Playin w'the big dogs!

abysmillard · Post by **abysmillard** » Sun Jul 15, 2007 11:00 am

I just received the ResMed S8 Vantage that I bought used from another board member! Two nights with it and I'm feeling like I'm getting better sleep than with the Escape. I was initially titrated at 8, but found through the bump-it-up-a-bit-at-a-time method that I felt better at 10.4. The APAP is giving me a 95% of 9.8, with spikes to 11 the first night and 13 the second. The first night I had no mask leaks, the second I had something like .02 L/S. My AHI last night was 13, with AI of 1.1 and HI of 11.9. The HI is a little better than the first night, when I didn't use the settling at all. I think I have increase the settling time and will see what that does to HI.

Certainly two nights is not enough of a trial to know anything. I'm anxious to get enough data to start using AutoScan, which also came with the Vantage.

Couple o' questions for the more experienced board members:

Does anyone have any experience running AutoScan on a Mac? I'm gonna set up Parallels Desktop as soon as my copy of Windows arrives. I can't use Boot Camp because it doesn't like my multi-partitioned drive. Has the Parallels/AutoScan set-up worked for others?

What should I do with my S8 Escape? Do CPAP machines break down often enough that I should keep it for a backup, or should I sell it to try to recoup some of the loss of having to buy the second machine out of pocket? Opinions?

I know that the ResMed machines adjust leak data for the ResMed masks, but what if you are using another brand of mask? Do you just find the ResMed mask that's closest in leak rate and set the machine for that? Of all the details of CPAP therapy, I think that this confuses me the most.

I learn an unbelievable amount from this board. Thanks to all who are willing to share their knowledge!

Slinky · Post by **Slinky** » Sun Jul 15, 2007 11:27 am

How long have you had your Escape? Did you get it thru a local DME supplier? Is it totally paid for?

Depending on your financial situation, given the little that you would be able to sell the Escape for, I'd keep it as a backup. Most of these machines last a long time but one never knows. AND the Escape could be a nice travel machine. You wouldn't have to dismantle and pack your Vantage to take w/you, at least on short trips.

However, if it was a strain to purchase the Vantage it wouldn't hurt to try to see how much you can get for the Escape. Its not being a fully data capable machine really devalues it.

Snoredog · Post by **Snoredog** » Sun Jul 15, 2007 12:24 pm

I have a Macmini 1.83Ghz. Intel core duo, w/1GB RAM running Tiger, I loaded Parallels 3.0 with Windows XP SP2 and it was a SLUG, barely usable in my opinion, can only imagine it being even slower attempting to run an application on it.

I removed the Parallels & XP as it was just wasting drive space.

Guest · Post by **Guest** » Sun Jul 15, 2007 1:27 pm

Hmm Snoredog an Apple fan, i'm begining to like you more and more everyday !

Guest · Post by **Guest** » Mon Jul 16, 2007 8:45 am

abysmillard wrote:My AHI last night was 13, with AI of 1.1 and HI of 11.9. The HI is a little better than the first night, when I didn't use the settling at all. I think I have increase the settling time and will see what that does to HI.

I'm still learning, and you may already know this, but 13/11.9/1.1 sounds pretty high. Not as bad as no machine (probably) but most hoseheads achieve better results.

jennmary · Post by **jennmary** » Mon Jul 16, 2007 7:24 pm

I agree.....with proper treatment the goal is to be under 5 AHI. That is high....even if it is mostly HI.

RiverDave · Post by **RiverDave** » Mon Jul 16, 2007 7:56 pm

I was reading (in another thread, and I can't remember which one) that the ResMed machines tend to overestimate the HI. My AI is fairly constant at about 0.9, but the HI runs from 3 - 6

I've been using the Vantage for about 3 weeks with only one very minor complaint - the thing tends to "whistle" at higher pressures (> 10 cm). It may just be me not used to having an extra noise in the room, though.

abysmillard · Post by **abysmillard** » Mon Jul 16, 2007 8:31 pm

Slinky: I had the Escape for over 4 months before I found out that it was data impaired. I've now had it about 6 months, so I don't think there's any returning it.

Snoredog: Sounds like it's gonna be an experience. Ideally I'll only have to launch Parallels once a week, so I might be able to live with it.

TGregg & jennmary: I agree the numbers are way high. The exciting thing is that I finally have numbers!

Thanks for the replies.

jennmary · Post by **jennmary** » Mon Jul 16, 2007 9:28 pm

That is the exciting part. If you went through your insurance they are likely doing a 10 month rental period before outright purchase. You may be able to return the machine and get your insurance to purchase this one instead....or at least help. I would find out. My insurance only did 1 month rental....but most others I have seen have done 10.

Glad you have the data......so even though the numbers are high at least you know you have something going on and can fix it. I am so happy for you. Keep us up to date on how you are doing.

goose · Post by **goose** » Mon Jul 16, 2007 10:17 pm

in the boat with you!!

AI's around 0.9 or 1
HI's around 11, 12, 13......

Still workin' on it
cheers
gg

abysmillard · Post by **abysmillard** » Tue Jul 17, 2007 8:07 am

In most cases my insurance coverage is pretty crappy, but in this case (of course) they purchased the Escape outright.

Last night AI 1.1 HI 7.4; don't like the AI going up but, hey, AHI of 8.5 is an improvement!

abysmillard · Post by **abysmillard** » Sun Jul 22, 2007 8:04 pm

Hey, Snoredog!
Based on your "glowing" review of Parallels Desktop, I ended up trying VM Fusion. Works great for AutoScan and a couple other Windows applications I've tried. Occasionally blocks up my OS10 use, but it's pretty temporary. Does what I need with minimal difficulty, and at $40 vs $80 for Parallels, it's great.

dsm · Post by **dsm** » Sun Jul 22, 2007 9:19 pm

RiverDave wrote:I was reading (in another thread, and I can't remember which one) that the ResMed machines tend to overestimate the HI. My AI is fairly constant at about 0.9, but the HI runs from 3 - 6

<snip>

Actually they don't over estimate HIs they report them pretty accurately. Respironics machines tend to under report HI or report HI as an AI. This is because of the way they do a guesstimate of what is leak and what isn't - The AutoTrak software is designed to do a best estimate. The Puritan Bennett & Resmed machines each have internal tables on known leak rates for a range of masks & thus if your mask matches one of these table entries, those machines can very accurately assess leaks and thus are far better able to identify hypopneas and flow limitations.

Good luck.

DSM

rested gal · Post by **rested gal** » Sun Jul 22, 2007 10:17 pm

dsm wrote:
RiverDave wrote:I was reading (in another thread, and I can't remember which one) that the ResMed machines tend to overestimate the HI. My AI is fairly constant at about 0.9, but the HI runs from 3 - 6

<snip>
Actually they don't over estimate HIs they report them pretty accurately. Respironics machines tend to under report HI or report HI as an AI.

I don't think any of the autopaps can be said to either "overestimate" or "under report" any of the events. There is absolutely no way to know that a person is (or is not) having an apnea or an hypopnea without being hooked up to a PSG (polysomnograph) machine.

What I found after using all three major manufacturers autopaps was this... ResMed S8 machines regularly reported a higher AHI (usually through a higher Hypopnea Index) for me than did Puritan Bennett and Respironics autopaps.

I did not take that to mean that the ResMed S8 was overestimating events or that Respironics or Puritan Bennett were "under reporting" them. I took the difference to simply be the way each manufacturer designed the algorithms for their respective machines.

In other words, each of the manufacturers have their own definitions of events and use their own definitions to report events. I don't think that means that one is overestimating or another is underestimating. Without using PSG at the same time, there's no way to know if any treatment machine is reporting what's really happening.

My edit: Added "S8" to all my references to ResMed machines in this old post, since the definition of hypopnea was changed by ResMed in the later S9 series machines.

Guest · Post by **Guest** » Mon Jul 23, 2007 12:02 am

rested gal wrote:
dsm wrote:
RiverDave wrote:I was reading (in another thread, and I can't remember which one) that the ResMed machines tend to overestimate the HI. My AI is fairly constant at about 0.9, but the HI runs from 3 - 6

<snip>
Actually they don't over estimate HIs they report them pretty accurately. Respironics machines tend to under report HI or report HI as an AI.
I don't think any of the autopaps can be said to either "overestimate" or "under report" any of the events. There is absolutely no way to know that a person is (or is not) having an apnea or an hypopnea without being hooked up to a PSG (polysomnograph) machine.

What I found after using all three major manufacturers autopaps was this... resmed machines regularly reported a higher AHI (usually through a higher Hypopnea Index) for me than did Puritan Bennett and Respironics autopaps.

I did not take that to mean that resmed was overestimating events or that Respironics or Puritan Bennett were "under reporting" them. I took the difference to simply be the way each manufacturer designed the algorithms for their respective machines.

In other words, each of the manufacturers have their own definitions of events and use their own definitions to report events. I don't think that means that one is overestimating or another is underestimating. Without using PSG at the same time, there's no way to know if any treatment machine is reporting what's really happening.

RG,

I can buy that

Good points

DSM

(love your new pic - nice colors - you get younger each year - must post a current one of self (getting older each month ) )

Playin w'the big dogs!

Playin w'the big dogs!

Re: Playin w'the big dogs!