New Machine - Worse Results BiLevel vs Auto CPAP

[dwrek]

Hi All,

I've been 100% compliant on my Resmed S9 VPAP ST with great results for 6 years - from titration of 36 AHI with events up to 3 minutes, including centrals to <1AHI and rare centrals. Took some dialing in, but I have only had to adjust my min/max based on weight fluctuations occasionally. My aerophagia comes and goes but overall is just some discomfort and occasional wake to relieve. So overall, a very positive therapy.

Recently, noticed leaking in the humidifier and the machine making weird almost straining noises in the middle of the night and squealing/wheezing. Therapy was fine, but it seemed to be leaking from seals somewhere related to humidifier and felt like I wasn't getting as much pressure and waking me up. Tore it down, cleaned it, but no improvement. So, went to my ENT to see about getting scrip for replacement and he offered a new machine Respironics Dreamstation AutoCPAP with AFlex. My doctor sung the praises of the auto vs bilevel and that I would enjoy the benefits of this over my old machine. I decided to keep my same mask to reduce the variables during the change as it has been working fine for years.

However... I find that the machine is chasing and not preventing the more serious events and also higher AHI. I'm snoring in the mask again, waking up from big events, sweating and heart racing, which I haven't done in years and now the fog is back. I tried upping the Min and Flex on it, but that doesn't seem to help. My Doc would not prescribe an updated bi level and said I had to to prove my intolerance to the new machine first which includes an AHI greater than 6. Above 1 is not acceptable to me as I know from history that small events are not my worry and the big ones need to be avoided. Also, they don't support ResMed anymore (couldn't even read my card) so they wouldn't offer the latest model.

The only improvement is that I don't have any aerophagia any more, which I really don't care about vs the other results, so it seems like a if it ain't broke, don't fix it situation.

As I see in so many posts, the obstacle to correct therapy seems to be the doctor, but I'd like to know if anyone else move from bi-level to autocpap and have any suggestions?

Thanks,

[Pugsy]

Well for one thing the S9 VPAP ST is a totally different machine from the DreamStation Auto CPAP.

[dwrek]

Well for one thing the S9 VPAP ST is a totally different machine from the DreamStation Auto CPAP.

Agreed. Was surprised the same Doc who prescribed the S9 prescribed the DreamStation. Nothing against it as it seems like a fine machine. I suspect from numerous comments that the sleep specialist that helped me get it originally is not there anymore and when I mention the word "central" the Doc and current DME helping don't know what it means... I know previously he relied on the the sleep specialist to help out, but with Insurance companies dropping in office studies most of those people have disappeared and the MDs are relying on DME's.

[Jas_williams]

The equivalent new machine to your S9 VPAP ST is a Resmed Aircurve VPAP ST your VPAP ST is not a basic bilevel it has a backup rate which if configured appropriately can encourage you to breath and treat Central Apnoea. The new machine you have been prescribed cannot treat CA's. post a daily chart from sleepyhead and we can take a look at whats goning but I suspect you have been prescribed the wrong machine and you need to return to your doctor.

[raisedfist]

I'd fire your doctor, and then just get another S9 VPAP ST or AirCurve 10 ST used online. They operate the same so the S9 of course should be cheaper.

[palerider]

So, went to my ENT to see about getting scrip for replacement and he offered a new machine Respironics Dreamstation AutoCPAP with AFlex. My doctor sung the praises of the auto vs bilevel and that I would enjoy the benefits of this over my old machine

What utter and complete hogwash.

If you actually *needed* an ST machine before, then *only* step *UP* is an ASV.

An auto cpap is a big step *DOWN*.

[palerider]

I'd fire your doctor, and then just get another S9 VPAP ST or AirCurve 10 ST used online. They operate the same so the S9 of course should be cheaper.

I'd just buy a new humidifier for the s9, or a new silicone seal for the inside of the s9. https://www.cpap.com/productpage/resmed ... p-lid-seal

[dwrek]

The equivalent new machine to your S9 VPAP ST is a Resmed Aircurve VPAP ST your VPAP ST is not a basic bilevel it has a backup rate which if configured appropriately can encourage you to breath and treat Central Apnoea. The new machine you have been prescribed cannot treat CA's. post a daily chart from sleepyhead and we can take a look at whats goning but I suspect you have been prescribed the wrong machine and you need to return to your doctor.

Thanks for recommendation. That's what I researched too and was thinking would be best. Had to rebuild my machine recently that had Sleepyhead on it. Let me get that back on there and see.

[dwrek]

I'd fire your doctor, and then just get another S9 VPAP ST or AirCurve 10 ST used online. They operate the same so the S9 of course should be cheaper.

Yeah, not too happy at this point as I protested initially and was rejected as he told me via his staff that I needed to try and fail on the Auto CPAP first. That's what I was thinking as last resort as the ResMed seems to work and I might still struggle a bit fine tuning the Respironics ST version since they have moved to only a Respironics shop. The ins. will cover the rental up to 10 months then I own as long as compliant, so that means find something used or go find a ResMed doc.

[dwrek]

So, went to my ENT to see about getting scrip for replacement and he offered a new machine Respironics Dreamstation AutoCPAP with AFlex. My doctor sung the praises of the auto vs bilevel and that I would enjoy the benefits of this over my old machine

What utter and complete hogwash.

If you actually *needed* an ST machine before, then *only* step *UP* is an ASV.

An auto cpap is a big step *DOWN*.

Yeah, I was skeptical, but was willing to try it just in case the machine was as advertised Also, the real world results have now been proven - at least to me so I can go from here with some facts.

[dwrek]

I'd fire your doctor, and then just get another S9 VPAP ST or AirCurve 10 ST used online. They operate the same so the S9 of course should be cheaper.

I'd just buy a new humidifier for the s9, or a new silicone seal for the inside of the s9. https://www.cpap.com/productpage/resmed ... p-lid-seal

Thanks - I was thinking about rebuilding it a piece at a time, but was looking at the whole machine as it's got 6 years on it now and would be good just to replace all if I can get some covered by ins. My insurance situation may change significantly in next few months so good to see if I can cover any big expense now. Thanks for the link, may do that until I get all this sorted.