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ResMed S9 Elite -- MANY apnea events still
#81
Hey, the lead I had on a used Respironics just resurfaced--seller finally called, and we are starting email about it.

What model do I need to be certain to get for the Auto version?

I have seen people mention '560', but I am seeing DS560xx where the xx varies. I want to be sure to get the right one if I decide to do this in order to have an Auto machine.
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#82
(06-19-2014, 10:17 AM)jcarerra Wrote: Yes. After I started seeing my data, I was very disappointed that they had set me up with the Elite instead of the Autoset.

Not to worry. As long as you can tolerate the higher pressures we can reach the same conclusions and find the right pressure. If it turns out that a higher pressure is needed to treat those events AND you have trouble tolerating that high of a pressure, then you have a convincing case for a prescription for the Autoset. Worse case scenario is you that you have buy a used one and you have the Elite as a back up machine.

Quote:A contradiction is that I see here all the time that you need many days to see what is going on--often 30 is recommended--yet the sleep study, from which *major* decisions are made, is ONE NIGHT. Granted, they have the leg, respiration, and brain data which offsets that some, but if you have an abnormal night, no amount of equipment is going to give them representative data.

It offsets it a lot, but essentially you are correct in that it does give you only one night's worth of data.

First of all, they have a EKG or whatever so they know what stage of sleep you're in when you have these events. And the technician can use that information. He knows you're in a deep sleep and he can use pressure changes to really zero in on the pressure needed to open the airway. If he can repeat that a few times during the night and get the same result it's a very good determination. The problem comes in when you aren't sleeping well during the study, and that happens to a lot of us.

Secondly, that 30-day thing is for tweaking. It may not apply here because you're getting clusters where your AHI/hour has significant spikes.

Quote:I am beginning to think I had one of my nights with no clusters during the study. In fact, since I always feel very "unslept" after no-cluster nights, and that is how I felt after the study, I believe there is a high probability I did not have one that night. Also, many of them have occurred between 5-7 AM, and they got me up at 5AM.

There's a good chance you're right about that, but if errors were introduced they can very likely be corrected because you have a data-capable machine and you know how to use it.

Ok, so let's start with the theory that these clusters are occurring as a result of an obstructed airway. The reason for the obstruction could be because your pressure is not high enough. And it could be that the reason a higher pressure is needed at that time is because you've rolled over on your back. (Your sleep study report can be examined to see if the technician noted any differences when you were in the supine position).

Raise the pressure a tad and see if there is a reduction in those clusters. Or sew a tennis ball into the back of your night shirt to prevent you from sleeping on your back. Or do both.

I would suggest you discuss all this with your doctor. See how your data looks after a week or so.

Be patient. Like you said, you behave differently on different nights so we need to look at periods of time that span many nights. It'll take a while to figure this out. Meanwhile try and enjoy those better days. Gratitude is a powerful mental health aid.
Sleepster
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#83
Just called the sleep doc's office to get an appt to discuss all this, but he is out of pocket until July 15. I have an appt with my PCP tomorrow, and he is one of the best in internal medicine, but I am not sure how deep he is in sleep knowledge--for detailed digging. I think I am just into a collect data period for a while--though things are pretty consistent with usually a cluster and usually the periodic breathing pattern.

By the way, I offer the highest of thanks for all the comments you (all) are providing. I zig zag, and you keep me pointed in the right direction. Seriously. I mean it.
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#84
just a quick note. Didnt get to read all of the previous comments. But make sure the EPR on the resmed is turned off. Or the cflex on the Repironics is turned off. These features do have an effect on your results(AHI). I turn this feature off on all new (to me) sleep apnea pts and have seen a noticeable difference. You may have to go into the clinical menu to turn these features off.
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#85
HELP!
The possible purchase of a Respironics has run into an operator error snag. Apparently the person who has it is completely non-technical, as he can't doesn't know the model number or where to find it.

Can somebody please tell me on a machine that MIGHT BE a Respironics REMstar System One Auto CPAP A-Flex DS(who-knows-what), where can I tell the current owner (in a town hour and a half away--can'tt just go look) exactly where is the model number on those machines??
(So that I can describe to him where to look.)

Also to previous commenter, I do have EPR off. only used it a few nights.
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#86
(06-19-2014, 01:16 PM)jcarerra Wrote: HELP!
The possible purchase of a Respironics has run into an operator error snag. Apparently the person who has it is completely non-technical, as he can't doesn't know the model number or where to find it.

Can somebody please tell me on a machine that MIGHT BE a Respironics REMstar System One Auto CPAP A-Flex DS(who-knows-what), where can I tell the current owner (in a town hour and a half away--can'tt just go look) exactly where is the model number on those machines??
(So that I can describe to him where to look.)

Also to previous commenter, I do have EPR off. only used it a few nights.

Have him remove the humidifier tank just in case and turn the unit over. On the bottom of the main unit he will find a label.

[Image: PR-model.jpg]

Have him read off the model number and you should be able to figure it out from the image above.

Best Regards,

PaytonA
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#87
Thanks. Just what I needed.
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#88
Another question...the person selling the Respironics has finally found the model numbers for the ones he has...750p 450p 250p 460p.

Should I be interested in the 750 (50 series)?
It will be an unbelievably good price if what he first mentioned holds up.
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#89
(06-20-2014, 03:28 PM)jcarerra Wrote: Another question...the person selling the Respironics has finally found the model numbers for the ones he has...750p 450p 250p 460p.

Should I be interested in the 750 (50 series)?
It will be an unbelievably good price if what he first mentioned holds up.

the 750 is the only one that's an improvement over what you have.

if you look at payton's chart, you'll see that the 450 and 460 are non auto machines, though the 450 offers a 'trial' auto function for 30 days, then it sets itself to whatever it figures you need and then acts like a cpap after that..

the 250 is a brick, no detail data.

the 750 is a bilevel auto, next step up over the auto machine, but no heated hose available.
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#90
I use a PR BiPAP Auto model 750. It's nice machine. The Auto algorithm is not the same as the auto algorithm used on the S9 AutoSet or the S9 VPAP. It's not as aggressive with the pressure increases in my experience, and that actually is an advantage in my case since the sharp increases in pressure on the S9 tended to bother me back when I was a newbie.

Way back in Fall 2010 when I was a newbie, I never did sleep very well with an S9 AutoSet, although my AHI numbers and leak data were fantastic. I had a lot of problems with aerophagia and the first change from straight CPAP to APAP helped, but I still continued to have problems. The switch to the BiPAP model 750 running in Auto was what finally allowed me to start sleeping half-way decently with a PAP machine.
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