New CPAP'er looking for the Holy Grail

[KSMike]

I've had the sleep study and have an Rx to start CPAP. Although I didn't sleep very well during the study with the FF mask, I did sleep for several hours. I think I'm going into this with my eyes open in terms of possible difficulties/adjustment period, etc., and there's no question in my mind that I want to make this successful. However, I'm getting SO little information from anyone about options on equipment... it's unbelievable to me that something so important seems to be so unsupported with information from doctors, DME's, etc. It feels like I've been told I have some form of serious disease, and "so let us know if you need anything else. Have a nice day."

Of course the sleep lab is connected with a DME (how convenient!) who called and had already done a pre-certification with my insurance to send out a machine. Which after doing a lot of reading here, sounds like the biggest piece of junk ever made. I told them to hold on until they hear from me.

Fortunately I do have very good insurance (for now!). So my question is (if there's any way to answer this), if you had the ONE TIME opportunity to buy the ONE machine that did everything you wanted or might want in the foreseeable future, based on all you've learned about CPAP machines over time, what would it be?

I realize the machine is just one component, and that I'll likely play musical masks for awhile finding the one. I can handle that, I just want to do the machine right the first time out, since once the insurance dollars are gone, they're gone.

So is there a "short list" of machines that everyone would go with if they had the chance?

Thanks for any and all help.

Mike

[Wulfman]

Mike,

What's your prescribed pressure?

Den

[cflame1]

If your pressure is moderate... not higher than 15 for sure, you definately want to get an auto... either a Respironics, Sandman, or Resmed. If it's higher than that, do an Auto Bipap... in which case you'll want a Respironics or Resmed. Check the reviews of these on cpap.com

Auto's:
Respironics M series Auto with Aflex (newer)
Respironics Auto with Cflex (could be either M series or not)
Resmed Auto Vantage II (newer)
Resmed Auto Vantage
Sandman Auto - doesn't have pressure relief (newer)
GoodKnight 420E

Auto Bipap's:
Respironics Auto Bipap (could be either M series or not)
Resmed S8 VPAP Auto

[KSMike]

Sorry, I don't have the Rx in front of me so I didn't think to post any details.

Pressure: 9cm H2O

[Wulfman]

With that pressure, just about any data-capable machine would provide decent therapy......straight CPAP or APAP. (assuming the titration was correct)

My "Holy Grail" machines are in my profile. Unfortunately, they're not being sold "new" anymore.

Den

[jda1000]

You're taking the right approach - my experience since my 11.4.08 sleep test is they tell you it's deadly, withhold crucial data - the sleep study, the clinical guide to the machine - and provide next to no customer service or follow up.

I wish I'd taken a very very proactive approach to every element of this since diagnosis. This is my first even vaguely serious need for health care, and needing to aggressively manage my care has been a real revelation.

On the other hand, I'm about 20 days into using a ResMed Autoset II, with a Mirage Quattro full-face mask, and seem to be adapting fairly well. I had a very hard time at first - rage, frustration, resentment, confusion - but have slept three consecutive nearly-full nights now, and feel better than ever.

Folks on this discussion board are very supportive and know their stuff.

Good luck!

[MrSandman]

Hey Mike this is Mike from KC area. You don't "NEED" an auto and as a matter of fact they can complicate treatment compared to a set pressure. At a pressure of 9 any CPAP will do the trick but I would look for one that you can get software for. A non-auto M-series Pro would be fine. Intellipap would be VERY quiet at a pressure of 9 and you can buy it with software.

[jules]

start by browsing this post to narrow down the machines - browser gave you a couple from there - wulfman has others on that list - I do too.

viewtopic.php?p=307168#p307168

[KSMike]

Thanks Mike!

How common is it for someone's prescribed pressure to increase significantly in time? I don't expect any machine to last the rest of my life (I'm 46), but I don't want to end up regretting it in 3-4 years because I didn't look down the road.

[jules]

If you use insurance, many companies use a 5 year life for machines. That will vary from policy to policy. By the time 3 or 4 years comes, you will be thinking new machine most likely anyhow.

[RipVW]

Hey Mike this is Mike from KC area. You don't "NEED" an auto and as a matter of fact they can complicate treatment compared to a set pressure. At a pressure of 9 any CPAP will do the trick but I would look for one that you can get software for. A non-auto M-series Pro would be fine. Intellipap would be VERY quiet at a pressure of 9 and you can buy it with software.

Hmm. An auto doesn't really "complicate treatment." With an auto, you have the option to run it in auto mode to check for optimal pressure need changes (and they DO change over time) and then run it in regular CPAP mode if your prefer that. MUCH simpler than trial & error method of seeking an optimal set pressure with a non-auto machine (or doing subsequent COSTLY titration sleep studies!). Get an auto and have the option--with a non-auto, you have no option. Well, that's my suggestion.

[MrSandman]

Mine has gone from 8 to 10 to 15 in 17 years... My weight has also gone from 175ish,210is,250ish so I think weight gain can increase your pressure.

[MrSandman]

Hey Mike this is Mike from KC area. You don't "NEED" an auto and as a matter of fact they can complicate treatment compared to a set pressure. At a pressure of 9 any CPAP will do the trick but I would look for one that you can get software for. A non-auto M-series Pro would be fine. Intellipap would be VERY quiet at a pressure of 9 and you can buy it with software.

Hmm. An auto doesn't really "complicate treatment." With an auto, you have the option to run it in auto mode to check for optimal pressure need changes (and they DO change over time) and then run it in regular CPAP mode if your prefer that. MUCH simpler than trial & error method of seeking an optimal set pressure with a non-auto machine (or doing subsequent COSTLY titration sleep studies!). Get an auto and have the option--with a non-auto, you have no option. Well, that's my suggestion.

All I can say is you are entitled to your opinion.

Good luck getting a good titration with an auto if it chases snores and other stuff. I shared your belief at one time but after buying 3 new autos this year and experimenting all I can say is that an auto is not a substitute for a sleep lab titration and adds variables that can really complicate the situation. I hate to say it but there is a reason so many Dr's aren't big believers in Auto's. The idea that an Auto is good just incase you gain or lose weight is a joke because they really aren't that good at finding and maintaining a proper pressure. You are better off to use straight CPAP and monitor the data and adjust pressure if needed.

Now I am a BIG believer in DATA capable but an Auto is not needed. So pick your battles and fight for a data capable machine and then buy the reader and software.

[Gerald]

Mike.....

Your 9cm requirement is the same as what the sleep center told me that I needed.

I purchased the following:

M-Series Auto with Aflex
M-Series Integral Humidifier
Card Reader
Viewer Software
High Filtration Filters (white)
Hose Cover
Hose Buddy Hose Hanger
Adapter for 12V DC operation
Quick Disconnect Hose Connectors
Choice of mask

The above equipment list is very similar to what RipVW is running.....and I believe what he told you is correct.
The M-Series Auto with AFLEX allows you the choice of (5) different modes of operation....and after experimentation, you'll determine the best for yourself.

if you let them "issue" you a "cheap-ass" machine, your chances of success will be lower......MUCH lower. Going into this battle you want a reasonably good "weapon".....not perfect.....maybe not the ultimate....but solid, good machinery....that'll allow you to adapt......and win the fight for survival. What I've suggested will get you going....solidly.....and allow you to make reasonable changes to the system....as you learn more.

Your biggest advantage....is that you've found this forum......and the nice people here.....who are glad to help.....as they were helped by others.

Gerald

[jules]

Good luck getting a good titration with an auto if it chases snores and other stuff. ...

Now I am a BIG believer in DATA capable but an Auto is not needed. So pick your battles and fight for a data capable machine and then buy the reader and software.

I agree with Browser. Data is mandatory. APAP is optional. You can self titrate with a straight CPAP when the time comes.

If you use a small range, you can titrate faster with an APAP but too many people use way too big of a range on their APAPs.

As much as owning an APAP is nice, an APAP is not the best thing since sliced bread.

I use my APAP these days with a very narrow range of 8.5 - 10 cause I am too lazy to change the pressure every time I change masks.