Back On The Resmed S8 Elite

Yup. Bundled up my Resmed S8 AutoSet Vantage and tucked her away as my backup machine. At least for the time being.

Had my first appointment w/a sleep neurologist for a second opinion regarding my continued fragmented sleep.

Actually, only saw her Nurse Practitioner and the gal who does the BP, pulse, weight, height, etc. Which I wasn't too impressed about.

On the other hand her NP was very thorough, a good listener, patient in explaining things, did the reflexes, balance, tuning fork, etc. tests. And gave me a list a mile long of blood tests to be done. What's more she actually HAD gone thru the medical records they had requested and had no problem referring off the top of her head to the year and major results of previous sleep & titration studies, etc. THAT alone was impressive. Most of the time I wonder why doctors even insist on previous medical records when its obvious they never even looked that them much less read any of them!!!

She did bring up the PLMs and mentioned a med we might consider - but she said it took about 3 months for the med to show any positive results. I told her I wasn't impressed. Save it until we explore all other avenues. She was okay w/that. We don't even know if the CPAP therapy reduced or eliminated the PLMs since I had so little titration sleep. Out of 3 sleep evaluations and 3 titrations only one sleep evaluation indicated any really excessive PLMs. And that was back in 1998.

This office has the software for Respironics but not the Resmeds so I had to take my data cards from my Elite and my Vantage to my 02 DME supplier to download and FAX to her office. (My sleep lab/sleep pulmo has the software for Respironics and Resmed. I don't know about any others.)

So, I'm reserving judgement until we get the results of the blood tests and she's had a chance to go over the downloads and our next appointment. I"m not too impressed that this office doesn't have the Resmed software, this sleep neurologist has been in practice in this area since at least 1998. She doesn't have her own sleep lab but still ....

Anyway, the NP suggested that she/they would prefer I go back on the Elite at the 8 cms at least until our next appointment. I really wasn't done experimenting w/the Vantage since I was holding to a week at each setting and only had 12 nights on it at two slightly different settings (6-11 cms & 7-11 cms) ... but since I wasn't noticing any improvement and higher HIs, tho the AIs were as good, I'm gonna be a good girl (for the time being) and I have my Elite buddy all ready to go tonight.

Just curious, why did you go back to the Elite, doesn't the Vantage have the ability to run in straight CPAP mode. I have been contemplating an Auto with the thought that it could be switched back and forth from auto and CPAP mode.

Slinky,

An S8 Vantage set to CPAP mode is exactly what an S8 Elite is.

These are the same physical machine but the Vantage has extra software but when the Vantage is set to CPAP mode it is running the same software as the Elite.

Both also run the EPR feature the same when in CPAP mode.

Good luck

DSM

Thanks, Doug. Yup, I knew and know that the Vantage can be run in CPAP mode. But, the Elite is still a capped rental via insurance until Sept or Nov of this year so I need to use it in case they want to know about compliance again before the capped rental is over and it belongs to me free and clear.

Sorry to confuse you, 6PtStar. I should have been clear WHY I was going back on the Elite instead of putting the Vantage in CPAP mode.

What they said. I would also speculate (as others here have) that some people actually have their sleep disturbed by the variations in pressure that an apap produces in its attempt to kill apneas. On the other paw, it will usually run at a lower pressure for most of the night than a cpap will, which may make for more comfortable sleep overall for some people.

People differ, and you will never know which is best for you unless you try them both. The beauty of the apap (and I DO like my Vantage) is that it allows you to try both, and if one works better for you, you do not have the hassle or expense of getting another machine.

I would use the Vantage as my regular machine, and keep the Elite in reserve or use for travel, if you find that straight cpap works better for you... just run the Vantage in cpap mode.

Good luck!

Ha, BookBear!!! We were posting at the same time and I beat you to the Submit key.

Your advice is good, but as I said, there's the ole insurance/compliance issue for the Elite. Don't wanna lose it! The Vantage is a self-pay.

Thanks for the good wishes.

I don't think you will notice any difference. The Vantage is going to find your 95% pressure and spend most of the time there anyway just like the Elite in CPAP mode, at least you'll be able to use EPR if you can tolerate it, but if you have any events even that will be disabled during those periods.

If your Neuro thinks the machine is the cause of your EDS I'm afraid they are again just throwing a dart and hoping they get lucky.

If you had other events on your PSG such as PLMD or spontaneous they should be looking at those instead of the machine. Your case is nothing new, they only know how to treat the easy obstructive SDB events, get beyond those and they are clueless. But at least a Neuro would be willing to try off label anti-seizure drugs to control the PLM's, but if there was one don't you think you would have read about it by now if it was effective?

Here try this new fangled XYZ drug for 3 months, if that doesn't work we have another one to try and if that one doesn't work we have yet another. Fact is none of them drugs really work long term, once your body becomes accustomed to it that new drug won't be effective any longer either.

If you have any spontaneous arousals seen on that report, I would try a GERD therapy approach with a medication like Prilosec to see if it lowers the number of those events seen, but the only way you'll know if that is effective is by having several PSG's and a strictly controlled diet during each one, would be difficult to achieve.

Snoredog wrote:I don't think you will notice any difference. The Vantage is going to find your 95% pressure and spend most of the time there anyway

That might be so in Slinky's case, considering the rather tight ranges Slinky was using while in auto mode.

One little clarification for the benefit of new readers who might be using software with any of the autopaps and might wonder what the 95th percentile pressure means (90th percentile when using Respironics or PB machines.) That percentile pressure number doesn't mean the machine spent 95% of the time AT that pressure. It means the machine spent 95% of the time AT OR BELOW that pressure.

Most of the time, if a person using software looks at the times spent at each of the pressures in their range, the amount of time the machine used pressures below the 95th (or 90th) percentile number is much, much more time than the time spent right at that one pressure.