Need some help selecting Autotitrating CPAP machine & accys.

Hello everybody,

I'm new to the forum, just got diagnosed with sleep apnea yesterday and got a prescription for an autotitrating cpap machine. I've been reading posts and looking through articles/stickies on the forum and have learn some stuff I didn't know, but felt I should post, say hello and ask some advice/get some opinions.

Here's where I'm at:
1. I'm a Respiratory Therapist by trade, but have been out of the field for about 5 years, first taking care of my dying father, then the last couple with health issues. I've had a couple breakthroughs lately in I've been diagnosed with Rheumatoid Arthritis and Sleep Apnea. So now I'll be getting treatment and hope to return to work as a Therapist soon. But I also have been a patient and know it's different on the patient's side of the house.

2. I studied sleep apnea and sleep studies in school and did sleep studies in my last job, but it was a small town hospital with limited resources, so most machines the patients ended up with were low budget economy jobs. Additionally, I've been out of the field long enough there's been several changes I'm sure.

3. I've tried a nasal gel mask on myself in the past with a friend operating the CPAP during my clinicals and at around 7 cm of pressure, it opened my nasal passages up beautifully and felt comfortable, but that was then, this is now.

Here's what I'm hoping for:

1. I have to pay for the machine myself and the doctor kept the prescription simple, so I can get what I want as long as I can afford it. I'd like to get a machine with heated humidifier and data collection if possible. But since I will be buying the machine or renting it, I'm not pressed to lock into a fixed value, then go to a cheaper machine.

2. I've like to get a good machine with good performance. I'm familiar with many of the manufacturer's I've seen online, but am not up to date on what's the latest/greatest in the last two generations.

3. I'm trying to find the intersection of best performance and cost available in an autotitrating machine. I've did some quick pricing and found in one case that an older generation machine, by the time you add the humidifier and heat tubing, costs as much as the current generation combined product.

4. I do have major allergy issues related to my nostrils with them often producing ridiculous amounts of mucous when I'm awake. I'm planning to go back to an ENT doc and get this addressed, but right now, the Arthritis meds and the CPAP machine are on my plate to deal with. I'm guessing a quality heated humidifier may help, but I also prefer a cold bedroom to sleep in, so I've got concerns about heated vs. cool humidification.

So basically, at this point, I'm kinda at a loss. I'm hoping you can give me some ideas on what's worthwhile and what's not, where to spend money for performance and where to not and what brands to look out. Please also ask me questions if you need to know more about me or my situation in order to help me. I'm very familiar with forum discussion in my hobbies, so I'm comfortable with discussion.

Thank you in advance for your help.

Dave

What machine you get depends on the nature of your sleep apnea.
If it is plain vanilla obstructive apnea, Then any of the Respironics machines in the 60 series models 460, 560, or 760 will do nicely. As the numbers go up, the capabilities increase and the 760 is a completely auto-titrating bi-level machine.
If it is complex apnea or central apnea, the only machine in the Respironics line that will help is the BiPap AutoSV ASV model 960 which will provide the treatment necessary.

There are comparable ResMed machines that will also work well for you. However, their ASV machine is not as flexible in setting the parameters as the 960 so that is a consideration. I don't have any personal experience with ResMed machines but others on this forum will be able to give you more extensive information about them. Pugsy, can provide excellent advice on selecting which machine will serve you best.

If you post some of the PSG result numbers, that will help in the advice you get - total AHI and individual components, etc.

With respect to autoset CPAP machines (not BiPap or ASV), most people on the forum seem to prefer one of the following:

- PR System One REMStar 60 Series Auto CPAP Machine
- ResMed S9 Autoset
- ResMed AirSense™ 10 AutoSet CPAP Machine with HumidAir™ Heated Humidifier (get the "For Her" version - same price and provides data on RERAs)

Good places to shop are cpap.com for new machines and secondwindcpap.com for low hour used machines (the Airsense was just released and probably isn't available used at this time)

Craigslist is also a possible source of used machines.

Hi Dave,
Another possibility would be to get a Resmed S9 Autoset. It records full efficacy data and automatically adjusts pressure within a preset range. Since the release of the Airsense 10, the S9s are being discounted (724 on CPAP.com). Another route since this is out of pocket is to go the used route. There are a few people on here who resell used machines McDover being one).

-tino

http://maskarrayed.wordpress.com/

Should answer a lot of your questions.

Assuming plain jane vanilla OSA... and since your doc gave you a RX for APAP then it's probably plain OSA you are dealing with.

I would look at these machines...all are full efficacy data machines with easy to obtain and use software (look at my signature links for additional software information).
All have optional heated hoses...and I would suggest getting one. Makes for more customization of humidity delivered as well as air temp delivered. Better to have it and not need it than need it and not have it.

The latest Resmed machine....just released in August...the AirSense 10 AutoSet for Her (even if you are a guy) because it has 3 modes of operation...cpap mode, regular apap mode and a special apap mode originally marketed for females but it might also be useful for the guys.
https://www.cpap.com/productpage/resmed ... idair.html
Humidifier is included in the package.

The S9 AutoSet that was the model prior to the AirSense
https://www.cpap.com/productpage/resmed ... chine.html
2 modes of operation...cpap and apap
humidifier is separate
https://www.cpap.com/productpage/resmed ... ntrol.html

In the Respironics brand line..
The PR System One 60 Series Auto CPAP
2 modes of operation...cpap and apap
humidifier is separate
https://www.cpap.com/productpage/pr-sys ... chine.html
https://www.cpap.com/productpage/pr-sys ... ifier.html
If considering the PR S1...do call for pricing...as these prices don't reflect the final price...Respironics won't let cpap.com list the discounted price..you have to call for it....the discount is significant.

The Devilbiss Intellipap is also a good machine but the data it collects is a bit lacking when compared to ResMed and Respironics plus to use the software you have to purchase a separate module which costs an additional $100.
https://www.cpap.com/productpage/devilb ... chine.html
So by the time you add in the module...it costs about what a PR S1 would cost.
It doesn't do flow rate or flag centrals...not a deal breaker but for a newbie I would want to see it if it were me.
Would make a great backup or travel machine though.
Or for someone who is an old cpap veteran who doesn't need all the extra detailed data...would work great.

In terms of comparison of the brands...I have used both the S9 and PR S1 brands (different model line) and it's a toss up...both are great machines. Both have minor pros and cons but none are deal breakers or makers.
Unless money/cost was significant factor...I would go with the new AirSense 10 AutoSet for Her if it were me....simply because I know ResMed makes a great product and that 3 rd mode might come in handy and it's better to have it and not need it than need it and not have it.
If money is a significant factor...get the PR S1 60 Series AutoCPAP (model 560). I don't remember the exact discounted price but I don't think the difference is huge.

Now if you want or would take a gently used machine or new open box machine...
Check out Secondwindcpap.com for some really good deals.

Pugsy wrote: Now if you want or would take a gently used machine or new open box machine...
Check out Secondwindcpap.com for some really good deals.

seconding pugsy's recommendation to hit up secondwindcpap.com and grab yourself a s9 autoset for inexpensive

having tried both the prs1 560 and the s9 autoset, I prefer the s9 series for a host of little nitpicky reasons.

here's a list of my reasons: viewtopic.php?f=1&t=99737&p=927976#p927976

Thank you everyone for responding so quickly. Since my business is a start up business selling sod and we're heading into winter, money may be tight, so finding a good quality brand used machine is a great option for me. Based on your recommendations, here's the machine I'm looking at buying:

http://www.secondwindcpap.com/ResMed_S9_AutoSet.html

What do you think? Good choice for cost vs. performance and data collection?

I plan on buying the machine with the humidifier and heated hose included from that website. I'll need a mask that fits and one can't really buy online without trying something on first. I plan on going to Care Medical in Athens, GA and getting them to let me try on the masks they sell. If I find one that fits, I'll simply buy it their for them letting me try on masks.

The lady on the phone at secondwindcpap recommended I look at the Resmed Mirage softgel and the Respironics comfortgel. Do you folks have other recommendations?

Finally, do I need to look at a battery pack immediately or can that wait?

Thank you again for your help.

Dave, unless you're planning on doing a lot of camping or have frequent, lengthy outages I wouldn't worry about the battery pack just yet.

Also, our hosts at CPAP.com offer return insurance with their masks, free with most of them, so you can try it on for 30 days at no risk.

A lot of folks (myself included) like the ResMed P10 nasal pillows for ease of use and comfort. I have no experience with nasal masks or ffm but those with more knowledge can direct you there.

DaveInGA wrote:What do you think? Good choice for cost vs. performance and data collection?

Great choice. It's a great machine and the data it collects is excellent. You can use SleepyHead or ResScan software. Send me a PM if you want to try ResScan but remember it's Windows only software and if you use a Mac you can't use ResScan unless you put Windows on the Mac. SleepyHead has a Mac version as well as Windows version.

I might have a free mask (unused) that you could just have.
Answer one question for me...can you normally breathe through your nose just fine during the day and night or do you have significant nasal congestion issues that you can't resolve and thus requires you to breathe through you mouth often?
I think I have a new Respironics Wisp mask you can just have.
This one..
https://www.cpap.com/productpage/wisp-n ... ck-pr.html
I need to check to make sure but I think I still have one of those.
Free...new and unused...all I ask is postage reimbursement if you can afford to (around $7 I think) and if you love it..just use it and if you hate it...offer it up for free to someone on the forum so it doesn't go to waste.
Send me a PM if you want the Wisp or maybe something else...I have a couple of nose nasal gel masks but need to check to see which ones and what sizes I might have..the Wisp comes with all sizes of cushions.

I think that machine will serve you just fine. The heated hose is a must have, especially for a cold bedroom. I used one for 3 years before I switched to ASV.

The mask is very personal. No amount of trying on at a DME will determine the RIGHT mask, although it may rule out several wrong ones. After 4 years and more than a dozen masks in my collection, the Wisp is my current go to for daily use. I have several full face for stuffy nose days. When I used the S9 Autoset with pressures below 12 cm H2O, my favorite was the Circadiance Sleepweaver Elan. I recommend you go to CPAP dot com and take their mask quiz. It should help you narrow down your choices. After 4 years on this site, I don't think I have seen 1 in 10 people who loved their first mask. Most go through several, a recent thread talked about trying 15 FFMs and ready to give up.

Pugsy wrote:Send me a PM if you want to try ResScan but remember it's Windows only software and if you use a Mac you can't use ResScan unless you put Windows on the Mac. SleepyHead has a Mac version as well as Windows version.

resscan is for masochists... *winks @pugsy*

sleepyhead also works on linux

DaveInGA wrote:Thank you everyone for responding so quickly. Since my business is a start up business selling sod and we're heading into winter, money may be tight, so finding a good quality brand used machine is a great option for me. Based on your recommendations, here's the machine I'm looking at buying:

http://www.secondwindcpap.com/ResMed_S9_AutoSet.html

What do you think? Good choice for cost vs. performance and data collection?

excellent choice, sir...

with the resmed and philips respironics machines, data collection is pretty much an all or nothing thing, the "entry level" machines (as they put it) don't collect any useful data for the most part, and all the rest of the machines all collect full data down to measuring your breathing 25 times a second, so you can see the trace of your inhales and exhales... like this:

palerider wrote:resscan is for masochists... *winks @pugsy*

Yeah..I tend to agree but I feel I have to at least offer it as an option so a person can decide for themselves.
FWIW...I feel the same about Encore Pro but when someone asks for it...I help them out with finding it but I won't offer tech support for it. Been there and done that and see no need to take on that workload unless no other option is available and just wanting Pro because it's there when SleepyHead works well..isn't enough reason.

There is info on different machines in the links in my signature line.

Getting the machine from Craigslist has worked well for me, but you may have to watch for a while to find a good buy. You'll see lots of people wanting more than a brand new online machine due to the high prices and phony insurance billing at local DME's. Be sure you know how to tell the difference between the good data capable machines and the dataless brick machines.