Help us choose a BiPAP auto machine!

Hello!

My husband has had sleep apnea for years. He had a sleep study years ago when we had health insurance, and they diagnosed him with mixed sleep apnea - both obstructive and central. The doctors told him that a CPAP wouldn't do him much good, so he's managed it with sleep positioning (sleeping on his side) and with my vigilance in shaking him every time I noticed him not breathing in the night. It worked fine in the early years of our marriage, but lately he's needed more; I don't know if his long lack of oxygenated sleep is catching up to him lately or if his apnea has changed, or maybe it's because I'm sleeping more deeply at night and so I'm not helping him to breathe as much as I used to. In any case, a friend of ours who also happens to be a doctor wrote him a prescription for a BiPAP auto machine, and said that the BiPAP will do him more good than a CPAP.

I am amazed at the myriad of options and price ranges on these machines! So tell me what options you like in your machine and what you don't think is worth the money. We can afford anything we need but would like to be wise with our money and not spend lots of money unnecessarily.

Thanks!
Miranda

Welcome to the forum.
For obstructive apnea with only a few centrals...
Take a look at the PR System One 60 series BiPap Auto model 760 that I have shown in my profile. It has a heated hose option which comes in handy. It's the latest in the Respironics bilevel machine models.
Full data which you will need to evaluate the therapy as well as easy to obtain and use software (free).

The ResMed S VPAP Auto is also a great machine but it costs a lot more and to be honest..not worth the difference in cost.
I happen to have owned and used both brands in the bilevel machines and some minor pros and cons with each but none are deal breakers.

Get the Auto adjusting pressure version of whichever Bilevel (bipap is Respironics brand name for bilevel pressure machine) machine you decide to get. It had 3 modes of operation in it where the fixed bilevel machine only has 2 modes of operation.
Auto adjusting comes in handy a lot of the time.

In the bilevel machines....concentrate only on the PR System One model or the Resmed S9 model...don't bother with any other brand bilevel machine. These 2 brands are the best.

How many centrals are we talking about in your husband's past history? If a significant number was your doctor friend thinking one of the special bilevel machines for centrals and obstructives? If so then those are in the ASV model line.
What does the RX say?

It would be helpful if you posted what the scrip says.
If its for a 'plain' auto BiPap machine it should say something like
Min EPAP = nn.n
Max IPAP = nn.n
PS = n.n

If its for an ASV type machine, there will be additional parameters and it won't mention IPAP.

Another vote for the PR System One 60 series BiPap Auto model 760; though if your husband has never had any CPAP therapy experience, is this doctor friend who wrote a script prepared to shepard him through finding the right settings? You can do this yourself with the PR system one (I found out that instead of 11/14, my pressure needed to be 15/18 to feel any difference in the morning), but there will be a learning curve and you'll have to realize this may take 3-6 months of patience (and maybe hatred of the thing).

Not to overcomplicate things, but I have found, in my experience, two other important differences between the two machines. I should also add that, just like your husband, I have moderate SA and some centrals (during my last sleep study, I had nothing but central events, but I was half awake during the whole night). Those are: the ability to adjust the trigger sensitivity and the different treatment of auto mode.

The former was the deal-breaker for me and the reason I had to switch to the ResMed: with the latter I am able to choose from 5 different levels of trigger sensitivity (I'm currently using the highest), while with the former, there is no adjustment, at all, and it is way too low for me. A couple of other related settings on the ResMed also helped a lot (e.g., duration of inhalation).

The differences in auto-mode between the two are subtle: it comes down to what limits can be set. The bottom line for me was that neither worked, so I'm using it in spontaneous mode. I believe on the PR-S1 you cannot set the pressure support at all: it would start at 2 cm H2O and change it as it sees fit. With my condition (not sure about your husband's) I cannot tolerate a small pressure support (kind of why I need a dual-level CPAP in the first place). However, even though with the ResMed, you can set the pressure support, you cannot set the starting pressure, which makes it start way too low for me (I'm at 10 EPAP / 16 IPAP). Or something like that, the point is, there are some other significant differences that you might need to consider, too.

Maybe a good way to decide would be to obtain the clinician's manuals for both and reading through them.

McSleepy

McSleepy wrote:I believe on the PR-S1 you cannot set the pressure support at all: it would start at 2 cm H2O and change it as it sees fit.

Not true . The new PR S1 760 in auto mode no longer has that 2 cm default up to whatever max is set. It now allows a minimum and maximum pressure support in auto mode and in fixed bilevel mode PS is obviously going to be fixed at whatever the difference is between EPAP and IPAP.
They have always allowed a PS maximum in auto mode but they did default to 2 cm when starting out the night...so pressure support has always been available on the PR S1 BiPaps.
Now with the 760 model it allows that minimum PS to be set also. Makes it quite nice. That's why I bought one.