Hi,
I just got my new AutoSet Spirit from the fine folks at cpap.com, and I hope someone can give me a pointer on its use. In my sleep study (where I only slept 4 hours) the clinician determined that my pressure should be set at 7. At the moment, my machine's range is set at 6-8. Should I raise the upper limit of the range just in case my sleep study missed analysing some events that required more juice to eliminate? Given that the machine is supposed to determine the correct pressure, is there any danger in raising this upper limit? If so, what might be a reasonable number?
Rob
How best to set AutoSet Spirit
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How best to set AutoSet Spirit
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wading thru the muck!
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Hi Rob,
Congratulations! You and I have the same titrated pressure of 7cm. I have my auto-pap set to a minimum of 6cm and a max of 20cm. I have not had any problem with the machine going wild. I have recorded a pressure of 11cm and 13.5cm on several occasions to deal with apneas. In the couple of months I've been recording data the software indicates my pressure called for 90% of the time is 7cm. How 'bought that for accuracy. I could have saved the $4600 for my two sleep studies by just using my auto-pap from the start. Same results much less money.
I'm interested to hear how you like your Spirit, Resmed makes great interfaces and I have to believe their machines are good too. I can't wait to see the upcoming S8.
Congratulations! You and I have the same titrated pressure of 7cm. I have my auto-pap set to a minimum of 6cm and a max of 20cm. I have not had any problem with the machine going wild. I have recorded a pressure of 11cm and 13.5cm on several occasions to deal with apneas. In the couple of months I've been recording data the software indicates my pressure called for 90% of the time is 7cm. How 'bought that for accuracy. I could have saved the $4600 for my two sleep studies by just using my auto-pap from the start. Same results much less money.
I'm interested to hear how you like your Spirit, Resmed makes great interfaces and I have to believe their machines are good too. I can't wait to see the upcoming S8.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
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rested gal
- Posts: 12883
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- Location: Tennessee
I'm not a doctor, not a health care professional of any kind, nor do I have any expertise about any of these machines.
That said, my personal opinion is that if my titration was 7 cm H2O, I'd set my autopap's high at 10 or even more. Ten is widely considered a safe pressure for the vast majority of people, since studies have shown that pressure induced or runaway "centrals" usually don't occur at 10 or below, and 10 clears obstructive apneas fine for most people.
I think your Spirit (like most modern autopaps) has a built-in algorithm throttle of 10, anyway, when it senses purely obstructive apneas. So, you probably would be fine setting the upper limit anywhere you wish. I think you're correct that the greatest value of having an autopap is for automatically increasing the "juice" a bit when needed at certain times on certain nights.
I've read two schools of thought on where to set the lower pressure. Some do best when it's set as low as they feel comfortable breathing at - which is usually no lower than 6. Putting the low down at 4 or 5 make some people (me, included!) feel suffocated. Others get better results if the low is set up very close to, or at, their titration number. In your case, since the titration was 7, your present low of 6 sounds fine.
6-10 6-11 6-12 .... any of those would be my first personal experimental tweaks if I were titrated at 7. I'd feel safe trying those. If I bumped the ceiling briefly on any of those modest highs (or even didn't ever reach them) I'd feel safe upping it even more, if I wanted to.
I wouldn't worry much about variations in the data from night to night, that stayed well below whatever max I had set while trying a few different pressures. I'd go by how I felt the next morning, and I'd probably feel equally good at any of those. Let us know how it goes.
That said, my personal opinion is that if my titration was 7 cm H2O, I'd set my autopap's high at 10 or even more. Ten is widely considered a safe pressure for the vast majority of people, since studies have shown that pressure induced or runaway "centrals" usually don't occur at 10 or below, and 10 clears obstructive apneas fine for most people.
I think your Spirit (like most modern autopaps) has a built-in algorithm throttle of 10, anyway, when it senses purely obstructive apneas. So, you probably would be fine setting the upper limit anywhere you wish. I think you're correct that the greatest value of having an autopap is for automatically increasing the "juice" a bit when needed at certain times on certain nights.
I've read two schools of thought on where to set the lower pressure. Some do best when it's set as low as they feel comfortable breathing at - which is usually no lower than 6. Putting the low down at 4 or 5 make some people (me, included!) feel suffocated. Others get better results if the low is set up very close to, or at, their titration number. In your case, since the titration was 7, your present low of 6 sounds fine.
6-10 6-11 6-12 .... any of those would be my first personal experimental tweaks if I were titrated at 7. I'd feel safe trying those. If I bumped the ceiling briefly on any of those modest highs (or even didn't ever reach them) I'd feel safe upping it even more, if I wanted to.
I wouldn't worry much about variations in the data from night to night, that stayed well below whatever max I had set while trying a few different pressures. I'd go by how I felt the next morning, and I'd probably feel equally good at any of those. Let us know how it goes.
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WillSucceed
- Posts: 1031
- Joined: Sun Nov 07, 2004 7:52 am
- Location: Toronto, Ontario
AutoSet Spirit
Hi Rob:
I've talked with the engineering tech at ResMed who tells me that, no matter what you set the upper limit at, the Spirit will NOT go above 10 on an apnea so as to prevent putting pressure on what might be a central apnea. It will, however, go above 10 to treat a hypopnea or snoring.
I agree with Rested Gal (I'm also not a Dr.) in that the upper pressure limit could easily be higher so as to treat those events that the machine determines are not central but are requiring a slightly higher pressure.
I trialed, for about 10 nights each, the Respironics RemStar Auto, the ResMed Spirit and the PB 420E and am just now deciding which one to purchase.
All of them worked well, and their "reports" were very informative. My sleep Dr. (I also had a crappy 2nd study) said that I should be at a pressure of 15 which was blowing me out of bed. I complained to him that I would rather be splinted open than blasted open -hence the home auto studies.
Respironics RemStar Auto:
Reported that my 90th percentile pressure was 9.3 but that it did, on all nights, go as high as 14 for very brief periods.
ResMed AutoSet Spirit:
Reported that my 95th percentile pressure was 10.2 but that it also went up to 14 on most nights for a brief period.
PB 420E:
Reported essentially the same as the other two machines.
I think I am going to buy the ResMed because I felt best during the day after using it at night (compared to the other machines) although the PB was a really close second. The Respironics machine left me feeling tired during the day. Also, the PB is noisy -->seems to transmit the sound of the machine right up the hose to my face. I have wondered if, due to its very small size, the machine is not as well insulated or sound baffled as are the bigger machines from ResMed and Respironics.
Hope this all helps.
So tell me, what duties/taxes, whatever, did you end up paying? GST only? What did the FedEx shipping cost. I'm thinking I will use cpap.com and am very interested to hear the details of your experience. I hope you don't mind sharing this with me.
Thanks
Paul
I've talked with the engineering tech at ResMed who tells me that, no matter what you set the upper limit at, the Spirit will NOT go above 10 on an apnea so as to prevent putting pressure on what might be a central apnea. It will, however, go above 10 to treat a hypopnea or snoring.
I agree with Rested Gal (I'm also not a Dr.) in that the upper pressure limit could easily be higher so as to treat those events that the machine determines are not central but are requiring a slightly higher pressure.
I trialed, for about 10 nights each, the Respironics RemStar Auto, the ResMed Spirit and the PB 420E and am just now deciding which one to purchase.
All of them worked well, and their "reports" were very informative. My sleep Dr. (I also had a crappy 2nd study) said that I should be at a pressure of 15 which was blowing me out of bed. I complained to him that I would rather be splinted open than blasted open -hence the home auto studies.
Respironics RemStar Auto:
Reported that my 90th percentile pressure was 9.3 but that it did, on all nights, go as high as 14 for very brief periods.
ResMed AutoSet Spirit:
Reported that my 95th percentile pressure was 10.2 but that it also went up to 14 on most nights for a brief period.
PB 420E:
Reported essentially the same as the other two machines.
I think I am going to buy the ResMed because I felt best during the day after using it at night (compared to the other machines) although the PB was a really close second. The Respironics machine left me feeling tired during the day. Also, the PB is noisy -->seems to transmit the sound of the machine right up the hose to my face. I have wondered if, due to its very small size, the machine is not as well insulated or sound baffled as are the bigger machines from ResMed and Respironics.
Hope this all helps.
So tell me, what duties/taxes, whatever, did you end up paying? GST only? What did the FedEx shipping cost. I'm thinking I will use cpap.com and am very interested to hear the details of your experience. I hope you don't mind sharing this with me.
Thanks
Paul
Re: AutoSet Spirit
Paul,WillSucceed wrote:Hi Rob:
...
So tell me, what duties/taxes, whatever, did you end up paying? GST only? What did the FedEx shipping cost. I'm thinking I will use cpap.com and am very interested to hear the details of your experience. I hope you don't mind sharing this with me.
Thanks
Paul
I'll get back to you today with all the costs after I contact Fedex.
Rob
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Ok, here is what I've found out:
Both the US and Australia are members of a group of countries on Canada Customs "Best Favoured" list. Medical equipment is duty free. I haven't yet been charged GST or PST, but I won't be surprised if I get charged it later. Brokerage is included in Fedex International Priority shipping. Shipping from Houston to Toronto was 123.74 Canadian dollars. So, to sum up:
My purchase (AutoSet Spirit, HumidAire 2i, Autoscan software with bag hose and manuals, 2 bags of filters) was 927.00 US. So converting to CA:
1136.97 CA
123.74 CA
=======
1260.71 CA
VitalAire in Toronto are selling the same setup for $1925 CA.
Rob
Both the US and Australia are members of a group of countries on Canada Customs "Best Favoured" list. Medical equipment is duty free. I haven't yet been charged GST or PST, but I won't be surprised if I get charged it later. Brokerage is included in Fedex International Priority shipping. Shipping from Houston to Toronto was 123.74 Canadian dollars. So, to sum up:
My purchase (AutoSet Spirit, HumidAire 2i, Autoscan software with bag hose and manuals, 2 bags of filters) was 927.00 US. So converting to CA:
1136.97 CA
123.74 CA
=======
1260.71 CA
VitalAire in Toronto are selling the same setup for $1925 CA.
Rob
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Guest
Hey Chris!Anonymous wrote:Congratulations...Another smart shopper via the internet. Feels good to save a few bucks. looks like enough to buy a few extra masks..Don't forget the surge suppressor.
Cheers,
Chris
I'm going to prepare a shopping list of parts from your post on "poor man's UPS" and build one myself!
Rob
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Guest
Hello Spiritus,
I've just completed my 7 day test of my backup system using a PB420E. I will post my results along with a list of supplys needed. Also, I will be testing my backup with inverter using my resmed spirit soon.. Its a bit more complicated as you need a pure sine wave inverter...It must be a pure sine wave inverter ! Not modified sine wave that is sold in most stores. I plan to post tomorrow.
Cheers,
Chris
I've just completed my 7 day test of my backup system using a PB420E. I will post my results along with a list of supplys needed. Also, I will be testing my backup with inverter using my resmed spirit soon.. Its a bit more complicated as you need a pure sine wave inverter...It must be a pure sine wave inverter ! Not modified sine wave that is sold in most stores. I plan to post tomorrow.
Cheers,
Chris
10 posts
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