Autos and Swift?

elliejose · Post by **elliejose** » Wed Aug 03, 2005 8:38 pm

Doc finally got my new script for an auto to the DME. I am trying to decide between the Remstar/C-flex and the PB420E. I had been using the C-flex on my Remstar Plus. However, I have been able to get along without it if I be sure and use the ramp. My mask is Swift and I like it. My question is, do any of you use both autos and Swift and if so do you have any problems with pressure. Cpap.com says nasal masks may affect the accuracy of pressure. at least, that is the way I interpreted what info said. DME says he only has Resmed auto, but will be glad to order what I would like.

Any and all suggestions and advice appreciated. I am having so much trouble getting everything to work for me, wish there was a way to try different ones before making a decision.

Guest · Post by **Guest** » Wed Aug 03, 2005 8:41 pm

Swift works fine with autos. No worries. 420E is a great unit and least expensive. Also smallest

:twis ted:

yawn · Post by **yawn** » Wed Aug 03, 2005 9:23 pm

I read on a thread today that said APAPs don't have the ramp feature. If that's important to you, you should look into that. I have a Resmed CPAP so I can't advise you on which Auto to buy.

m_l · Post by **m_l** » Wed Aug 03, 2005 11:05 pm

elliejose,

The PB 420E does have the ramp feature. I use it with the Swift also, working fine so far. Depending on your pressure C-flex will help. I to was unsure on which machine to get. In the end I decided on the PB 420E and using the ramp feature. I was titrated at 9. I was told that with my low pressure, I would not benefit much from C-flex. That instead ramp was more important. So far that advise has worked out for me. As I don't have trouble breathing against my pressure.

Hope this helps
Mike

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CPAPopedia Keywords Contained In This Post (Click For Definition): 420E, C-FLEX, swift, Ramp

elliejose · Post by **elliejose** » Thu Aug 04, 2005 5:40 am

Oh, I forgot to add, my pressure is 14.

Ellie

WillSucceed · Post by **WillSucceed** » Thu Aug 04, 2005 7:14 am

The auto machines, including the PB 420E DO have a ramp feature. It functions somewhat differently than ramp on a CPAP. Ramp on a CPAP starts at a lower -than-tritated pressure and gradually works up to the titrated pressure over the course of time set in the ramp.

So, if your titrated pressure is 14, and your ramp pressure is 8 and your ramp time is 20 minutes, your machine will (when you push the ramp button) drop to a pressure of 8 and take 20 minutes to work up to a pressure of 14. The pressure difference between 14 and 8 is 6 (14-8=6); the machine has 20 minutes to get from 8 to 14, so, it will do a 1 point of pressure increase every 3.33 minutes. (20 minutes divided by 6 points.)

This slow, incremental increase in pressure gives you time to fall asleep while the pressure is low.

On the auto machines, the ramp is actually a delay. With the auto machines, you set a range of pressure (8-15, for example) and a initial pressure (8, for example) and a delay (ramp) time (20, for example). When you hit the delay (ramp) button on the auto machine, it tells the machine to stay at the initial pressure (8) for 20 minutes and then, to start adjusting pressure within the set range (8-15) as needed.

So, with an auto machine, you do not get an incremental increase in pressure to the titrated pressure, you get a delay in pressure change (to give you time to get to sleep) for whatever length of delay (ramp) you have set.

Make sense?

WillSucceed · Post by **WillSucceed** » Thu Aug 04, 2005 7:34 am

My question is, do any of you use both autos and Swift and if so do you have any problems with pressure. Cpap.com says nasal masks may affect the accuracy of pressure.

I know that some of the documentation from Respironics says that certain masks are not compatible with their auto machine. An example is their own Comfort-Lite interface. However, I have used the Comfort-Lite with the RemStar Auto and all was well. I believe that the auto machines can/do tolerate nasal pillow interfaces without problem.

HOWEVER, Puritan-Bennett states in their documentation that their 420E machine will work with any interface in their line-up of interfaces, including Breeze, which is a pillows-based interface with a narrow connecting tube between the pillows and the air hose from the PAP machine. This is a dynamic of PB's internal sensor line which runs through the air hose, allowing the machine to sense pressure at the mask, rather than 6 feet away at the machine, after the air has bounced off the water in the humidifier tank.

I don't know if it really makes a difference, but, for me, when it came time to choose an auto machine, I tried 3 of them (RemStar, 420E and Spirit) and liked the 420E best because of it's small size, internal sensor line, adjustable triggers and data analysis software.

If you MUST have the exhalation relief that C-FLEX gives, (and the RemStar algorithm works for you) the RemStar is a great choice. It's a bit big and bulky, but very sturdy and reliable. C-FLEX does not work for everyone, but for those that it does work for, it is much-loved.

If you DON'T need exhalation relief, think long and hard about the 420E as it has great features that the other machines don't have, is clearly the smallest, and has great data analysis software. Further, it is designed to work with any interface. I have tried 8 different interfaces (Comfort-Lite, Activa, Swift, Breeze, Aura, Snapp, NasalAireII and Infinity) and it has worked perfectly with all of them (based on how I felt in the morning AND data from the Silverlining software).

Not-withstanding all of the above, if at all possible, trial all of the auto machines for at least one week each. This is the only way to be sure that you will select the machine that works best for you. All of the manufacturers use different algorithms in their respective machines. Although it is unlikely, one or more of the machines might not be the right fit for you. When I trialed the machines, the RemStar was not right for me and; I felt tired during the day and the data from the software showed that it was not giving me enough pressure (compared to the other machines.)

The Spirit and the 420E both gave me great treatment (better than the RemStar) so I based my purchace selection on features. The 420E was the clear winner for me. I've had no regrets regarding choice.

It is most likely that any of the machines will give almost all users good treatment. If possible, take the time, and expense, to trial them all before you buy.

sarkel · Post by **sarkel** » Thu Aug 04, 2005 7:42 am

Can someone clarify - does anyone use the SWift with the REMstar Auto?
the literature says there "might" be pressure problems?

capt · Post by **capt** » Thu Aug 04, 2005 8:00 am

I think that you will be happy with either the 420e or a ResMed AutoSpirit. All of WillSucced's recommendations to get a 420e are excellent, I would add that the 420's optional humidifier looks like one great unit. I must say that I really like my AutoSpirit, which I have been using for four months now. If you do a lot of travelling the small size and weight of the 420 should definitely be taken into account.

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CPAPopedia Keywords Contained In This Post (Click For Definition): 420E, resmed, humidifier

seagull · Post by **seagull** » Thu Aug 04, 2005 8:21 am

Hey, I am experimenting with auto vs straight on remstar auto with the swift.
I love the swift, and I wear it fairly loose. I have been having problems when the pressure reaches 11. I tightened the head strap a bit and it seemed to help. It was leaking I think because it was so loose. However, I do think on the auto, it is ramping up pressure every time I lift mask a bit to scratch my nose for instance. I also think it is ramping up if I consistantly take deep breaths. I still haven't decided if I like auto mode. My pressure will probably be 11 or 12. Still don't know. So I am adjusting it myself. I say all this even though I haven't been sleeping well with the machine on. I did have a great 2 hour nap yesterday with the straight cpap mode set on 10, ramped up from 8.

WAFlowers · Post by **WAFlowers** » Thu Aug 04, 2005 8:47 am

Will, that was the first good explanation I've seen of how ramp can (and does) work with auto mode. It makes sense to me. Thank you!

WillSucceed · Post by **WillSucceed** » Thu Aug 04, 2005 9:12 am

Will, that was the first good explanation I've seen of how ramp can (and does) work with auto mode. It makes sense to me. Thank you

My pleasure... you are welcome.

I do think on the auto, it is ramping up pressure every time I lift mask a bit to scratch my nose for instance

An auto machine will increase pressure to compensate for the leak. It should, however, reduce pressure to an appropriate treatment level as soon as you get the leak stopped. At risk of sounding silly, I keep a thin bamboo skewer next to the bed that I can use to gently get in, around, under the nasal pillow if I need a bit of a scratch. This way, I don't have to lift the interface up and create a big leak.

WillSucceed · Post by **WillSucceed** » Thu Aug 04, 2005 9:23 am

the 420's optional humidifier looks like one great unit.

I am using the H2O humidifier that PB has recently introduced. I am really pleased with it. It has a large water capacity -->part of the humidifier tank is elongated such that its metal plate, the part that is in contact with the heater plate, is quite large. Part of the plate is hidden under the shelf that the CPAP machine sits on.

For those of you who have the RemStar heated humidifier, your tank is fairly tall and narrow. With the PB heated humidifier, the tank is quite wide and flat, with a tall section that attaches to the CPAP machine. In comparison, the PB has a larger surface in contact with the heater element and, seems to get the water warmed much faster than does the RemStar unit.

The PB has a seperate on/off switch which is INCONVENIENTLY located on the back of the humidifier, as is the temperature control dial. There is no control on the CPAP unit that manages the heated humidifier -->you have to remember to turn this unit on and off seperately from the CPAP unit.

Also, the heated humidifier has it's own power cord. It is not wired into the CPAP unit like the RemStar is.

So, controls for the RemStar unit, and the ResMed integrated humidifer are well placed and accessible. Controls for the PB are a pain in the butt.

The PB and RemStar tanks are easy to work with whereas the ResMed tank, in my opinion, is a huge pain. Too many pieces to worry about and a small heating element.

If PB had put the controls in a better location or, wired the unit so that it could be controlled by the CPAP machine, it would be perfect. As it is, controls are a pain, but the large heating element, good water capacity and ease of use make it just a great unit. Well worth the coin that it cost.

By the way, we here in Canada don't even have the H2O unit yet. I got mine in the USA and just carried it over the border.

capt · Post by **capt** » Thu Aug 04, 2005 10:00 am

WillSucceed, that is interesting about the controls and power cord for the PB humidifier. I too live in Canada and have just been able to see the pictures of the PB humidifier. From what I could see I thought it was using a single power cord and was almost totally integrated into the 420 series. It still looks like a pretty nice unit though. I got my AutoSpirit delivered from cpap.com to my father's home in Ohio, and brought it back home after a visit. One of the reasons I bought the ResMed because the dme that carries ResMed products here in Calgary provides excellent service, and also the other ResMed products I have used were really good. I do like the auto shut down and other auto features that it has too.

GoodKnight · Post by **GoodKnight** » Thu Aug 04, 2005 2:21 pm

cpap.com says on their page for the Swift that Resmed says it can be used with auto machines.
I use the Swift with Remstar Auto with CFLEX and it works great. No problems.

Mask	Humidifier