UARS: AirCurve 10 VAUTO $500 vs Dreamstation APAP $400

[hombreingwar]

So I got UARS RDI 13 diagnosed in Jefferson (philadelphia) Sleep Center two weeks ago.
My AHI is only 1 or 2, and I'm not eligible for CPAP coverage according to Jefferson's ENT doctor.
(I was anorexic all my life until 32, I went to ENT because my tonsils kinda large, but not too much, and bothered me with viral infections).

(btw, I got diagnosed with adult ADHD last week (35 yo) by a psychiatrist, so if it's really UARS you bet I'm going to treat it).

Same week I saw Jefferson's sleep medicine doctor to review my in-lab sleep study. I told her I'm going to buy CPAP myself, she knew about my ADHD diagnosis.

The thing is I was going to ask her for a BIPAP prescription (used) or Resmed AirSense 10 (I was willing to buy new...), but she told me they don't work/prescribe BiPAP even for their OSA patients at their sleep center... She ended up prescribing me Dreamstation APAP (5-20 pressure, 0-3 Flex) to buy on my own (after trying Provent for a month, also got a prescription for it, she told me it would be cheaper to try it first...).

She insisted on Dreamstation APAP over Airsense 10 because it would be better at detecting RERAs I believe she said. She wants to see me in THREE months and to look at the machine data to check for leaks, and to tweak it maybe

So now I look at Ebay, and damn, AirCurve 10 VAUTO (used) is only $500 (1500 to 2500 run hours), and Dreamstation APAP almost new for $400, it sounds like AirCurve is a better deal overall. And based on everything I read I'm not sure what would happen, if I end up needing high pressure for my UARS, I'd need BiPAP, and it seems to be better for comfort even at low pressure.

I wonder what do you guys think? Would be kinda rude to disregard my MD's prescription, buy BiPAP that she doesn't use with any patients, but still show up 3 months from now with data. I don't find any reliable info that Dreamstation is better at detecting RERAs, maybe it was true before AirSense updated their software and got that "FOR HER" thing. Not sure how hard it would be to get newer firmware If I get year old AirCurve from Ebay.

[babydinosnoreless]

I have the aircurve 10 bilevel. It doesn't show RERAS. At least I've never seen it in my reports.

[ragtopcircus]

The Airsense For Her reports RERAs. Supposedly some newer Airsense Autosets do also. Regardless though, they also log Flow Limitation data. I assume the Aircurve does too.

Dreamstations log Flow Limitation and RERA events, but not the FL data. If it doesn't go over the vent threshold, you won't see it.

[Dog Slobber]

The Airsense For Her reports RERAs. Supposedly some newer Airsense Autosets do also. Regardless though, they also log Flow Limitation data. I assume the Aircurve does too.

The AirSense 10 AutoSet and Elite models have supported RERA reporting for a long time now.

https://www.resmed.com/us/en/consumer/p ... toset.html

Rera.png

[slowriter]

The Airsense For Her reports RERAs. Supposedly some newer Airsense Autosets do also. Regardless though, they also log Flow Limitation data. I assume the Aircurve does too.

All of the above is true, but in my experience, RERA reporting is not reliable. My airsense for her machine was telling me my entire CPAP trial period I had zero RERAs, but when I went in for a titration study, I had like 20/hour.

I find the FL data helpful though, all of these machine have it.

[palerider]

I wonder what do you guys think?

The VAuto is a superior machine by orders of magnitude. There's absolutely no comparison.

Would be kinda rude to disregard my MD's prescription, buy BiPAP that she doesn't use with any patients, but still show up 3 months from now with data

"rude"? is she your friend? is she paying you to come see her? I kinda doubt, I'm willing to bet that what's actually happening is that SHE works for YOU... keep that in mind, and that it's YOUR health, not hers that's at issue.

. I don't find any reliable info that Dreamstation is better at detecting RERAs, maybe it was true before AirSense updated their software and got that "FOR HER" thing.

The VAuto doesn't have the rera stuff, but, that doesn't really matter, what's more important is how well your sleep breathing is treated, not how well failures to treat it are reported.

Not sure how hard it would be to get newer firmware If I get year old AirCurve from Ebay.

near impossible.... Doubt that there's any new firmware anyway.

[palerider]

All of the above is true, but in my experience, RERA reporting is not reliable. My airsense for her machine was telling me my entire CPAP trial period I had zero RERAs, but when I went in for a titration study, I had like 20/hour.

Doesn't really matter, different machines, different environment, different night.

[hombreingwar]

I'm confused slight by the definitions of "Pressure Support", I thought it was a difference between IPAP and EPAP pressures, but I guess it's more complicated.

I also assumed until today that EPAP can be set to a fixed value, and let IPAP auto-vary within a certain range... I guess AirCurve is "fixed pressure support" both IPAP and EPAP are kept within a fixed difference.

[palerider]

I'm confused slight by the definitions of "Pressure Support", I thought it was a difference between IPAP and EPAP pressures, but I guess it's more complicated.

I also assumed until today that EPAP can be set to a fixed value, and let IPAP auto-vary within a certain range... I guess AirCurve is "fixed pressure support" both IPAP and EPAP are kept within a fixed difference.

What makes you think that?

PS=ipap-epap, that's all there is to it.

[Pugsy]

ResMed bilevel machines all offer a fixed PS with the exception of their ASV machine.
Most people won't need PS to auto adjust anyway. You don't need auto adjusting PS.
Now the Respironics bilevel auto machine do offer a variable PS in auto mode only. I own such a machine. I also own and currently use the ResMed AirCurve VAuto.

The DreamStation Auto CPAP machine offers exhale relief only up to 2 cm and you get that only if you breathe rather forcefully. Think of it as PS up to 2 cm. Doesn't compare to what you can do with the ResMed bilevel pressure support.

There is a reason that I am using the AirCurve 10....it's the better machine IMHO. Suits my needs better.

Given a choice between the DreamStation Auto CPAP and the AirCurve 10 VAuto......the AirCurve 10 wins out hands down.

Check with forum member LSAT. Sometimes he can get his hands on AirCurve 10 VAuto machines with lower hours than the one you found on EBAY and I know and trust him....and the price is in the same neighborhood as the EBAY machine.

[palerider]

The ST-A iVAPS also has varying PS... (for what it's worth)

[slowriter]

All of the above is true, but in my experience, RERA reporting is not reliable. My airsense for her machine was telling me my entire CPAP trial period I had zero RERAs, but when I went in for a titration study, I had like 20/hour.

Doesn't really matter, different machines, different environment, different night.

~45 days of zero machine reported RERAs, then at same settings in the lab many RERAs scored by the technician doesn't tell us something?

Certainly suggests to me the likelihood was extremely high I was getting RERAs that the machine wasn't reporting.

[palerider]

All of the above is true, but in my experience, RERA reporting is not reliable. My airsense for her machine was telling me my entire CPAP trial period I had zero RERAs, but when I went in for a titration study, I had like 20/hour.

Doesn't really matter, different machines, different environment, different night.

~45 days of zero machine reported RERAs, then at same settings in the lab many RERAs scored by the technician doesn't tell us something?

I'm quite sure it tells you *something*. what it tells you is the question. The fact that you were having a *titration* implies that your pressure wasn't optimal for the whole period, or were those 20/hr *after* they said "yup, that's the right pressure"? (to me, that would me it wasn't the 'right pressure'.

Certainly suggests to me the likelihood was extremely high I was getting RERAs that the machine wasn't reporting.

could be, but there are a lot of factors.

[Pugsy]

~45 days of zero machine reported RERAs, then at same settings in the lab many RERAs scored by the technician doesn't tell us something?

Certainly suggests to me the likelihood was extremely high I was getting RERAs that the machine wasn't reporting.

We have no idea what criteria the lab uses for scoring and we have no idea what ResMed uses for scoring criteria for their RERAs.
Sleep status is really needed to confirm RERA because an arousal needs to be seen (so we have to be asleep first) and the machine doesn't have any way to know if we are asleep or not.
The best it does when it flags a RERA is say that our breathing "looks like the breathing that happens after an respiratory related arousal".

It doesn't surprise me one bit that the machine didn't flag something that gets flagged in a lab setting when it comes to RERAs.
My personal opinion is to take the RERA data the machine provides (or doesn't provide in you case) with a grain of salt. Just because the machine doesn't flag them doesn't mean they didn't happen. RERA flagging is very new and IMHO leaves a lot to be desired.
About all I know is when someone does have a lot of RERAs flagged ....they must be having some really crappy sleep quality.
But just because they don't have any flagged doesn't mean that they don't have crappy sleep quality.
Until if/when these machines can actually distinguish if we are awake or asleep I take the RERA data or lack of data with a grain of salt.

[raisedfist]

The lab doesn't always get things right. Most scoring of events is automatic these days and then someone just signs off on it. I would go with the better machine (ResMed) and don't worry about anything else.