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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
bank4cat
 
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why go to a autopap

Postby bank4cat on Tue Sep 12, 2006 4:40 pm

i have a remstar pro2 with cflex, i am curious about the auto machine...does the auto make better numbers and overall theropy or just more comfortable.


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Goofproof
 
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Postby Goofproof on Tue Sep 12, 2006 6:21 pm

It's all about options, With the Pro 2, you can get most of the answers to treatment you need, if you invest in the software and reader, lot's of others out there aren't so fortunate.

I used the Pro 2 to find my Sweet Spot. The Doc. set me at 14 Cm. the sleep study had me at 12 Cm., By using the software, I found the spot at 15.5 CM. At 16 CM Centrals entered the picture.

The APAP changed the way finding the best pressure worked. The auto allowed me to spend 3/4 of the night at a pressure 2 or more cm. lower, more comfort, less leaks and discomfort.

It also makes a difference what interface you use, each one needs to be adjusted for it's best operating conditions. I now have my treatment pressure avg in the 12 to 13 cm range 90% of the night, the numbers are good AHI <1.1 .. With the Pro 2, I would have to go back to 15.5 CM for the same results.

If there's two ways to get there, why not take the easiest road! Jim

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Postby inacpapfog on Tue Sep 12, 2006 7:45 pm

I enjoy the ability to sleep with a machine that knows when rise to meet my pressure needs through the night! Like Goofproof points out, a straight cpap keeps prescribed pressure going the complete night. As an apap user, I spend less than 20% of my time at my prescribed pressure. Less pressure through the night means less aerophagia for me!!!


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GoofyUT
 
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APAP

Postby GoofyUT on Tue Sep 12, 2006 7:52 pm

More than anything else, an auto-titrating machine will blow the LOWEST pressure that you require to maintain patency of your airway, throughout the night and as such, generally improves compliance (usage) significantly.

APAPs are not thought to be a good idea in certain cases, such as those with a history of heart failure for which the increased pressures that an APAP may get to may aggravate the occurence of central apneas or Cheyne-Stokes respiration (CSR) that oftern accompanies heart failure. For those, ResMed's new VPAP ADAPT ASV or Respironics' HeartPAP may be better choices.

For the rest of us, auto-titrating machines have provided greater comfort and therefore, more complaince in most cases, though there are those that will continue to sleep better with constant pressure from a CPAP. BTW, every model APAP can be set to run in CPAP mode. CPAPs CAN'T be set to run in APAP mode, however.

There are dramatic differences though, in the ways that APAPs from the different manufacturers perform, however. So, you will find that you'll do better on one brand or the other, and you OUGHT to do what you can to at lkeast try the variety of different brands until you find the one that works best for you.

For example, REMStar Autos are universally revered here. But they are NOT for everyone. They tend to be slower in responding to SDB events, and so, these events can cause arousals. ResMeds are very quick and aggressive in their response, but this aggressive attack tends to arouse some folks resulting in poorer sleep. So, make sure that you insist that you be given the opportunity to try them out to find the one that works best for you, if at all possible.

Hope this helps.

Chuck


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Wulfman
 
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Re: why go to a autopap

Postby Wulfman on Tue Sep 12, 2006 7:57 pm

bank4cat wrote:i have a remstar pro2 with cflex, i am curious about the auto machine...does the auto make better numbers and overall theropy or just more comfortable.


Are you currently monitoring your therapy with software?
There's nothing wrong with the machine you have.
If you've got the extra cash and want to buy a second machine, then I would say get the Auto (not the M version). If you're thinking about replacing the Pro 2 with an Auto, then I would say "Why bother?"

Den

(4) REMstar Autos w/C-Flex & (6) Pro 2 CPAPs w/C-Flex - Pressure Setting=12 cm (straight CPAP)
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Pirate
 
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Postby Pirate on Wed Sep 13, 2006 5:53 am

I originally had the Remstar Plus machine. My titrated pressure was 14. After several years of use, I began to feel like the machine wasn't blowing as hard, so I bought a manometer. It tested at 11. I reset the machine to 14 using the manometer which was 17 on the machine, but the pressure was too high and I couldn't sleep. So I bought a new Remstar Auto w/ Cflex and set the parameters to 11 - 17. Since May 30, my average pressure is 11.2 and the 90% pressure is 11.6. The pressure graph in Encore Pro indicates an almost rythmic pressure wave between 11 & 12 all night long and it's never gone above 14.

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Snoredog
 
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Postby Snoredog on Wed Sep 13, 2006 10:45 am

The RemstarPro2 is a good machine, it records sleep data just like the Auto.

Depending on what pressure you are at, autopap can result in lower pressure used throughout the night. If you only need 10-minutes worth of high pressure for the night that is all it supplies then it drops back down to the Min. pressure setting.

If your current pressure is around 10cm or less you would not see any benefit over your Pro machine. If your pressure is like 15cm, then you could benefit from the autopap.


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Recovering from titration

Postby arthuranxious on Wed Sep 13, 2006 2:42 pm

I had my first ever titration study last night.... a mixed experience. My suggestion that because I have a beard I might have less leaks with nasal pillows was accepted and I was tested with a Swift. Not bad, not perfect but didn't leak and didn't hurt although comfortable would be an overstatement. They asked me to sleep on my back because my supine index of apneas was 52 at the diagnostic study. I tried, didn't fall asleep, or so I thought. After an hour or so I turned on my side,my usual sleeping position, and was half asleep. At 2:00 a.m. I began to panic that I would never fall asleep, sat up and asked for help "Couldn't I have sleeping meds, I don't want to be up all night?" Supervisor called, I admitted that I have never taken sleeping pills in my life, and she said, you have been sleeping very nicely until a few minutes ago, just go back to sleep." Eventually I slept fairly well and woke up thinking it was morning but when I looked at my watch it was 10 to 5. A few minutes later, my hose began making horrible noises, and I called the tech. He said its just water in your hose, opened the hose and poured it out. (Why hadn't he heard it if he had really been monitoring me?) After that I dozed on and off, hearing the people coming out of other rooms and so on, but stayed in bed like a good boy until the tech came in at 7:30... I was too tired to move anyway.
Breakfast came I was too exhausted to eat or even sip lukewarm decaf. I went back to bed but couldn't sleep, felt like after transatlantic trip.
Tech asked, did you sleep well? I said no, he marked down Patient seems well rested, patient says slept worse than at home.
ANyway they have me down for 7 cm. and I wonder if I didn't really sleep normally, why would I rely on their estimate, don't I have to get an automatic?


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Postby chdurie2 on Wed Sep 13, 2006 8:32 pm

arthur--

please check your pm.

caroline

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TheWife
 
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Postby TheWife on Thu Sep 14, 2006 11:16 pm

Goofproof wrote:It's all about options, With the Pro 2, you can get most of the answers to treatment you need, if you invest in the software and reader, lot's of others out there aren't so fortunate.


How much does it cost to get setup with software? We're in Canada, and my husband is on a trial with a DME supplier, and he's got a RemStar C-Flex machine now, but we don't have the software to read it. The guy at the store said it would cost about $1000 by the time we bought the software, cables, card reader etc. That sounds insane!

What other option is there to read the data? Go back to the store every time for them to download it? Are there machines where you can read the data directly from the machine without purchasing software?

Theresa


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cflame1
 
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Postby cflame1 on Fri Sep 15, 2006 5:26 am

you can get the software and the reader from cpap.com for less than
$200


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Postby oldgearhead on Fri Sep 15, 2006 5:35 am

How much does it cost to get setup with software? We're in Canada, and my husband is on a trial with a DME supplier, and he's got a RemStar C-Flex machine now


Theresa - The software/reader package is 170 USD from CPAP dot com.
I believe there is little restriction on sending Respironics products to Canada. However, I think ResMed products cannot be sent to Canada.

You MUST have one of these units and a 'Smart Card' or the software
is of very little value:
RemStar Pro 2 (plain Pro won't work)
RemStar Auto w/C-Flex
RemStar 'M' Pro
RemStar 'M' Auto


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oldgearhead
 
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Postby oldgearhead on Fri Sep 15, 2006 5:41 am

...does the auto make better numbers and overall theropy or just more comfortable.


Re-read GoofProof's post on this subject. His battle at high pressures is
more commendable than the rest of us at 7 - 12 cm/H2O.


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Postby TheWife on Fri Sep 15, 2006 10:16 am

oldgearhead wrote:You MUST have one of these units and a 'Smart Card' or the software
is of very little value:
RemStar Pro 2 (plain Pro won't work)
RemStar Auto w/C-Flex
RemStar 'M' Pro
RemStar 'M' Auto


Right now, he's trying out a RemStar C-Flex. Is the Smart Card the little card that I see inserted into the side of the machine? Does the software install on a PC? Without the software, I guess that extra feature is useless?

$200 to $1000 is a huge markup, even with the exchange rate to Canadian $$. And I don't think my insurance company would pay for it.

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Last edited by TheWife on Fri Sep 15, 2006 11:54 pm, edited 1 time in total.

snoregirl
 
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Postby snoregirl on Fri Sep 15, 2006 10:20 am

I don't think that there is such a thing as just a Remstar Cflex

It would be Remstar Pro or Remstar Pro2 or Remstar Plus or Remstar AUTO

There is a red (I think that is the color) word after Remstar on the machine. That will tell you if it can use software. Just Pro or Plus can't. Pro2 or AUTO can.

The software goes on the computer. The slot is for the smart card. Think of the smart card like the card that you put in a digital camera. You take it out and read it on your computer with the card reader and software. All the current Remstar macines have the smart card, but only the Pro2 and Auto (from the older series non-M) have the ability to collect data more than just straight compliance -- hours used).

$170 US is the price at CPAP.com. not $1000
The $170 is total for the card and reader

First you have to determine which model of Remstar you have to see if you can use the software.

You are very right, it is doubtful if insurance will pay for software



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