need advice on choosing a machine

Hi everyone. I'm in the market for a new machine and really need advice. I've been complaining about my machine to my team for the past 5 years with no success.

I've been using APAP for the past five years, except for a period when I lost so much weight that I stopped using it at all. (Didn't last, sadly.) I've had a constant issue with pressure that's too high -- ironically, I was perfectly happy with my machine at first, but when I took it in because I thought there was something wrong with the humidifier, they discovered it was defective and not giving as much pressure as it should. They replaced it and I've been miserable ever since.

At my last visit with my doctor, they found my numbers weren't as good as they should be and raised the pressure to 8-14. I wasn't doing that well before but now it's even worse and I'm starting to have daytime sleepiness and feeling like I need naps. My body just can't seem to tolerate high pressures.

I looked at the used cpap machine site and they make some very big claims about some machines really adjusting to what you need. Is this all hooey? Is there a magic machine out there that can give me the pressure I need without making my sleep worse?

Any advice is much appreciated.

Oh, I thought I had my info in my signature. The current machine an autoset Vantage, which I use without the humidifier. My mask is a resmed airfit.

shaina wrote: Is there a magic machine out there

No.

Now that we got that out of the way ...

shaina wrote:My body just can't seem to tolerate high pressures.

This is a common complaint of CPAP users. It's common to have to work through some problems before feeling comfortable with the machine. This forum can help you. Can you give us some details of what your symptoms of intolerance are like?

shaina wrote:At my last visit with my doctor, they found my numbers weren't as good as they should be and raised the pressure to 8-14.

Is it safe to assume this pressure is 8.0 minimum and 14.0 maximum? What were your pressures before they raised it?


We can help you pick out a new or used machine, and it is usually not complicated. We can help you with problems tolerating pressure and show you have to use some of the machine's pressure relief features. The machines we will recommend provide data that you can use to manage your therapy and troubleshoot any problems that you are having. But first, we would like to get some more information.

shaina wrote:My mask is a resmed airfit.

ResMed has several models of AirFit masks - http://www.resmed.com/us/en/consumer/pr ... masks.html .

Which model do you use? Does it cover nose and mouth or only nose?

xxyzx wrote:what does the data show

if the apnea is controlled then other causes can be making you tired

those so called numbers are just surrogate statistics
that give a rough guide to bureaucrats and doctors about treatment

you need to rule out low O2 and high heart rate
then look for other causes that disturb your sleep or make you tired

you may need an ASV
yes they adapt to you breath by breath and are the kinder gentler solution handling everything the others can do

but your insurance probably doesnt care about you only compliance
so they may not want to provide the one that works best for your situation

if you dont need it the wont put out the pressure to open obstructions that are not there
if you have open air and stop breathing they will breathe for you until you start again

you may be starting to have centrals
what does the data show ?

as to choosing a machine
ONE SIZE FITS NOBODY
one that is more automatic has to be better than one that is fixed

Throwing the kitchen sink at her is about as useful as a screen door on a submarine.

xxyzx wrote:

shaina wrote:Hi everyone. I'm in the market for a new machine and really need advice. I've been complaining about my machine to my team for the past 5 years with no success.

I've been using APAP for the past five years, except for a period when I lost so much weight that I stopped using it at all. (Didn't last, sadly.) I've had a constant issue with pressure that's too high -- ironically, I was perfectly happy with my machine at first, but when I took it in because I thought there was something wrong with the humidifier, they discovered it was defective and not giving as much pressure as it should. They replaced it and I've been miserable ever since.

At my last visit with my doctor, they found my numbers weren't as good as they should be and raised the pressure to 8-14. I wasn't doing that well before but now it's even worse and I'm starting to have daytime sleepiness and feeling like I need naps. My body just can't seem to tolerate high pressures.

I looked at the used cpap machine site and they make some very big claims about some machines really adjusting to what you need. Is this all hooey? Is there a magic machine out there that can give me the pressure I need without making my sleep worse?

Any advice is much appreciated.

=============

what does the data show

if the apnea is controlled then other causes can be making you tired

those so called numbers are just surrogate statistics
that give a rough guide to bureaucrats and doctors about treatment

you need to rule out low O2 and high heart rate
then look for other causes that disturb your sleep or make you tired

you may need an ASV
yes they adapt to you breath by breath and are the kinder gentler solution handling everything the others can do

but your insurance probably doesnt care about you only compliance
so they may not want to provide the one that works best for your situation

if you dont need it the wont put out the pressure to open obstructions that are not there
if you have open air and stop breathing they will breathe for you until you start again

you may be starting to have centrals
what does the data show ?
has
as to choosing a machine
ONE SIZE FITS NOBODY
one that is more automatic has to be better than one that is fixed

She has been using an APAP for the past 5 years. Everyone does not have centrals and everyone does not need an ASV.

ChicagoGranny -- I think I'll have to take this one question at a time.

symptoms: at the worst, when I was thinner, I was getting very painful bloat and gas. That hasn't happened in a while. But since the pressure change, I'm waking up with inflamed, distended feeling nostrils. I also feel less rested than before, though that's a fairly low bar.

The current pressure is 8 minimum to 14 maximum. The previous pressure was 4 to 12 (my own setting. I didn't realize then that there's an issue with having a wide range.)

The mask I use is this one: http://www.resmed.com/us/en/consumer/pr ... r-her.html Size medium nasal pillows.

BTW, I've been using a cpap for over 20 years. The previous two machines I had were fixed pressure and worked well for me.

I am a big fan of doing what works, especially for other people. If you did better with fixed, I would go back to a fixed pressure. I keep trying to make an APAP work better for me than a CPAP, but I seem to always feel better with the CPAP. I believe in my case that the slight pressure increases cause arousals for me, so I rest better with CPAP. But in all thinks, your milage may vary to what works for you.

shaina wrote:ChicagoGranny -- I think I'll have to take this one question at a time.

Good idea!

shaina wrote: But since the pressure change, I'm waking up with inflamed, distended feeling nostrils.

Does the inflammation dissipate during the day? If not, the problem might be allergies or dry room air. If it does dissipate during the day, that might narrow it down to a CPAP issue, which we can offer suggestions to relieve.

How much water is your humidifier consuming overnight?

Regarding the distension, as soon as the pressure comes on, it distends my nostrils. I like this because it helps to open up the nasal passages to a good flow of air.

shaina wrote:The current pressure is 8 minimum to 14 maximum.

That is a pressure range that will treat many people well. Of course, there are exceptions. Can you read your daily AHI and leak level from your machine's display? Data is often crucial to troubleshooting and solving problems.

shaina wrote:The mask I use is this one: http://www.resmed.com/us/en/consumer/pr ... r-her.html Size medium nasal pillows.

Do you get dry mouth during the night, or do you have it in the morning upon awakening? If so, how severe is it? Do you notice any mouthbreathing while using CPAP?

Will your insurance pay for a replacement machine at this time?

If you fill out your equipment profile, https://www.cpaptalk.com/ucp.php?i=prof ... pment_info , members will be able to see it every time you post. If you can't find your machine or mask in the dropdowns, entering into your signature - https://www.cpaptalk.com/ucp.php?i=prof ... =signature

It's common to take some time to work through problems and achieve a comfortable, effective CPAP therapy.

Thanks for taking the time to answer!

I think the inflammation does dissipate, but it definitely came on with the new pressure. It's pretty uncomfortable for some time. And my nose is kind of generally achey now.

I'm not currently using the humidifier, because I've never found it to make the slightest difference.

I don't currently know how to get the data from my machine. I suppose I might be able to find out how to do this from the internet.

I do experience dry mouth, largely because of medication, I think. My husband reports that I sometimes mouth breath, mainly on my back. I've tried several chin strap, which never stay on.

I was planning to pay for the new machine out of pocket, because I find having to go through a company makes it so much more expensive. I do have a prescription from my doctor.

shaina wrote:I don't currently know how to get the data from my machine.

I believe these instructions will work for your ResMed AutoSet Vantage:

1) Hold the left and the right keys down for a few seconds until the screen says "efficacy data"

2) Use the up and down keys to scroll through your data including your 95% pressure (the pressure that your machine operates at or BELOW 95% of the night), your Apnea-Hypopnea Index (AHI), your Apnea Index (AI) and your Hypopnea Index (HI), as well as your leak rate BEYOND the bias rate of the mask you have set in the settings menu (or your DME set for you). BTW, the indices all use the following formula: total # of events/total minutes/60=average events/hour AHI is apneas AND hyponenas, AI is apneas only, HI is hypopneas only.

3) Use the left key to select data for the day,week, month, six months or year.

Since you are currently using a ResMed machine, for an up-to-date replacement, I recommend ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier - https://www.cpap.com/productpage/resmed ... idair.html

Be sure to comparison shop prices. I recently bought a used machine with low hours and a one-year warranty at a considerable savings. Forum members can help you find one from a reputable supplier.

Be sure to get the AutoSet model. Keep your old machine as a backup. Machines do sometimes break.