Could really use help selecting a machine, possible UARS.

I have been diagnosed with mild sleep apnea recently. However, due to my history and reasons I will not go into I'm pretty sure I have a combo of UARS.

Anyway, I want to buy a used PAP machine instead of what my insurance is offering because it will be significantly cheaper (I have not paid my deductible yet). This means I need an Auto machine.

I want something that monitors flow limitations because i read that is best for UARS and I want a BiPaP because I am a light sleeper and think it will be more comfortable.

What I am looking for is an Auto Bipap that I can pull data from myself and can monitor flow limitations.

I currently looking at this machine:
ResMed S9 VPAP/BIPAP S with Heated Humidifier

Any reason this doesn't seem like what I am looking for?

I am completely new to this, trying to get my machine as soon as possible and everything seems confusing with so many different machines. I will appreciate any help you can give me.

Also, could someone explain just a little about the sleepyhead software? Can anyone get it and can you use it on all machines?

Thank you!!

Jarboejoe wrote:I currently looking at this machine:
ResMed S9 VPAP/BIPAP S with Heated Humidifier

This model doesn't offer auto adjusting pressure mode.
It offers cpap mode and bilevel fixed mode.
If you want auto adjusting pressure mode then the S9 VPAP Auto is what you want in terms of the ResMed S9 unit.

BiPap is a Respironics trademark name for a bilevel device.
ResMed's trademark name for their bilevel devices in the S9 model line was VPAP...they now use AirCurve as the trademeark name for their bilevel devices.
The term BiPap is really a Respironics term but it has sort of gained generic status.
There is no such thing as a S9 VPAP/BIPAP S machine....there is a S9 VPAP S and a S9 VPAP Auto.

SleepyHead is free and works with Respironics and ResMed machines really well and pretty well with DeVilbiss and F & P machines. If you really want to try a bilevel machine you need to target your research on either ResMed or Respironics as they are the leaders in the bilevel department. DeVilbiss makes a bilevel machine but it is so rarely seen that we can't help you with it and I wouldn't even consider it if it was me.

If you are really wanting bilevel (and there's nothing wrong with it because even though it might not be needed, it sure wouldn't hurt to add in the extra layer of comfort that bilevel offers) and want auto adjusting pressure capabilities then these are what you need to target

Resmed line...the S9 VPAP Auto or the latest model which is the AirCurve VAuto

Respironics line...the PR System One 60 Series BiPap Auto model #760 or the latest model which is the DreamStation BiPap Auto

There are pros and cons to either brand but they are very minor differences and none really a deal maker or deal breaker IMHO. I have owned and used both the PR S1 model 760 and the ResMed equivalent S9 VPAP Auto. In terms of OSA therapy it's probably a toss up. In terms of UARS therapy that's something I have no experience in but the Respironics machines will flag RERAs (Respiratory Event Related Arousals) and the ResMed machines don't. We don't know if RERAs are something that is useful to have as a data point in terms of therapy evaluation or not. I just thought I would mention it....I think if I was really wondering about UARS then I would lean towards Respironics brand just to have that extra data point.
In terms of flow limitation reporting...Respironics flag the actual FL event where ResMed presents FL reporting as a graph. I prefer the actual event flagging myself but others prefer the graph.

The Respironics bilevel 760 model offers a variable pressure support or a fixed pressure support (that difference between inhale and exhale) where ResMed only offers a fixed pressure support.
I do not know what situations might be better treated with variable vs fixed pressure support. I never could really find any information about that detail.

So there are minor differences between the 2 brands...the ResMed may be a tiny bit less noisy (at least from my experience) but it's not like the Respironics is horribly loud...it isn't.

In terms of UARS therapy...I am on the fence as to which one I would be wanting to use if it were me.
In terms of OSA therapy...the ResMed edges out the Respironics for me anyway.
From what I have read about UARS..it's a really tough nut to evaluate because the normal data points reported by these machines aren't measuring UARS stuff..they are measuring OSA stuff.
From what I have read about UARS it seems like those patients need more pressure to relieve symptoms than what is technically acceptable in terms of AHI for OSA therapy.
I do wonder if the slightly more aggressive algorithm of the ResMed machines might be an advantage in this situation. ResMed's respond a little faster but that change might be an issue if the change disturbs sleep and Respironics kinder gentler response might let a person sleep better. From what I have read UARS patients tend to be sort of super sensitive to the least little thing causing those unwanted arousals.
So the kinder gentler approach could maybe be an advantage.

So that's all the pros and cons I can think of at the moment.
I think you would probably do very well with either brand for the OSA side of things....but I just don't know about the UARS possibility side of things. I don't know if one brand would maybe be better than the other in your situation in terms of the UARS possibility.
If there is an advantage between brands...it's going to be a small advantage.

If you are simply wanting data points for evaluation...Respironics for sure but data points aren't the end all measuring tool.

You can use SleepyHead or the brand software (we can find it for free) or even use both if you wish.
https://sleep.tnet.com/equipment
If you go to the top of the announcements section and take some time to read my SleepyHead tutorial stuff you can see some examples of all software reports.

Have you had any kind of titration study to know what pressure you may need? The exhaled pressure relief on a cpap may be sufficient for comfort if you require lower pressures. Being able to get away with a cpap would save you a ton of money, being out of pocket, unless you get really lucky with a deal find.

Thank you very much pugsy! That helped alot.

I think i am going with the ResMed S9 VPAP™ Auto with H5i™ Humidifier-Certified Pre-Owned.



I have not had a titration, they want to just do it with an auto-cpap. I have read UARS requires higher pressure so I want to get a Bipap now then find out later that I need it.

Jarboejoe wrote: I have read UARS requires higher pressure....

Not according to our expert Sludge/Muffy/etc

APAP can provide pressures high enough, but it doesn't support EPR>3. UARS treatment is alleged to require a bigger pressure support (difference between inhale and exhale), which is only availabe in VPAP.

The major issue of UARS is that the patient is extra sensitive, which results in extra arousals from sleep, which generally are not easy to quantify.

Don't expect VPAP to create a miracle out of the box. You will have to work dillegently to find your proper settings. I don't mean tof discourage, just trying to be realistic

Thanks to everyone, this has helped me so much. I have one more question if any one could give some more advice.

I am buying this used and planning on experimenting my self to find the right pressure. Do you think I could do that with just a VPAP or would it be better to get an AUTO VPAP?

Get the VPAP Auto if at all possible.
The VPAP S has 2 modes of operation...fixed cpap (single pressure) and fixed bilevel (the 2 pressures ..one for inhale and one for exhale).
The VPAP Auto has 3 modes of operation...the same 2 as the S model but it also has an auto adjusting bilevel mode where the 2 pressures can auto adjust as needed....so it's like 3 machines in one.
You may not need auto adjusting mode but it's better to have it and not need it than need it and not have it. It might come in handy.

Now if your choices are S model and Auto models have a huge difference in price and the S model is a huge savings to the pocketbook...what you are wanting to do can be done with the S model...just takes a little longer and a little more work and might not be ideal but it could be done.
I am someone who sees some marked pressure difference during the night and you may or may not have something similar but having auto mode available means you can use lower pressure during the part of the night where lower pressures get the job done and it only goes up to higher pressures only for the times that it is needed. Without auto mode you have to use higher pressures all night long just to deal with the maybe shorter times where higher is needed. Now it can be done but it might not be as easy as with auto mode.

Pugsy wrote:Get the VPAP Auto if at all possible.
The VPAP S has 2 modes of operation...fixed cpap (single pressure) and fixed bilevel (the 2 pressures ..one for inhale and one for exhale).
The VPAP Auto has 3 modes of operation...the same 2 as the S model but it also has an auto adjusting bilevel mode where the 2 pressures can auto adjust as needed....so it's like 3 machines in one.

since you *can* set it up to act exactly like an autoset, I like to think it's like four machines in one

so, yeah, I too recommend getting the s9 vpap auto, or air10 vauto if at all possible.