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Self-treating Suspected UARS — Any Advice on Equipment?
#1
Self-treating Suspected UARS — Any Advice on Equipment?
Hello all, I’m hoping I can get some tips or recommendations on what equipment to purchase.

A bit of background
I’m a 32 year old male with an average-to-slender build (6’, ~200lbs). After having symptoms for years, I’ve finally decided to figure out what is going on with me. I’ve suspected some sort of sleep breathing disorder for the last few years, but no luck in getting a diagnosis. From everything I’ve read, I very likely have UARS.

I had an in-lab study which showed an AHI of 2.7 (but 4.3 while in REM), and almost entirely hypopneas (only 2 apneas, which were both central apneas). Oxygen saturation never dipped below the low 90s, averaged around 93-94. I do snore and also grind/clench my teeth a great deal, likely as a result of the airway blockage.

I’ve been examined by a sleep dentist who suspects I do have UARS based on my anatomy and symptoms (brain fog, headaches, neck and shoulder aches, teeth grinding, TMJ clicking, dry mouth, acidic feeling in throat, fatigue, sleepiness, irritability). He is the only doctor I’ve spoken with who even knows what UARS is, so I’m thrilled about that. Because I don’t have an AHI of 5 or more, he wants to make me a mandibular advancement device, though I will have to pay for it in full out of pocket ($2-3,000).

At this point, I think I’d rather just buy a CPAP machine online and try to take care of this myself. I’m a web developer by trade, so I’m very comfortable with technology and working with data, so getting the data from a machine and into SleepyHead should be no problem for me.

Equipment
I’ve read that perhaps the best machine for someone like me would be the ResMed AirSense 10 AutoSet for Her (I’m male, but supposedly this model is better for UARS). Is this the unit I should be getting?

As far as masks go, any recommendations for me here? I like the idea of a nasal pillow type of mask, but I’m a little concerned that I will have trouble with it because I do have a fair amount of nasal congestion due to allergies (I take Claritin and use Nasacort every night before bed). Any specific model I should look at, or should I be looking for a full face type mask instead?

Thanks for any help you can provide!
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#2
RE: Self-treating Suspected UARS — Any Advice on Equipment?
Here's a link that might be helpful. http://www.apneaboard.com/forums/Thread-...light=UARS
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#3
RE: Self-treating Suspected UARS — Any Advice on Equipment?
I don't care if you get an Autoset or Autoset for her, the important feature for you is exhale pressure relief (EPR) which acts like a bilevel with up to 3-cm pressure relief. As long as you get one or the other, I'm all in on your idea. A true bilevel (BiPAP/VPAP) would be the best solution.

The link I think you really need to see is this one: http://www.apneaboard.com/wiki/index.php..._and_BiPAP
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#4
RE: Self-treating Suspected UARS — Any Advice on Equipment?
If youre self treating and self paying Id get a VAuto. You're AHI doesnt warrant a fixed pressure support. I have dysautonomia and fatigue, maybe ME/CFS, who knows. But everything improved dramatically for me, all the symptoms you speak of, when I changed to VAuto, I'd not jump on the EPR wagon, the setting itself causes alot of trouble, some people get CA's some aerophagia issues. With the Vauto you will have a better support and room for experimantation.

I bought a S10 Autoset before I got VAuto and I wished I got a Vauto from the start.
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#5
RE: Self-treating Suspected UARS — Any Advice on Equipment?
(06-05-2018, 03:19 PM)Walla Walla Wrote: Here's a link that might be helpful.

Thanks! This was one of the threads I found that recommended the AirSense 10 AutoSet for Her.

(06-05-2018, 03:28 PM)Sleeprider Wrote: I don't care if you get an Autoset or Autoset for her, the important feature for you is exhale pressure relief (EPR) which acts like a bilevel with up to 3-cm pressure relief. As long as you get one or the other, I'm all in on your idea.

The link I think you really need to see is this one:

Wow, that was a great read. I see that the majority of Dr. Krakow’s patients have a gap of 4cm or greater (for UARS patients), with most prescriptions he writes being in the 5-6cm range. I assume that gap is the same as the EPR number you mentioned, and if so, do you think the 3cm would be enough for me to feel a difference in symptoms?

Obviously it would if my “prescription” would be somewhere around 2-3, like Dr. Krakow mentions as patients who would benefit from APAP. I’m just wondering if I hypothetically needed a 4-6, if the AirSense 10 AutoSet would be enough, or if I should go for a AirCurve VAUTO, as crowtor suggests. I see everyone that has replied in this thread thus far uses that machine. I can only find it on Amazon for approximately double the cost of the AirSense 10 AutoSet ($675 vs $1300), so I would prefer to go that route only if necessary.

(06-06-2018, 04:27 AM)crowtor Wrote: If youre self treating and self paying Id get a VAuto. You're AHI doesnt warrant a fixed pressure support. I have dysautonomia and fatigue, maybe ME/CFS, who knows. But everything improved dramatically for me, all the symptoms you speak of, when I changed to VAuto, I'd not jump on the EPR wagon, the setting itself causes alot of trouble, some people get CA's some aerophagia issues. With the Vauto you will have a better support and room for experimantation.

I bought a S10 Autoset before I got VAuto and I wished I got a Vauto from the start.

Thanks for the suggestions, crowtor. Before reading about the AirSense 10 AutoSet for Her, I actually was leaning towards the AirCurve V10 VAUTO, based on some things I read on [[ Auto Word Filter: links to DME-owned sites not allowed ]] , I believe. But then reading another thread here and several people recommending the AirSense 10 AutoSet made me reconsider. That, coupled with the giant price difference for me since I am paying out of pocket, had me thinking that’s the route I would go. But, like I mention above, if I really would benefit more from the AirCurve V10 VAUTO, I definitely will go that route.

Does anyone have any more thoughts on this? I’m a pretty sensitive person as far as my body goes, so I’m wondering if I’m one of those people who would need a larger gap.

Thanks again!
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#6
RE: Self-treating Suspected UARS — Any Advice on Equipment?
(06-06-2018, 08:39 AM)FoggedOut Wrote: Wow, that was a great read. I see that the majority of Dr. Krakow’s patients have a gap of 4cm or greater (for UARS patients), with most prescriptions he writes being in the 5-6cm range. I assume that gap is the same as the EPR number you mentioned, and if so, do you think the 3cm would be enough for me to feel a difference in symptoms?

Obviously it would if my “prescription” would be somewhere around 2-3, like Dr. Krakow mentions as patients who would benefit from APAP. I’m just wondering if I hypothetically needed a 4-6, if the AirSense 10 AutoSet would be enough, or if I should go for a AirCurve VAUTO, as crowtor suggests. I see everyone that has replied in this thread thus far uses that machine. I can only find it on Amazon for approximately double the cost of the AirSense 10 AutoSet ($675 vs $1300), so I would prefer to go that route only if necessary.

(06-06-2018, 04:27 AM)crowtor Wrote: If youre self treating and self paying Id get a VAuto. You're AHI doesnt warrant a fixed pressure support. I have dysautonomia and fatigue, maybe ME/CFS, who knows. But everything improved dramatically for me, all the symptoms you speak of, when I changed to VAuto, I'd not jump on the EPR wagon, the setting itself causes alot of trouble, some people get CA's some aerophagia issues. With the Vauto you will have a better support and room for experimantation.

I bought a S10 Autoset before I got VAuto and I wished I got a Vauto from the start.

Thanks for the suggestions, crowtor. Before reading about the AirSense 10 AutoSet for Her, I actually was leaning towards the AirCurve V10 VAUTO, based on some things I read on  [[ Auto Word Filter: links to DME-owned sites not allowed ]] , I believe. But then reading another thread here and several people recommending the AirSense 10 AutoSet made me reconsider. That, coupled with the giant price difference for me since I am paying out of pocket, had me thinking that’s the route I would go. But, like I mention above, if I really would benefit more from the AirCurve V10 VAUTO, I definitely will go that route.

Does anyone have any more thoughts on this? I’m a pretty sensitive person as far as my body goes, so I’m wondering if I’m one of those people who would need a larger gap.

Thanks again!

I later modified my post that the first choice is bilevel rather than CPAP with EPR.  The Airsense 10 will always limit your opportunity to use pressure support to 3-cm.  The VPAP (Aircurve 10 vauto) gives you nearly unlimited pressure support, not to mention the ability to change the trigger and cycle sensitivity for inhale and exhale, as well as manipulate the time that IPAP is available on each breath.  With UARS, it is not pressure, it is pressure support, and only the bilevel offers that at levels greater than 3-cm. 

For your consideration, Supplier #2 has a "Gently Used ResMed S10 AirCurve VPAP Auto w/ Heated Humidifier $799. The vendor is reliable and the machine is exactly what you want.
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#7
RE: Self-treating Suspected UARS — Any Advice on Equipment?
(06-06-2018, 08:50 AM)Sleeprider Wrote: I later modified my post that the first choice is bilevel rather than CPAP with EPR.  The Airsense 10 will always limit your opportunity to use pressure support to 3-cm.  The VPAP (Aircurve 10 vauto) gives you nearly unlimited pressure support, not to mention the ability to change the trigger and cycle sensitivity for inhale and exhale, as well as manipulate the time that IPAP is available on each breath.  With UARS, it is not pressure, it is pressure support, and only the bilevel offers that at levels greater than 3-cm. 


For your consideration, Supplier #2 has a "Gently Used ResMed S10 AirCurve VPAP Auto w/ Heated Humidifier $799.  The vendor is reliable and the machine is exactly what you want.

Sorry, I either didn’t see that or didn’t know what that meant at the time. Cool, if the AirCurve VAUTO is the best route to go, then I will definitely spend the extra money. I think I’d prefer to buy a new machine, if possible, but thanks much for the link to the supplier with the gently used one.

Is there any concern to buying a used machine, health-wise? Also, do you know if that vendor requires a prescription. I couldn’t really discern that by taking a quick glance at their website.
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#8
RE: Self-treating Suspected UARS — Any Advice on Equipment?
Supplier #2 does request prescriptions. They are not strict about where it comes from, so you could actually use you primary doctor to provide eveything you need. Apnea Board has a Sample Prescription Form to help with your request: http://www.apneaboard.com/wiki/index.php...escription

There is no problem with the gently used machine. They provide a warranty and only accept machines with low-hours and from smoke-free homes. For a new machine, without prescription, I notice there is a Vauto from Medguru LLC on Amazon for $1299.00. There sre some distributors selling on Craigslist. They typically advertise a new Autoset or Dreamstation Auto for $495 and provide a phone number for contact like 888-965-7655 and require PayPal for orders. They can be called, and will quote a Vauto. These tend to be pretty competitively prices and it's not a scam.
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#9
RE: Self-treating Suspected UARS — Any Advice on Equipment?
I would like to add that if all the features aren't necessary that the Vauto offers, it can be configured to perform like any Resmed auto Cpap, but an autoset can not perform like a Vauto.
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#10
RE: Self-treating Suspected UARS — Any Advice on Equipment?
(06-06-2018, 10:20 AM)Sleeprider Wrote: Supplier #2 does request prescriptions. They are not strict about where it comes from, so you could actually use you primary doctor to provide eveything you need. Apnea Board has a Sample Prescription Form to help with your request:

There is no problem with the gently used machine. They provide a warranty and only accept machines with low-hours and from smoke-free homes. For a new machine, without prescription, I notice there is a Vauto from Medguru LLC on Amazon for $1299.00. There sre some distributors selling on Craigslist. They typically advertise a new Autoset or Dreamstation Auto for $495 and provide a phone number for contact like 888-965-7655 and require PayPal for orders. They can be called, and will quote a Vauto. These tend to be pretty competitively prices and it's not a scam.

Okay, thanks for the information, Sleeprider!

(06-06-2018, 11:17 AM)JesseLee Wrote: I would like to add that if all the features aren't necessary that the Vauto offers, it can be configured to perform like any Resmed auto Cpap, but an autoset can not perform like a Vauto.

Thanks, JesseLee, that’s good to note. Based on that, and all of the above, it sounds like I will definitely be getting the AirCurve 10 VAUTO.
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