Should my first machine be an APAP? (Opinions sought)

sir_cumference · Post by **sir_cumference** » Thu Jul 28, 2005 1:53 am

WAFlower - good to see you on this site as well - I saw your posts on the other one! And obvioulsy if you are going to pay for it yourself, getting a CPAP would be stupid when you can get an APAP and if push come to shove you can set it to CPAP. For me its a no brainer.

As for masks!!!! The first issue is if you leak through your mouth or not! If so, you will need a full face mask for which I can give no advice at all! But if you don't have that problem, then you need to think about how you sleep, on your back, your sides, your tummy.

I use the Resmed swift which is easy to put on and pull off, and has few down sides except that the side arms can irritate after a while. If I were you I would expect to buy one mask and then within a few months buy another. I would say that if you don't leak or breath through your mouth then the swift is a very safe bet as a starter mask. (Tip: always wash your face before you put your mask on as it is residue of body oils that causes masks to leak).

Other nasal masks that people like include the breeze and Aura, although there has been more home modification with these other two masks to keep them comfortable and in place that with the swift (from what I can see).

As for software ... why get hung up about it? Do you really need it? You may want to get geeky, but if you have an APAP and it works and if you need to you can look at the last nights results, why pay for something that could end up turning you into an obsessive? For what it's worth, my advice would be not to bother even thinking about software until you have the machine and mask and have used them for a couple of months. Only then, if you really feel the need to go geek - then think about the software (and your bank balance). Anyway, by that time you may well want to spend extra money exploring further mask options rather than getting software.

Anyway - goodluck -
sir_cumference

WillSucceed · Post by **WillSucceed** » Thu Jul 28, 2005 7:11 am

Rested Gal wrote:

I like to save each of my nightly files separately with a descriptive name that includes the mask I used, number of hours/minutes I slept, pressures I set, and a few other little notes in the filename if something unusual happened.

Geek!! Get thee behind me.

Not only do I save the files from Silverlining, I print, every morning, the nightly analysis and graph. Then, I write on the printed sheet what mask I used, what humidity level I set and if I had any booze during the evening, etc., that might have an impact on how I slept. All in a binder. Makes for scintillating reading! And you thought you were obcessive, NOT!

Sorry RG, I could not help but laugh. I've gotten to the point of being able to predict what the graph will look like, relative to pressure and leak, based on what mask I use and what I did (read: consumed) during the evening.

I do not export any data to Excel; have never seen the need. I just review Silverlining and have my AHI down to <1 per hour for the night.

Just as an aside, I have used the Silverlining software to set the 420E to work in increments of .5 instead of the default of 1.0 I find that this seems to make for fewer awakenings during the night. I've read posts about the 420E that suggest that it is aggressive in it's management of hypop and apnea events. I notice that I can have a pretty high number of 'runs.' Setting the device to work in increments of .5 seems to have lessened the 'aggressive' impact of pressure changes such that I feel less change and am wakened less by the pressure changes.

WAFlowers · Post by **WAFlowers** » Thu Jul 28, 2005 8:07 am

sir_cumference wrote:WAFlower - good to see you on this site as well - I saw your posts on the other one! And obvioulsy if you are going to pay for it yourself, getting a CPAP would be stupid when you can get an APAP and if push come to shove you can set it to CPAP. For me its a no brainer.

Sir, I'm at the point where I'm looking everywhere I can for all the info I can get. I'm like a sponge, just soaking it up. It looks like there's a lot of good info on this forum!

You're right. Given my insurance coverage (high deductible) there's no question that I'm going to bypass insurance and just buy. Given that, it makes sense to buy an APAP. I guess that question is behind me now.

As for masks!!!! The first issue is if you leak through your mouth or not! If so, you will need a full face mask for which I can give no advice at all! But if you don't have that problem, then you need to think about how you sleep, on your back, your sides, your tummy.

Of course I haven't a clue as to whether or not I leak through my mouth and I won't know until I try.

As to sleep position, I'm all over. I started last night almost on my stomach (sorta on my right side but over more), moved to my back, then my left side.

Has anyone been known to roll so much as to wrap a hose around their neck and choke themselves?

I use the Resmed swift which is easy to put on and pull off, and has few down sides except that the side arms can irritate after a while. If I were you I would expect to buy one mask and then within a few months buy another. I would say that if you don't leak or breath through your mouth then the swift is a very safe bet as a starter mask.

You and rested gal have both suggested the Swift now. I'll give it a good look.

Actually at this point I'm thinking I'll get something like the Swift to try but also buy a ComfortSelect at the same time. Why? It is what I used during my titration and found it to be comfortable, it is inexpensive as a 2nd mask, and having a 2nd mask of a different style will let me trade-off and give my face a break. Like I said before, I'm willing to do almost anything (including spending almost any amount of $$$) to give myself the greatest chance of success.

As for software ... why get hung up about it? Do you really need it? You may want to get geeky, but if you have an APAP and it works and if you need to you can look at the last nights results, why pay for something that could end up turning you into an obsessive?

I'm not hung up on it and I don't really need it. Really, I view the availability of software merely as a bonus. I'm curious, but not (yet) obsessed. I would like to make what is happening more transparent and less opaque, but it is secondary to success. I'm a scientist who believes that empirical evidence trumps theory every time!

OTOH, if I can gain a better insight into what is happening with me, I might be able to proactively work to improve my situation and be more successful in my treatment.

... Only then, if you really feel the need to go geek

Too late! I was a geek before the word was coined.

Anyway - goodluck -
sir_cumference

Thanks you Sir (Cumference). Your message tipped my decision on the machine and is starting to sway me on the mask issue as well. A 420E and Swift would appear to be well suited to my lifestyle of frequent business travels, not to mention camping with the family (in a popup/tent trailer).

Wulfman · Post by **Wulfman** » Thu Jul 28, 2005 9:22 am

Bill,

I normally don't "recommend" equipment, but I hate to see such a lop-sided poll.....so I'll put my vote in for the CFLEX equipment from Respironics. I'm happy with what I'm using. I have a feeling that your curiosity WILL become closer to an obsession as time goes on.....it's probably the "geek" factor. In my case, it was to obtain enough evidence to prove my sleep doctor was wrong and to be proactive with my therapy. I just couldn't imagine waiting for long periods of time not knowing what was happening during the night. I probably could have gotten an APAP, but from what my numbers are looking like, I don't think it would have helped any more. For the last two nights in a row, my AHI was .2 (that's POINT 2) and I haven't had a single apnea in weeks.....so I'm not complaining at all about what it's doing for me.

Good luck in your selection and good luck with your therapy.

Den

(another "geek")

WAFlowers · Post by **WAFlowers** » Thu Jul 28, 2005 9:34 am

Wulf (Den), when I said "your message tipped my decision on the machine" I mean APAP vs. straing CPAP. Which machine I'm still deciding on. As I said earlier I can see advantages in both the REMstar and 420E (it is down to those 2).

I've still got time to decide; I'm counting the days until I get my prescription! I almost fell asleep behind the wheel for the first time today after a particularly bad night. Good thing it was at a long stoplight and not while moving!

Wulfman · Post by **Wulfman** » Thu Jul 28, 2005 10:07 am

THAT ain't good!!!
The only time I seemed to show symptoms of this affliction was after a couple of hours staring at computer screens. It began to develop two or three years ago and got progressively worse. Usually mid morning and mid afternoons were the worst. Never had ANY symptoms while driving. I had about convinced myself that I had developed narcolepsy, "computer hypnosis" or something like that. It always seemed to be worse on flat-panel displays or laptop screens. Seldom got any indications before it happened either. It's now been quite a while since I've had any "computer screen fatigue", so I'm faithfully using my machine so it doesn't come back.

Later,
DW

rested gal · Post by **rested gal** » Thu Jul 28, 2005 10:37 am

I'm counting the days until I get my prescription! I almost fell asleep behind the wheel for the first time today after a particularly bad night.

That danger is one of the big reasons that a noted sleep doctor made this presentation, even though it's more in regard to what doctors should do for people without medical insurance:

"Not Every Patient Needs To Go To the Sleep Lab" by Barbara Phillips, M.D. MSPH

momexp5 · Post by **momexp5** » Thu Jul 28, 2005 11:31 am

chrisp wrote:Absolutely not. Do NOT get an auto . If you do you will not have any way to measure how great the 420E is. You must get a plain cpap as your first unit. At least for a month. How else will you get to experience aerophegia, burning chest, gas pain and flatulance. Just look at it as paying your dues.

OMG, Chris, you had me completely lol... thanks

ozij · Post by **ozij** » Thu Jul 28, 2005 11:37 am

Rested Gal and WillSucceed,

I wish I had the patience to document things like you two!
Wow!
Maybe I'll try again...

O.

momexp5 · Post by **momexp5** » Thu Jul 28, 2005 11:50 am

I love geeks.

Look at my avatar, for Pete's sake.

We are proudly geek here.

Have you all heard that it's even very trendy right now?

http://www.hoagiesgifted.org/pg_cult.htm

ozij · Post by **ozij** » Thu Jul 28, 2005 12:10 pm

WillSucceed wrote:Setting the device to work in increments of .5 seems to have lessened the 'aggressive' impact of pressure changes such that I feel less change and am wakened less by the pressure changes.

Yup. Same here - the .5 increments are much better.

O.

WillSucceed · Post by **WillSucceed** » Thu Jul 28, 2005 12:18 pm

I wish I had the patience to document things like you two!

Keeping concise documentation is what helped me convince my Sleep Quack to prescribe autoPAP and, helped my to shame the insurance company to pay for it after they had already coughed up coin for the CPAP.

I guess I don't need to be keeping this sort of documentation now, except that I'm still learning about treatment and am still tweaking my machine relative to what mask I use. I seem to have found the best pressure range for me and am satisfied with the mask choices that I have. Having recently tweaked the machine to work in .5 increments instead of the default of 1 seems to have helped alot.

When I look at the data in the morning, and see a really low AHI coupled with how good I feel, I get a bit of a reassuring boost that reminds me to see xpap treatment a something that I am doing FOR myself rather than something that I am doing TO myself.

sir_cumference · Post by **sir_cumference** » Thu Jul 28, 2005 1:03 pm

WAFlowers - I think you're going to be ok! And that you have just the right attitude and approach to making sure the whole APAP thing works well for you.

And, as an added bonus, I reckon you've found the ideal subject to bore everyone you know with (a fact with all geeks, they assume that they're interesting while boring the pants of every one else).

I think the real test will be in about a year from now. If you're still checking the software daily (like someone else above mentioning no names) then I'm sorry to have to tell you that you have geekitus - a repetitive strain injury for which there is no known cure!
sir_cumference

Wulfman · Post by **Wulfman** » Thu Jul 28, 2005 1:19 pm

HEY there, Sir_C.......I resemble that remark......
(checking the software daily....not the "bore everyone you know" part....because WE'RE not "boring".....SO THERE!)

Later,

WAFlowers · Post by **WAFlowers** » Thu Jul 28, 2005 1:32 pm

sir_cumference wrote:And, as an added bonus, I reckon you've found the ideal subject to bore everyone you know with (a fact with all geeks, they assume that they're interesting while boring the pants of every one else).

I resemble that remark!

Actually my wife and I just put 2+2 together for a friend. He's been suffering cardiac problems -- arythmia and palpatations along with hypertension -- and his wife says he snores heavily and sometimes gasps for air. I sent him all the info I have on OSA and he's going to speak with his doc, ASAP.