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[News] Philips-Respironics "DreamStation" - new CPAP series on the way
I just returned my new Dream Station and got the Resmed Airsense instead after 5 days of use. It appeared that the algorithm on auto mode was flawed, both starving me of air periodically and over inflating me at other times. AHI increased to 9+ on this machine which I find unsatisfactory. Tried different settings and got as low as 3.8 but still had issues waking up gasping. Not cool.
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Odd, as so far as I know Philips had not made major changes to the algorithm between the PRS and the Dreamstation. And the PRs had a very effective algorithm.
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(10-14-2015, 04:57 PM)distributorguy Wrote: I just returned my new Dream Station and got the Resmed Airsense instead after 5 days of use. It appeared that the algorithm on auto mode was flawed, both starving me of air periodically and over inflating me at other times. AHI increased to 9+ on this machine which I find unsatisfactory. Tried different settings and got as low as 3.8 but still had issues waking up gasping. Not cool.

Originally I used a PRS1 set to a range of 15 - 20 cm H2O. When the card reader broke (since repaired) I retired it as a backup machine and bought an S9 Autoset, which I set to the same range, and all the other settings as close as I could to the PRS1. On the PRS1 my average AHI was between 3 and 4. On the S9 Autoset my AHI dropped to an average of 0.65.

Now, was this because the S9 Autoset has a superior algorithm? Or was it because the PRS1 detects events better? I suspect I will never know.

I am sure, however, that all the manufacturers have dissected the code used by their competitors, if for no other reason than to avoid even inadvertent infringement. In the US the penalties are the same whether accidental or deliberate.
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(10-14-2015, 01:08 AM)player Wrote: I wouldn't lose my tonsils... they apparently are important.

When I was young, they were considered to be useless, if not worse, just something unnecessary that gets infected. The consensus seemed to be that we'd all be better off without them, and that they should be removed any time it was convenient or necessary to do so.

Then they decided they had to do with developing the immune system, and it became almost taboo. Later, they seem to decide they didn't do much in adults, but helped children. They seem to be thinking they mean less in children. Currently, I think they believe they help your immune system somewhat, but aren't a big deal if you remove them.

e.g. Don't take them out on a whim, but remove if you have a reason that's good enough to put with the pain and risk of surgery.

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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Tonsils are part of the immune system, providing aid in local and upper respiratory tract protection, but if they turn, then they can damage the immune system and should be removed. Healthy tonsils should be left in place. In adults they serve a lesser purpose than in children, since the immune system if more robust and has less need of the small help the tonsils provide, but should be removed if they obstruct breathing.

If you have chronic tonsillitis, they should be removed at any age. To give you an idea of the science behind it (yes, it is not just an opinion or common practice because we think maybe there is something there, there is real research and understanding in it) here is the medicalese for it, and I remind you that this is the sort of thing we read and write daily, but I think non-medical types find confusing, so if your eyes cross, don't sweat it, mine do sometimes to, and I'm used to this stuff:

"With chronic or recurrent tonsillitis, the controlled process of antigen transport and presentation is altered due to shedding of the M cells from the tonsil epithelium. The direct influx of antigens disproportionately expands the population of mature B-cell clones and, as a result, fewer early memory B cells go on to become J-chain–positive IgA immunocytes. In addition, the tonsillar lymphocytes can become so overwhelmed with persistent antigenic stimulation that they may be unable to respond to other antigens. Once this immunological impairment occurs, the tonsil is no longer able to function adequately in local protection, nor can it appropriately reinforce the secretory immune system of the upper respiratory tract. There would therefore appear to be a therapeutic advantage to removing recurrently or chronically diseased tonsils." *

Some of you would seize on the words "appear to be" to mean uncertainty and that it may not be true, but that is just the way we speak - science, even medical science, denies dead certainty and always couches itself in qualifications. It used to be common practice here even in pronouncing death to first say "the patient appears to be dead" before giving TOD for the certificate. Even know I still follow the old practice of saying to a patient that they seem to be recovered, when current guidelines tell us that that can feel under-affirmative to a patient and we should say something to the effect of, "You're fully recovered, well done!".

*ref:http://www.entnet.org/HealthInformation/upload/CPG-TonsillectomyInChildren.pdf
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(10-14-2015, 05:47 PM)JJJ Wrote: Now, was this because the S9 Autoset has a superior algorithm? Or was it because the PRS1 detects events better? I suspect I will never know.

A bit of both, some people respond better to one method of pressurisation, some respond better to another. Detection could be better in one than another also.

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I'm reporting back about the change to the new ResMed. My first night's sleep was an AHI of 2.0 over 9.4 hours of sleep! I'm glad I returned the Dream Station.
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Well done, DG, and good luck. Many happy nights for you!
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(10-14-2015, 05:47 PM)JJJ Wrote: [quote='distributorguy' pid='134337' dateline='1444859852']
When the card reader broke (since repaired) I retired it as a backup machine and bought an S9 Autoset.
JJJ,
My card reader broke on my 3 year old Remstar Auto, I was wondering how your repaired your card reader. Put my card in and it came out with the little dividers ripped off.
Thanks for advice or links to information about repairing a card reader.
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(10-15-2015, 11:37 AM)pumpkln Wrote:
(10-14-2015, 05:47 PM)JJJ Wrote: [quote='distributorguy' pid='134337' dateline='1444859852']
When the card reader broke (since repaired) I retired it as a backup machine and bought an S9 Autoset.

My card reader broke on my 3 year old Remstar Auto, I was wondering how your repaired your card reader. Put my card in and it came out with the little dividers ripped off.
Thanks for advice or links to information about repairing a card reader.

In my case it was a couple of the contacts inside the reader that were bent back so they weren't making contact. I didn't realize what the problem was until I peered into the slot with a magnifying glass and light. To fix it I used a tool that looks like a dentist's pick to bend the contacts back where they belong. It was a tricky operation that required another person to hold the light and magnifying lens, 'cause my body came with only two arms.*

In your case it might be just the card. Does the card still work in a computer or elsewhere?

*Note to God: Next time around evolve the intelligent species on a planet from the insects.

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