Seeking recommendation on new APAP

[jskinner]

Hello everyone. Most of you probably won't remember me but I used to be a regular here. Sadly in 2011 I was injured in a nasal surgery and haven't been around since then. You can read more about my story at nasalcripple.com. I'm very grateful for all the support I received on this forum way back then.

In 2015 I underwent another surgery that has allowed me to use CPAP again. I have been using an old M-Series APAP since then. Recently the humidifier started acting up so I am looking to upgrade. I used to keep up on what are the best machines but haven't done so recently. I'm looking to find what is the best on the market these days from a data collection point of view. I'd like to have software to use with it to analyze results easily and in detail, such as SleepyHead.

What does everyone recommend for an APAP? Which are the best for those of us who like to look at there own data?
Thanks, James

PS I still think of SnoreDog from time to time...

[Comfortably Numb]

Hello everyone. Most of you probably won't remember me but I used to be a regular here. Sadly in 2011 I was injured in a nasal surgery and haven't been around since then. You can read more about my story at nasalcripple.com. I'm very grateful for all the support I received on this forum way back then.

In 2015 I underwent another surgery that has allowed me to use CPAP again. I have been using an old M-Series APAP since then. Recently the humidifier started acting up so I am looking to upgrade. I used to keep up on what are the best machines but haven't done so recently. I'm looking to find what is the best on the market these days from a data collection point of view. I'd like to have software to use with it to analyze results easily and in detail, such as SleepyHead.

What does everyone recommend for an APAP? Which are the best for those of us who like to look at there own data?
Thanks, James

PS I still think of SnoreDog from time to time...

I'm pretty new here but I followed a lot of recommendations and decided on the Resmed AirSense 10 Autoset with heated humidity. I have been extremely pleased with all aspects of this unit. I can't imagine using anything else.

[Pugsy]

I remember you and from time to time have wondered about how you were after the 2011 disaster.

For apaps...you pretty much can't go wrong with either the latest ResMed AirSense 10 AutoSet or the Respironics DreamStation Auto CPAP.
As usual minor pros and cons with either but none are real deal makers or deal breakers for most people.
Software easy easily obtained.
SleepyHead works well with both...it's Beta and a little buggy sometimes but nothing horrible. Besides it's not like ResScan or Encore was ever perfect anyway.
I can help you with Encore or ResScan depending on which one and if you want it.
If you go here and poke around in the software stuff you can get some examples of what SleepyHead will show.

Respironics auto adjusting (apap) algorithm is a bit different from the algorithm used by ResMed. I have used both brands and there's some minor differences...ResMed tends to respond a little fast both in increasing and decreasing the pressure in auto mode. For some people it works out better and for some it doesn't. Most people probably would do well with either.

I haven't yet tried the DreamStation model line (own the prior model PR System One) but I have tried the AirSense/AirCurve model line. I own the AirCurve which is the bilevel version of the AirSense model name.

Any idea what pressure you are needing? If higher pressures like in the teens to where someone might feel more comfortable with some exhale relief I usually suggest the ResMed model because I think that it's form of exhale relief is a little better at the higher pressures.
If pressure needs are unknown then I usually suggest the ResMed because it covers all bases very well.

Couple of minor difference in the brands in how they flag snores or Flow limitations...Respironics does flagged events and ResMed does graphs. Neither a deal breaker.

Me personally.....I lean towards preferring the ResMed. I like the faster response myself plus I think it might be a tiny bit less noisy. We are talking barely perceptible differences to me anyway in terms of motor noise.

There are some new masks out here now that are leaps and bounds better than what was out there 5 or 6 years ago.
Which mask type are you going to be using?

[D.H.]

I have a Phillips Respironics Dream Station Auto CPAP. It’s my fourth machine since 1999; the others were all “bricks.” Here's my review, the good and the bad.


Advantages:
• Automatic means that it will raise the pressure as needed when it senses distress. I think I fell more refreshed than before.
• Good statistics are generated, so you can see how you slept, and make adjustments as needed. In addition, stats are good for your doctor to see how you are doing.
• Machine is very quiet.
• Heated hose is very good, never had rainout despite full setting on humidity.
• Automatic altitude adjustment (good for travel).
• Leak compensation.
• Auto/on and auto/off can be activated and deactivated separately.
• Puts out the prescribed pressure more precisely than my old machine (yes, I verified this).


Disadvantages:
• Machine is a bit larger than the major competing machine.
• Sometimes, there is a burning smell, especially after a potty break. I’m pretty sure it’s harmless.
• Frequently, the water does not last the whole night. I generally wake up at least once overnight, so I refill it at that time. This might not work for everybody.
• Some have complained about the brightness of the display when you turn it off and back on, such as for a potty break. I don’t find this a problem. In fact, I use the light to reattach my mask to the hose.
• The power cord has a proprietary signal, so you cannot use a different cord, even if the voltage, wattage, amperage, and fitting are all identical. This means that if you need a replacement cord (or a spare cord), you have to get the cord specific to Dream Stations. If you want to use a battery (such as for camping and electrical outages), you have to buy an $80 proprietary device to generate this signal.

[Guest]

PS I still think of SnoreDog from time to time...

So do I and you too... Welcome back James - YOU were a Pioneer if the data review market.

I say whatever works with Sleepyhead and you have access to. I use a 60 series System 1. If you are buying OOP the Sys 1 or even S9 can be had at very reasonable prices these days and do provide data. I think once you get used to one rhythm you tend to stick with that.

Glad to hear you are doing better.

[Goofproof]

Glad to see you are still around. Can't help on recommendations, still using the old "TANK", it's only 11 years old, still a pup! Be Well! Jim

[jskinner]

I followed a lot of recommendations and decided on the Resmed AirSense 10 Autoset with heated humidity.

I've only been looking into this a couple days but based on the recommendations here and my own research I'm thinking this is what I will get.

I remember you and from time to time have wondered about how you were after the 2011 disaster.

Hello again Pugsy! I'm not going to lie it has not been easy. I warn anyone thinking about nasal surgery to improve CPAP use to be very careful! I constantly feel short of breath since 2011.

Any idea what pressure you are needing?

I have my machine set at 8-10. It is not quite enough to stop all apneas but any higher and I tend to get centrals.

Which mask type are you going to be using?

When I started using CPAP again in late 2015 I went out and got a Resmed AirFit P10. I am astounded how much better masks have gotten! I do get a few mouth leaks but I'm not really willing to go to a full face mask given how light and unobtrusive the P10 is.

Welcome back James - YOU were a Pioneer if the data review market.

Thanks for the kind words. I had a lot of fun writing Encore Pro Analyzer. I felt bad that I wasn't well enough to keep working on it but thankfully SleepyHead came along!

Glad to see you are still around.

It is nice to see so many familiar forum members

[Gryphon]

Welcome back to the forum. I remember you also from when I was around back in 2007. I'm very sorry about your horrible experience with nose surgery. I've been very tempted to have sinus surgery my self but the thought of what you went through has held me back. I've had chronic sinus problems since I was a kid. I had one doctor who seamed all excited to root around inside my nose with a "cauterizing wire" his words... but I turned down the offer.

I also use the new Auto ResMed Airsense 10 and love it.

There have been some successes with treating the ENS with an implant. I know in the past one of the big issues keeping people from being able to help treat ENS was that a lot of the medical profession involved didn't understand what it was and lots of people with a real medical condition were being refereed for psych consults etc... "It's all in your head" They didn't understand it or why the problem should exist so they obviously couldn't have messed up. The only rational explanation was the patient was crazy. I did some research when I was considering sinus surgery about ENS and thought i'd mention it for what it's worth. I'm sure you've already read any thing I may have come across.

Wish you well and hope someday soon you'll be able to find a solution that offers you relief.

Gryphon

[Pugsy]

When I started using CPAP again in late 2015 I went out and got a Resmed AirFit P10. I am astounded how much better masks have gotten! I do get a few mouth leaks but I'm not really willing to go to a full face mask given how light and unobtrusive the P10 is.

Yeah, it's a pretty sweet little mask. I still try all the new ones when they come out if for no other reason than to break the boredom.
Right now trying the new Respironics DreamWear Gel Nasal pillows. Experiment is going well but like any mask out there...there's always some little something that I wish (at least for me) was just a teeny tiny bit different.

Like you I probably get a few mouth leaks but I am also unwilling to go to full face. Some nights no mouth leaks at all...some nights maybe 10 minutes in sporadic segments and on a very rare occasion maybe 30 minutes out of 8 hours. Since I sleep through it all and I know that with a full face mask I wouldn't likely sleep so good (past FFM experiments tell me that) I see no reason to create more sleep disturbance just to maybe fix maybe mouth leaks that are of short duration for the most part. For me the cure is worse than the disease.

I predict you will really like the ResMed AutoSet....I can't think of one bad thing to say about it unless it might be that it might use up all the water in the water chamber depending on the setting and your ambient humidity. That's the only thing I have found that might be a problem for me with the AirSense/AirCurve models. Some nights I have actually woke up to a dry water chamber after a little less than 8 hours. Do get the heated hose...even if you don't need the warmth for rain out prevention it enables a person to get more consistent and more customizable humidity delivery. I use mine year round...crank it up in the winter and turn it way, way down in the summer and all the time the humidity that I get stays the same. I don't have to worry about allowing for ambient humidity or rain or whatever.

Don't be a stranger. It's good to see old friends.

[jskinner]

Welcome back to the forum.

Thanks Gryphon.

I've had chronic sinus problems since I was a kid. I had one doctor who seamed all excited to root around inside my nose with a "cauterizing wire" his words... but I turned down the offer.

In my opinion cauterization is one of the more risky sinus procedures as it damages mucosa. If you do feel you need surgery I would recommend looking into balloon sinuplasty, not risk free but less risky. Given what I have gone though I would say be very careful. So many ENTs are sure that their procedure is safe and then the patient ends up with damage. Personally I would get any sinus surgery done by an ENT that knows all about ENS. Still not a guarantee that you won't get it but at least they tend to be a bit more careful. Message me privately if you want to chat more, I've leaned a lot about the nose over the past 5-6 years and could recommend some doctors that I think are safer.

There have been some successes with treating the ENS with an implant.

ENS is still poorly understood. It seems to be a combination of mucosal damage and/or structural damage. In 2015 I participated in a nasal study at Ohio State University. Earlier this year they published a small prospective 6 person case study on ENS titled Computational fluid dynamics and trigeminal sensory examinations of empty nose syndrome patients. As it turns out I am one of the patients included in that study. You can read my interpretation of the results of that as it pertains to my case here on Facebook. I have gone to Columbus, Ohio for several experiment ENS treatments (ACell+prp injections) but only got minor temporary relief. There really is currently no cure but people are hopeful about stem cells. I run a site called nasalcripple.com and I work closely with the Empty Nose Syndrome International Association

Its a terrible condition to live with.

I predict you will really like the ResMed AutoSet.... Do get the heated hose...

I'm really looking forward to that feature. Things have really changed. I can finally retire my hose cozy

Don't be a stranger. It's good to see old friends.

Thanks. I really dropped out of life for quite a few years. Trying to get back in to the swing of things a bit since getting back on CPAP. ENS has really slowed me down

[deerslayer]

WOW, good to hear your still kickin James !
i miss the good ole days on here with Rested Gal , Wulfman & so many others that helped guide & educate this old fart. God Bless

[RonS]

Jim,
Welcome back.

re: masks are amazing
Yes!!! I've been PAPping for a decade and loved my "new" Fisher & Paykel Opus 360, then I was wowed by the Respironics Nuance Pro, and now the Dreamwear nasal cushion is simply amazing.

I had troubles with CPAP with centrals and switched to BiPAP and that was a big plus. I started to deal with aerophagia with the higher pressures and returned for a titration study only on my side as I "never" sleep on my back, and was able to get great control with biPAP of 8/12.

I'm using a brand new Aircurve 10 VAuto in straight BiLevel "S" mode.

Good luck, buddy!

[greyhound]

Hi Jim,

Good to hear you're well enough to restart CPAP. It's been 5 years since I ran into you at a community dinner in Nova Scotia.

I upgraded from my M-Series APAP to a Respironics Dream Station last year and like it very much. Can't compare it to the Resmed equivalent which I had also considered. I elected to continue with Respironics because I did well with their APAP algorithim. No way of knowing whether Resmed would have been better or worse.

You'll find the Sleepyhead software has more data than you'll need. No need for you to write (and me to test) a new program.

Good luck.
Harris

[kteague]

Thanks for the link to your compiled story - I remember it as it unfolded. Sure hope the future holds solutions for you and others with ENS. Your particular situation is one that needs publicized and it's understandable you can't be real involved in everything. I follow you on Twitter, and it's good to see you are still out there doing your part to spread awareness.