Airsense 10 Autopap vs. Dreamstation Autopap

[Jenk2k]

Any feedback from the group or anyone who's tried both?

1. I have an Airsense 10 from Apria and it seems to be working okay, but I feel like it's algorithm isn't quite getting up to the pressure I need. Doc has it set between 10 and 20 cm/H2O. My algorithm pretty much averages out at 12.9 or so.

I've been considering finding me one somewhere and trying it out. Any thoughts?

2. Has anyone had issues with a Sleep doctor objecting to you adjusting your own settings? I had a bad experience once with a really aggressive office manager who I got into a disagreement with over poor payment practices and the disclosure of my healthcare information to coworkers. Shortly after that happened I got an insane letter saying I wanted to be my own doctor and that I would need to find another doctor in 10 days or so. This has made me gun shy about doing anything like that. I would appreciate any thoughts or advice the group might have.

[Gasper62]

I think that violating a patient's privacy is a major faux pas and highly actionable if it can be proved. I would enjoy putting the fear of god into them if I were you. File a formal complaint or two with the AMA and governing state entities, see how much they like you then ! ~~ http://www.ama-assn.org/ama/pub/physici ... tions.page?

[Hose_Head]

Any feedback from the group or anyone who's tried both?

1. I have an Airsense 10 from Apria and it seems to be working okay, but I feel like it's algorithm isn't quite getting up to the pressure I need. Doc has it set between 10 and 20 cm/H2O. My algorithm pretty much averages out at 12.9 or so.

I've been considering finding me one somewhere and trying it out. Any thoughts?

2. Has anyone had issues with a Sleep doctor objecting to you adjusting your own settings? I had a bad experience once with a really aggressive office manager who I got into a disagreement with over poor payment practices and the disclosure of my healthcare information to coworkers. Shortly after that happened I got an insane letter saying I wanted to be my own doctor and that I would need to find another doctor in 10 days or so. This has made me gun shy about doing anything like that. I would appreciate any thoughts or advice the group might have.

1) There's not a whole helluva lot of difference in therapy between these two machines. Rather than shop around for a different machine, why not try first to maximize your therapy with the one you've got. You say you "...feel like it's algorithm isn't quite getting up to the pressure I need..." but you don't say why you feel this way. What is your average AHI at that setting? As a general rule, I like to set my autopap low setting at 1 cm below my 95% pressure setting; the high setting can be left at 20.

2) From what you say, you have ample evidence to look for another sleep doctor. Your current sleep doctor's attitude towards patient involvement in therapy is proof that you need to look elsewhere. You can do better.

[robysue]

Any feedback from the group or anyone who's tried both?

1. I have an Airsense 10 from Apria and it seems to be working okay, but I feel like it's algorithm isn't quite getting up to the pressure I need. Doc has it set between 10 and 20 cm/H2O. My algorithm pretty much averages out at 12.9 or so.

What makes you feel that your Resmed AirSense 10 AutoSet is not quite "getting up to the pressure" you need?

And: Is the ramp on and are you talking about when you are trying to get to sleep at the beginning of the night? Or are you talking about how things feel once the pressure is at 10cm? Or are you talking about how the machine responds to snoring and events?

Suggesting what you might want to do really depends on having a less vague description of the problem.

2. Has anyone had issues with a Sleep doctor objecting to you adjusting your own settings? I had a bad experience once with a really aggressive office manager who I got into a disagreement with over poor payment practices and the disclosure of my healthcare information to coworkers. Shortly after that happened I got an insane letter saying I wanted to be my own doctor and that I would need to find another doctor in 10 days or so. This has made me gun shy about doing anything like that. I would appreciate any thoughts or advice the group might have.

A lot of people have had no problems from the their sleep docs when it comes to adjusting their own pressure. A lot of people have received wet noodle whippings. And a lot of people have run into serious problems with the doc pushing back.

The best advice seems to be "Fire the doc" if he won't treat you with the respect you deserve.

Finding a quality sleep doc can take time. I wound up going through 3 sleep docs before finding Sleep Doc #4, who actually respects me and really listens to me. Sleep doc #1 fired me as a patient. I and Sleep Doc #2 fired each other simultaneously. I fired Sleep doc #3. To be fair, my changing my own pressure settings was not an issue in any of these situations, but Sleep Docs #2 and #3 really did not "get it" when it came to discussing CPAP adjustment problems. Sleep doc #1 just couldn't handle someone not adjusting after 8 or 9 months of working really hard.

[Janknitz]

I have not used the Dreamstation, but I had a PRS1 auto that I used for six years and I recently acquired an Airsense auto. So I can't speak to the Dreamstation algorithm. But I can tell you that the Airsense algorithm feels very "soft" to me--for lack of a better term--after all those years of the PR. I love it!

With the PR, I always felt that I had to keep up with the breathing pace that it set. I got used to it, but it never felt quite natural or 100% confortable. I don't feel forced at all with the Airsense, I feel it follows my breathing instead of the other way around. It's almost like it's not there. Despite that, the data tells me it's doing a great job of treating my apneas--I'm usually at 0.2 for the night. I feel like I sleep more deeply and comfortably. If I do wake, it's easier to fall back to sleep because I don't have to pace my breathing to do it.

You may not perceive the effect--the data tells the story. IMHO, you already have the best machine out there.

[Thatgirl]

I think that violating a patient's privacy is a major faux pas and highly actionable if it can be proved. I would enjoy putting the fear of god into them if I were you. File a formal complaint or two with the AMA and governing state entities, see how much they like you then ! ~~ http://www.ama-assn.org/ama/pub/physici ... tions.page?

Not just a faux pas, completely illegal. I agree with reporting it to the authorities.

http://www.hhs.gov/hipaa/filing-a-compl ... index.html

[Gasper62]

"Not just a faux pas, completely illegal."

You musta' missed the second part....... "highly actionable" ~~


ac·tion·a·ble

/ˈakSH(ə)nəb(ə)l/

adjective
Law

adjective: actionable

giving sufficient reason to take legal action.
"slanderous remarks are actionable"

[Thatgirl]

My mom uses a PRS1 Auto. My dad uses a Resmed Autoset for Her in Autoset mode. My mom needs a little less pressure than my dad. The difference in their pressure graphs is pretty interesting.

[Wulfman...]

Any feedback from the group or anyone who's tried both?

1. I have an Airsense 10 from Apria and it seems to be working okay, but I feel like it's algorithm isn't quite getting up to the pressure I need. Doc has it set between 10 and 20 cm/H2O. My algorithm pretty much averages out at 12.9 or so.

I've been considering finding me one somewhere and trying it out. Any thoughts?

2. Has anyone had issues with a Sleep doctor objecting to you adjusting your own settings? I had a bad experience once with a really aggressive office manager who I got into a disagreement with over poor payment practices and the disclosure of my healthcare information to coworkers. Shortly after that happened I got an insane letter saying I wanted to be my own doctor and that I would need to find another doctor in 10 days or so. This has made me gun shy about doing anything like that. I would appreciate any thoughts or advice the group might have.

Even though they each have different ways of delivering this therapy, it should still be possible to get decent therapy with either one. And, then there's always straight pressure if you really want to optimize your therapy.

Maybe you need to move your minimum up to about 12 or so and see what things look like.

This therapy is really no different than having prescribed medicines and modifying the doses (yourself). There's no law that says you HAVE to take the doses that are prescribed, and if you find that a different dosage has better results, then you can still use the modified dosages.

I actually fired my sleep doctor after a couple visits after my sleep study. I got my data-capable machine, monitored my therapy with software and found that I was able to use almost half the pressure that I had been prescribed. He wasn't happy, but I had a pile of printouts to show him and he couldn't say much.......other than "How did you figure out how to change your pressures?" (like it was a big secret)

If you have documentable evidence/proof that they revealed any health information to your co-workers, I'd contact a lawyer.
Depositions could be taken from them and used in court.


Den

.

[robysue]

My mom uses a PRS1 Auto. My dad uses a Resmed Autoset for Her in Autoset mode. My mom needs a little less pressure than my dad. The difference in their pressure graphs is pretty interesting.

Thatgirl, you have the labels on the graphs reversed.

The top graph is a Resmed AutoSet with its characteristic "wave" shaped pressure curve with steep increases reaching a peak and the machine immediately starts gradually decreasing the pressure right away.

The bottom graph is a PR Auto CPAP with its characteristic periodic wedge shaped test pressure increases, long periods at a given pressure, and test decreases that result in the machine deciding NOT to decrease the pressure, but rather take it back up to the current baseline.

[Thatgirl]

My mom uses a PRS1 Auto. My dad uses a Resmed Autoset for Her in Autoset mode. My mom needs a little less pressure than my dad. The difference in their pressure graphs is pretty interesting.

Thatgirl, you have the labels on the graphs reversed.

The top graph is a Resmed AutoSet with its characteristic "wave" shaped pressure curve with steep increases reaching a peak and the machine immediately starts gradually decreasing the pressure right away.

The bottom graph is a PR Auto CPAP with its characteristic periodic wedge shaped test pressure increases, long periods at a given pressure, and test decreases that result in the machine deciding NOT to decrease the pressure, but rather take it back up to the current baseline.

Oh my gosh, you're right! They totally are reversed!!! Thank you for catching this! I've corrected the labels, now. And that horrid spelling of Respironics.

[robysue]

Oh my gosh, you're right! They totally are reversed!!! Thank you for catching this! I've corrected the labels, now. And that horrid spelling of Respironics.

Thanks for editing.

And as for spelling Respironics? I can never, ever remember if it's Respironics or Resprionics. That's why I just call it PR most of the time.

[Thatgirl]

Oh my gosh, you're right! They totally are reversed!!! Thank you for catching this! I've corrected the labels, now. And that horrid spelling of Respironics.

Thanks for editing.

And as for spelling Respironics? I can never, ever remember if it's Respironics or Resprionics. That's why I just call it PR most of the time.

I can never remember how many L's Philips has

[Jenk2k]

Thanks everyone for all the great posts.

Regarding the exposure of my PHI to coworkers, yes it was a massive F_up. They faxed the wrong number on the same trunk as my employer and then my info got passed around at work. This was around 2011 and the lady obviously wrote down the wrong fax number and screwed up. At the time I was pretty pissed off about it, I wrote them a letter demanding that they take such a letter out of my healthcare records. I have since moved across country and doubt I have all the evidence, but I haven't followed up to check if they got rid of that letter. I could probably write a whole thread about this, but it's not going to help me with my health right now, and that's really what I need to talk about.

With respect to machines, my data shows about a .4 - .5 AHI and averages 12.9 cm/H2o. The RERA and other events are very very low.

I do not use ramp - i have no issues getting to sleep. I do use the comfort thing (i forget what they call it on the airsense) and I have a heated hose. But I still feel as though the pressure could be a little higher. Maybe the algorithm is right, and I am wrong. I"m not really sure, but I feel like I'm only 80% there. I have an appointment on the 31st with a new doc who I hope is cool. I have no way to really know so I'm going into a new relationship blind here and I would hate for the data download to show that I'm playing with the settings and the new doc get weird about it. On the flipside, I know that docs would love to refer you for endless sleep studies at your expense without regard to what makes sense. I'm definitely down with being assertive about what I need, but I also don't want to shoot myself in the foot.

I appreciate all the feedback or even just ideas to consider. Thanks.

[Thatgirl]

Thanks everyone for all the great posts.

Regarding the exposure of my PHI to coworkers, yes it was a massive F_up. They faxed the wrong number on the same trunk as my employer and then my info got passed around at work. This was around 2011 and the lady obviously wrote down the wrong fax number and screwed up. At the time I was pretty pissed off about it, I wrote them a letter demanding that they take such a letter out of my healthcare records. I have since moved across country and doubt I have all the evidence, but I haven't followed up to check if they got rid of that letter. I could probably write a whole thread about this, but it's not going to help me with my health right now, and that's really what I need to talk about.

With respect to machines, my data shows about a .4 - .5 AHI and averages 12.9 cm/H2o. The RERA and other events are very very low.

I do not use ramp - i have no issues getting to sleep. I do use the comfort thing (i forget what they call it on the airsense) and I have a heated hose. But I still feel as though the pressure could be a little higher. Maybe the algorithm is right, and I am wrong. I"m not really sure, but I feel like I'm only 80% there. I have an appointment on the 31st with a new doc who I hope is cool. I have no way to really know so I'm going into a new relationship blind here and I would hate for the data download to show that I'm playing with the settings and the new doc get weird about it. On the flipside, I know that docs would love to refer you for endless sleep studies at your expense without regard to what makes sense. I'm definitely down with being assertive about what I need, but I also don't want to shoot myself in the foot.

I appreciate all the feedback or even just ideas to consider. Thanks.

An AHI between 0.4 and 0.5 is excellent! That's also great that you're falling asleep well. What's making you say you're only 80% of the way there and needing more pressure? Are you not waking up feeling refreshed?