Is changing S8 Escape II Auto from CPAP to APAP bad?

[Veridor]

Here's the numbers from my sleep study:
AHI: 175.7, broken down as follows:

77 OAs, 20 mixed apneas, 83 central apneas, 252 hypopneas, with a total of 432 respiratory events.

[DreamOn]

Since you have so many central apneas, you may want to see if you can get your ResMed S8 Escape II Auto exchanged for a ResMed S9 AutoSet machine. Perhaps your doctor can help you obtain that (with a machine-specific prescription) if the DME gives you any problem. The same insurance billing code is used for all CPAP and APAP machines, but often the DME is looking to make the most profit so they give you the more basic machine. Especially with your very severe, complex sleep apnea, you and your doctor NEED the data!

The new S9 machines (which just came out this month) can report central apneas, as well as obstructive. The S8 machines cannot. Another nice feature of the S9 machines is that they have climate control (ClimateLine tubing is optional).

[ifrimmel]

Here's the numbers from my sleep study:
AHI: 175.7, broken down as follows:

77 OAs, 20 mixed apneas, 83 central apneas, 252 hypopneas, with a total of 432 respiratory events.

As I understand AHI it is a function over time - i.e. the period over which these events happened - It seems you only slept less than 2.5 hours. Not really a fair indication .. I am guessing this is your first sleep study .. what did they do on your 2nd sleep study ?

[Veridor]

I only had the single, split study, at my doctor's request, as I was at the point of nodding off while driving. They woke me up 2.5 hrs into the study and started CPAP titration.

[ifrimmel]

Since you have so many central apneas, you may want to see if you can get your ResMed S8 Escape II Auto exchanged for a ResMed S9 AutoSet machine. Perhaps your doctor can help you obtain that (with a machine-specific prescription) if the DME gives you any problem. The same insurance billing code is used for all CPAP and APAP machines, but often the DME is looking to make the most profit so they give you the more basic machine. Especially with your very severe, complex sleep apnea, you and your doctor NEED the data!

The new S9 machines (which just came out this month) can report central apneas, as well as obstructive. The S8 machines cannot. Another nice feature of the S9 machines is that they have climate control (ClimateLine tubing is optional).

REPORT. Not fix. CSA needs specific diagnosis and hardware. He should be working with his doctor. S9 is not the answer.

[Veridor]

So I shouldn't get the S9, even to monitor CSA's?

[Veridor]

The thing is, I still had some CSA's after being titrated to 12 cm in the treatment part of my study.

[ifrimmel]

The point here is.. HOW DO YOU FEEL !!???

If you feel fine.. then .. you are done (or at least know what you need to do ) . Stick to it ! Live on and be happy ..

If life still sucks .. then .. a call to the doc is in order.

[Veridor]

The point here is.. HOW DO YOU FEEL !!???

If you feel fine.. then .. you are done (or at least know what you need to do ) . Stick to it ! Live on and be happy ..

If life still sucks .. then .. a call to the doc is in order.

I feel ok, but I am just concerned that I had so many CSAs and want to make sure that's getting addressed too, along with mouth or mask leak I may be unaware of, as I'm not quite as chipper as I was after the study night.

[JohnBFisher]

... I feel ok, but I am just concerned that I had so many CSAs and want to make sure that's getting addressed too, along with mouth or mask leak I may be unaware of, as I'm not quite as chipper as I was after the study night.

I think you really should have a unit that helps you track your therapy. You've already noted why. You were on the point of nodding of while driving. You are abosolutely correct that you should monitor leak rates, as well as you AHI value. You want a unit that will provide as detailed data as possible.

You will almost certainly get some grief from your DME and possibly even your doctor.

Present them with this analogy. How are diabetes and sleep apnea similar? They are both chronic conditions that require therapy for life.

How do they differ?

Well, if you have Type 2 Diabetes, your doctor and the medical community "gets it". They understand that you need to monitor your blood glucose level and be certain it stays in a healthy range. They understand that untreated high blood glucose will lead to serious, life threatening complication.

Unfortunately, if you have sleep apnea, your doctor and the medical community may not "get it". In fact, they often don't want you to see the data. But the same situation exists. If your sleep apnea is not well managed, then the risk of complications is just as life threatening. In fact, I would say the excessive daytime sleepiness that you exhibited is even more life threatening. And it might just be due to a problem with mask leaks of which you are unaware if you do not have a machine that can help you track your therapy.

Remind your doctor and DME of the potential consequences of being unable to adequately manage your therapy. That should move them off their collective duff.

By the way, it is not unusual to find you don't feel quite as chipper after that first night. It is such a night and day difference that that first night is HEAVENLY. Almost 20 years ago I wnated to walk out of the room with the unit they used for titration. I did not care what it took. I *HAD* to have one of those units.

And just this past December I wanted to do the same thing again. I was titrated on an ASV unit (to address my Central Sleep Apnea) and I was ready to walk out wiht THAT unit. The first decent night of sleep in months, if not years.

But it's not unusual to need to struggle to get stable sleep after that first night.

Since you had a split night study, it should include information about the apneas once the CPAP was applied. If you continued to show central apneas afterward the use of centrals you are definitely correct you should monitor that. Often the use of CPAP by itself will allow your brain to better regulate your breathing. It is possible it is more connected with your body responding to the obstruction than it is some other underlying problem. But without any monitoring you will not be able to see if it is an issue.

Anway, do stick around. Hopefully we will be able to help you answer questions as you continue along this road.

[DreamOn]

Since you have so many central apneas, you may want to see if you can get your ResMed S8 Escape II Auto exchanged for a ResMed S9 AutoSet machine. Perhaps your doctor can help you obtain that (with a machine-specific prescription) if the DME gives you any problem. The same insurance billing code is used for all CPAP and APAP machines, but often the DME is looking to make the most profit so they give you the more basic machine. Especially with your very severe, complex sleep apnea, you and your doctor NEED the data!

The new S9 machines (which just came out this month) can report central apneas, as well as obstructive. The S8 machines cannot. Another nice feature of the S9 machines is that they have climate control (ClimateLine tubing is optional).

REPORT. Not fix. CSA needs specific diagnosis and hardware. He should be working with his doctor. S9 is not the answer.

ifrimmel, just to be clear, I didn't say that the S9 or other CPAP/APAP machine would fix CSA. His doctor has prescribed an APAP machine at this point. Veridor definitely needs to be working closely with his doctor. His current machine (S8 Escape II Auto) can report no useful data. I believe that a machine capable of reporting full data will help him determine if leaks are a problem and can give his doctor the data needed to determine if another type of machine will be more appropriate as a next step.

In Veridor's initial post on this thread he stated "I'm also in the process of trying to have the DME give me an efficacy-data-capable machine," so I was addressing that. We're talking APAP machines here, since that's what his doctor has prescribed. I like the way the S9 AutoSet breaks down the data, and I think the climate control is a nice feature. The S8 AutoSet II is also a terrific ResMed APAP.

[sleepycarol]

The Escape II Auto does provide limited data other than compliance via the screen. You must do it before noon as it is wiped out at noon. It does NOT store the data on the card so a card reader and software are useless.

It will show AI and AHI. I would suggest that you start writing these down to at least keep track of those. I would assume that those numbers will rise if you have leakage (although it would be ideal if it showed this as well).

My son-in-law has the machine you have and (although I recommended he change it to an Autoset II) loves it. He has access to my M series apap when he wants full data he can borrow it for a short while. I would suggest try to upgrade to the Autoset II, if possible. It gives more detailed data and does save the info to the card so that it can be downloaded later (much better in my opinion).

At least the Escape II Auto does provide very limited data, at least it is a step in the right direction. Now no flames please. I feel ALL machines need detailed data, but for now some data is better than no data and apparently manufacturers aren't going to make all machines fully data capable (shame on them).

[LinkC]

Scroll up and read carefully what John said!

It seems to have been lost in the flurry of "what model machine should I get" discussion. If your doctor is competent and interested, he's the best source to determine machine specifics/capabilities. Your first job, as John suggested, is to MAKE him interested (if he isn't). Then your second job is to educate yourself on the specifics of YOUR case (with your doctor is preferred...but without his help if necessary.) HINT: If you have to elicite help from anonymous strangers on a message board who know nothing about your case except what you've told them, you probably need more education to make informed decisions. But it's your life...

[Veridor]

Scroll up and read carefully what John said!
HINT: If you have to elicite help from anonymous strangers on a message board who know nothing about your case except what you've told them, you probably need more education to make informed decisions. But it's your life...

That's a bit harsh, isn't it? I thought the whole point of sites like this was to provide a source of experience and knowledge. I'm trying daily to learn more about my case, and the fact I have CSAs in addition to OSAs made me concerned I might need a more data-capable machine.

[JohnBFisher]

... That's a bit harsh, isn't it? I thought the whole point of sites like this was to provide a source of experience and knowledge. ...

LinkC really does want you to see the full benefits of therapy. He did not intend for it to be "harsh". Rather he's pointing out from his experience and the experiences of folks such as me. What he recognizes is that in addition to the type of machine you also need to understand how to guide your therapy. Sounds crazy, but it often takes just that for us to get the best possible outcome.

Anway, everyone here hopes you continue to have good results, adjust well to therapy and are able to get a unit that will help you effectively monitor your xPAP therapy.