choosing a BiPap

[winkin']

I'm trying to decide between the PR System One BiPap w/AutoFlex and the new ResMed AirCurve VPap (BiPaP)
I'm not a "consistent breather" and I toss around a lot. My study put me at a "6" but I'm in the 11-13 range. I had to turn off the ramp because I wasn't getting enough air. Used multiple masks but haven't found the right fit yet. I'm a mouth breather. Went from the Sullivan chin strap (a joke) to the premium which always ended up on the floor. Full Face masks claustrophobic.
I've been using the Air Sense 10 For Her and though it's the best of the bunch so far, I still can't get a normal breathing rhythm cycle. I wake up frequently (despite the good readings) and actually feel worse with it.
This is my third (and last) attempt at C Pap therapy. I really want this to work. If any one who's had these problems, has found relief with one of these machines, I'd like to hear..particularly 1) pros/cons 2)smooth, natural switch between the inhale/exhale, 3) quietest 4) best data (compatible with Mac)
Thanks for any input. I need to decide ASAP. Please be kind in your responses.

[JDS74]

I'm trying to decide between the PR System One BiPap w/AutoFlex and the new ResMed AirCurve VPap (BiPaP)
I'm not a "consistent breather" and I toss around a lot.

Could you elaborate a little on what "consistent breather: means?

My study put me at a "6" but I'm in the 11-13 range. I had to turn off the ramp because I wasn't getting enough air. Used multiple masks but haven't found the right fit yet.

Do you mean pressures of 11-13 cmH2O rather than an AHI of 11 to 13? A common problem with using the ramp function. It starts too low and gives the feeling of not enough air.

I'm a mouth breather. Went from the Sullivan chin strap (a joke) to the premium which always ended up on the floor. Full Face masks claustrophobic.

If you cannot use a full face mask due to claustrophobia, consider the Oracle 452 oral mask. Check out my link in my signature block on my experiences with this mask. I, too, am severely claustrophobic and this is the mask that solved that problem.

I've been using the Air Sense 10 For Her and though it's the best of the bunch so far, I still can't get a normal breathing rhythm cycle. I wake up frequently (despite the good readings) and actually feel worse with it. This is my third (and last) attempt at C Pap therapy. I really want this to work. If any one who's had these problems, has found relief with one of these machines, I'd like to hear..particularly 1) pros/cons 2)smooth, natural switch between the inhale/exhale, 3) quietest 4) best data (compatible with Mac)

The difficulties with the "breathing cycle" is one of the reasons I chose Philips Respironics instead of ResMed. When I first started, I read many comments that the ResMed machines seemed to "force the change" from exhale to inhale too soon while the Respironics was "smoother'. I never had any of that feeling while using the Respironics Auto BiPap machine model 750 (current model for the Auto BiPap is the 760. I'm now using the Auto BiPap ASV advanced model 960)

Chin straps with any type of full face mask or oral mask can induce additional obstructive events because they tend to move the jaw slightly backwards. A better solution is a soft cervical collar that just supports the jaw when the facial muscles fully relax when asleep. Jaw drop while using a nasal mask is helped with either a chin strap or a cervical collar as the jaw positioning has little effect for nasal masks.

Thanks for any input. I need to decide ASAP. Please be kind in your responses.

[SewTired]

I can't answer most of your questions. The word you are seeking to describe this type of machine is bilevel. Bipap is just Respironics name for their machine. My brother has the latest Respironics bipap and it is very quiet. His mask is louder I think due to the higher pressure although he received a replacement cushion for his Fisher and Pakel full face mask yesterday and that was very quiet. Apparently they updated the cushion design.

Sleepyhead works on the Mac and reads my brothers machine just fine. I also have Resrionics app on my I touch and have no problems with that.

That's the total knowledge I can give you. I know zip about Resmeds bilevel. Hope this helps.

[winkin']

Hi JDS,
I guess it does sound rather funny to say "not a consistent breather" What I mean is that my breathing pattern (inhale/exhale) tends to change..sometimes I take longer breaths, some shorter. sometimes I barely move at night and sometimes I'm all over the place. The sleep study only shows one night. I think one of the problems is that even on the apap, my breathing felt too structured. I was constantly awakened and felt more tired when using it. (Then again, last night without it, I woke up gasping for breath-again not something I experience every time without the machine, but enough that I'm willing to give this third time (years apart) my best effort.
The numbers referred to the cmH20. That's why I turned off the ramp. But my DME set it to start at 8 and even though it rose faster, it still was uncomfortable at times.
That is interesting about the cervical collar. I will check out the oracle. My next attempt was going to be The Hybrid with the built in chin cup.
I spoke with someone at the Cpap company and he recommended the respironics as well. I did like this new AirSense 10 though and wish it had worked out. I read a review about the Phillips adjusting the IPAP & EPAP independent of each other but then I read about the very smooth transition with the AirCurve.
Is the 960 for a specific problem? I'll have to check the one I'm interested in. I think it's the System One with Auto flex , not the one that says "pro".

[winkin']

Thank you for your input, Sew Tired.

[Sleeprider]

I don't think you can go wrong with either the PRS1 760 or the Aircurve VPAP auto. Both are very quiet comfortable machines. A 960 is a servo-ventilator and is intended for patients that have central sleep apnea and need a timed backup to cause a breath when they don't take one. Unless you have serious central sleep apnea, I don't think you could justify the cost.

Bilevel therapy allows you to set a lower expiration pressure (EPAP) that is sufficient to prevent OA, then a separate inhalation pressure that resolves H and RERA. The Philips and Resmed machines work a bit differently. Philips Auto BiPAP you set the EPAP, minimum and maximum pressure support (PS) and maximum IPAP. The range of PS can change through the night so that as EPAP rises in response to snores and flow limitations to prevent OA, the total pressure support may vary. As a result EPAP and IPAP move independently. So with PRS1 Auto, using a PS of 4.0 to 8.0, EPAP and IPAP may be anywhere from 4.0 to 8.0 cm apart.

With Resmed Vauto, the PS is a set pressure difference. So with a PS of 4.0, EPAP and IPAP are always 4.0 cm apart. Resmed uses EasyBreath, and Respironics uses BiFlex. Telling you which one is "best" is futile. Both are good, and IMO better than CPAP or APAP. In my case, I can get very good treatment for AHI with an Auto CPAP machine, consistently less than 1.0 AHI; however I end up with a RERA index of 1-3. This leaves me less rested than the treatment I experience with Bilevel that treats me to a 1-3 AHI (mainly CA), but less than 0.5 RERA. Everyone is different, and you'll have to figure out what works for you.

Disclaimer: My experience is with PRS1 machines. If I inadvertently posted any incorrect information about the Resmed machine, then the correction to be posted soon by PaleRider is correct.

[winkin']

I don't think you can go wrong with either the PRS1 760 or the Aircurve VPAP auto. Both are very quiet comfortable machines. A 960 is a servo-ventilator and is intended for patients that have central sleep apnea and need a timed backup to cause a breath when they don't take one. Unless you have serious central sleep apnea, I don't think you could justify the cost.

Bilevel therapy allows you to set a lower expiration pressure (EPAP) that is sufficient to prevent OA, then a separate inhalation pressure that resolves H and RERA. The Philips and Resmed machines work a bit differently. Philips Auto BiPAP you set the EPAP, minimum and maximum pressure support (PS) and maximum IPAP. The range of PS can change through the night so that as EPAP rises in response to snores and flow limitations to prevent OA, the total pressure support may vary. As a result EPAP and IPAP move independently. So with PRS1 Auto, using a PS of 4.0 to 8.0, EPAP and IPAP may be anywhere from 4.0 to 8.0 cm apart.

With Resmed Vauto, the PS is a set pressure difference. So with a PS of 4.0, EPAP and IPAP are always 4.0 cm apart. Resmed uses EasyBreath, and Respironics uses BiFlex. Telling you which one is "best" is futile. Both are good, and IMO better than CPAP or APAP. In my case, I can get very good treatment for AHI with an Auto CPAP machine, consistently less than 1.0 AHI; however I end up with a RERA index of 1-3. This leaves me less rested than the treatment I experience with Bilevel that treats me to a 1-3 AHI (mainly CA), but less than 0.5 RERA. Everyone is different, and you'll have to figure out what works for you.

Disclaimer: My experience is with PRS1 machines. If I inadvertently posted any incorrect information about the Resmed machine, then the correction to be posted soon by PaleRider is correct.

Thanks, Sleeprider.
You've lost me a bit at the end but then again my machine uses MyAir to track me and it's nowhere near as informative as sleepyhead, which I hope to install with the new machine. That is if my insurance approves a bi-level. Then computer-challenged me will deal with trying to figure out sleepyhead..and finding a good mask.
So far I'm leaning towards the PRS1.

[palerider]

particularly 1) pros/cons 2)smooth, natural switch between the inhale/exhale, 3) quietest 4) best data
.

1. the resmed vpap will feel more like what you are used to, and it is the most adjustable if you need something other than generic bi-level support.
2. the resmed is as smooth as what you're using because they use the same pressure shaping routine.
3. resmeds are typically a bit quieter than respironics
4. they have comparable data.

your current machine works with sleepyhead, it would be incumbent on you to get sleepyhead and ditch myair, you might not need a bi-level if your current treatment was optimized.

[winkin']

Thanks palerider.
I'll take this into consideration.