference between fixed CPAP and auto CPAP. We don't know what your prescription is, but let's say it is for bilevel at 12/8. That is a pressure support of 4. Using an auto bipap (respironics), we could allow a minimum EPAP of 7 and Maximum IPAP of 14 with a pressure support of 2-5 and the machine will self-adjust in that range to produce even better results than fixed BPAP. The algorithm will increase EPAP to resolve obstruction, pressure support for hypopnea, an IPAP for ventilation. It's really genius and not much more expensive that BPAP-S or Pro.

Try to get the auto bilevel machine in either flavor. It's much easier to dial in, but both will produce decent results. The biggest difference is that Philips Respironics auto allows a variable PS allowing EPAP and IPAP to move independently, while Resmed machines use a fixed PS and the EPAP and IPAP move together.
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#4
Thanks Sleeprider and COmbe!

Sorry for the confusion on the PR machine, I do intend to get an auto machine.  I had attached my sleep study and it indicates pressures of 15/11 for the machine to be set.  It did seem that I had mixed AHI vaules from 0 to 24 over the differnt pressures that I was subjected to.  I don't really understand why though.  I am somewhat aware of what a bipap does with a certain pressure for inhalation and a different pressure for exhalation, I am not quite sure what pressure support is though?  Based on my sleep study are there any recommendations that I should discuss tomorrow with the Dr.?  Thanks
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#5
Silversnore.  I'm still new at this, so there will probably be a better explanation, but It seems they were able to resolve the OSA at relatively low pressures but your arousals/RDI were too frequent to achieve meaningful sleep.  

They were able to resolve the RDI by placing you on a BiPap, and were satisfied with the results.  

I'll leave the recommendations to others, but I would definitely make sure the script says "BiPap auto or vpap auto".   BiPap auto being respironics, and vpap auto being Resmed.
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#6
Pressure support (PS) is the mathematical difference between IPAP and EPAP. In your case 15-11=4. You are using a PS of 4. Your prescription is written 15/11 over PS 4. If you had auto BPAP it could be something like 17/9.0 over PS 4.
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#7
Thanks guys,

If I can persuade the Dr. to have the machine programed in auto mode, would the 17/9 with a PS of 4 be a recommendation to start my therapy?

Thanks guys,

If I can persuade the Dr. to have the machine programed in auto mode, would the 17/9 with a PS of 4 be a recommendation to start my therapy?

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#8
That would work if the doctor is willing to dispense with an auto prescription. It brackets your fixed pressure and just allows pressure to rise and fall a bit during the night.
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#9
Thanks guys, I feel better prepared now for my meeting with the Dr.
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#10
Hi silversnore,
Good luck to you at your appointment. I look forward to hearing what machine you got.
trish6hundred
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