Newbie with equipment questions

[catfell]

Hi everyone,

I'm very glad to have found this forum, although I had no idea how much there was to learn about CPAP, and it's a little daunting.

I have been diagnosed with sleep apnea (36 episodes per/hour) and have been titrated in a sleep lab.

I'm looking for advice about CPAP machines and nasal pillows.

My DME company is coming tomorrow and has informed me that I will be getting any of the following machines:
Respironics PR System One REMstar Auto CPAP Machine
Resmed S8 Elite II CPAP Machine
Fisher Paykel SleepStyle 240

It looks like the Respironics is a fairly new machine, the Resmed S8 Elite II seems well liked on this forum and I can't seem to find any opinions on the FP SleepStyle 240.

What should I be looking at to compare the machines?
From a brief phone conversation, I think the DME prefers the PR System One REMstar Auto CPAP.

BTW, I'm a mac owner, so I don't think I will be able to review my numbers without getting windows.

I do travel both domestically and internationally. So size and multi-voltage compatibility is a consideration.

Secondly, I used a FP Opus 360 nasal pillow during my fitting at the sleep study. It felt comfortable and the technician told me that she was impressed how little leakage I had (I don't know the actual numbers.)

The DME thinks very highly of the Mirage Swift LT, but my doctor prescribed the Opus.
Both the Opus 360 and the Mirage Swift LT are covered by my insurance, and I have asked to have both available to try on tomorrow. Is there any other nasal pillow I should consider? I sleep mostly on my back, but do sleep on either side and chest.

I'm just a little worried that I don't have any experience deciding which machine or nasal pillow fits or works better for me, and assume that exchanging equipment may be a huge headache.

Sorry for the lengthy post/question.

-catfell

[JohnBFisher]

... I'm very glad to have found this forum, although I had no idea how much there was to learn about CPAP, and it's a little daunting.

I have been diagnosed with sleep apnea (36 episodes per/hour) and have been titrated in a sleep lab.

Think of it as a chronic health condition that you will need to learn to manage. It's not as daunting as something such as diabetes, but to be effective, you should be involved in the treatment. You know, better than any doctor or test, what works for you. If you wake up feeling miserable, that is a much more important indicator than all the studies in the world. However, it will take a while for you to start to feel the improvement (unless you were SEVERELY sleep deprived).

I'm looking for advice about CPAP machines and nasal pillows.

My DME company is coming tomorrow and has informed me that I will be getting any of the following machines:
Respironics PR System One REMstar Auto CPAP Machine
Resmed S8 Elite II CPAP Machine
Fisher Paykel SleepStyle 240

It looks like the Respironics is a fairly new machine, the Resmed S8 Elite II seems well liked on this forum and I can't seem to find any opinions on the FP SleepStyle 240.

What should I be looking at to compare the machines?

I fear I can not help much here, other than to note that I've used Respironics machines for the past 18 years. I am very happy with their durability. And the new machine appears to now be able to track additional type of events, such as central apneas and Respiratory Effort Related Arousals (RERAs). How it does that I do not know, since that should require additional input to determine. But even if it is a good estimate, that is good information to have.

From a brief phone conversation, I think the DME prefers the PR System One REMstar Auto CPAP.

I would ask them "Why?" Do they get a greater discount on one machine over another? Do they have more experience with one brand over another? What is their reasoning.

BTW, I'm a mac owner, so I don't think I will be able to review my numbers without getting windows.

The DME should be able to run the reports for you. Ask them about it.

I do travel both domestically and internationally. So size and multi-voltage compatibility is a consideration.

Check out the machines at a site such as https://www.cpap.com. They usually note the power requirements, though you can also visit the manufacturer's website. For example, for the Respironics model:

http://respironicsremstars.respironics.com/

The specification page notes that it handles "100 - 240 VAC, 50/60 Hz". See:

http://respironicsremstars.respironics. ... tions.aspx

By the way, you did not mention this. I would insist on a heated humidifier being prescribed with the unit. It makes a huge difference in your comfort.

Secondly, I used a FP Opus 360 nasal pillow during my fitting at the sleep study. It felt comfortable and the technician told me that she was impressed how little leakage I had (I don't know the actual numbers.)

The DME thinks very highly of the Mirage Swift LT, but my doctor prescribed the Opus.

Both the Opus 360 and the Mirage Swift LT are covered by my insurance, and I have asked to have both available to try on tomorrow. Is there any other nasal pillow I should consider? I sleep mostly on my back, but do sleep on either side and chest.

I'm just a little worried that I don't have any experience deciding which machine or nasal pillow fits or works better for me, and assume that exchanging equipment may be a huge headache.

Clearly coming here and asking questions is a great way to learn about the machines. You will find that the mask selection really does require a "try it, before you buy it" approach. Ask the Respiratory Therapist to try the different masks. Try it with a machine at pressure and while laying down. Toss and turn. Let your facial and mouth muscles go completely slack. Does air start to leak? Are you normally a mouth breather? Do you need a chinstrap? Will that help you? (It doesn't help me. The air just leaks around my tongue and through my teeth.) Definitely try it. It will take longer the first time they see you. However, they should offer you that time. If not, then find another DME!!

Sorry for the lengthy post/question.

No need to apologize. Besides reading, asking questions is how we all learn.

[Muse-Inc]

Welcome aboard! Great folks and info here.

I'm a fan of ResMed machines so I admit I'm biased . The Elite II will give you efficacy data like leak, AHI, AI, and HI on its LED (considered the most LED data of all the machines) so you don't have to buy the software immediately tho it does offer more data when you're ready to take charge of your therapy. It offers great exhalation relief. If it were me and I knew then what I know now, I'd opt for the AutoSet II auto-titrating CPAP (APAP) as it can be set as a straight pressure aka CPAP or as a APAP delivering pressure based on your preceding breaths attempting to abort potential events -- this will also allow you to periodically do a home titration to verify current pressure needs. I keep a log of all my data to review for overnight leaks while I still remember what happened in my last sleep and to watch trends. Buying outright is 90% of the time less expensive than your insurance co-pay; my co-pay was $890 for a machine I could have bought for about $350. Our host is inexpensive and will price match.

Mask: if you can afford it, I'd find a full face mask (FFM) as well as a pillow mask that fit well, for congestion/colds and for a lightweight minimal mask. I'm claustrophic, so a nose mask and traditional FFM aren't for me. I wore the Respironics OptiLife pillow mask for 24 months and now the RespCare Hybrid FFM (only covers mouth and has nasal pillows).

[Slinky]

I am a tried and true definitely biased Resmed fan. HOWEVER, that Respironics PR SystemOne IF it really is the Auto would be doggone tempting even for this ole Resmed die-hard if I wasn't going to have access to the software and data regardless which device I accepted. (Altho the Resmeds can't be beat for ease of access to and amount of data available via the LCD screen w/o need for software). The Resmed S8 Elite II is one heck of a good device - but - it is NOT an Auto.

A fully data capable Auto is a doggone nice device to have if your titration study was "off" a bit or if your weight or other circumstances change.

I'm hearing good things about the new F&Ps that just came out but I'm not familiar w/which is which, which is an auto, which is a straight CPAP and which are full data capable (I know the Auto is but I don't know the Auto's "number". I've seen the data download printouts and rather liked them.

My personal preference is for fully data capable and access to that data over an Auto in line of importance to ME. One things if for sure - at least two, and I strongly suspect, all three, offerings are good and one heck of a whole lot better than ou would get from a lotta local DME providers!!!

[catfell]

Thanks for the quick replies, please keep them coming.

Slinky, what's so special about an "Auto" machine? Does it make it easier to exhale? Does it adjust the pressure on its own, regardless of what it was set at? Does it make coffee with the leftover water from the humidifier ?

[Slinky]

Eh, they can be used for at-home titrations. And if you are one who has EXTREME pressure needs in one position more than in another they can allow fluctuating pressures for that scenario. FEW of us NEED that type of fluctuation. CPAPs can only work as a CPAP. APAPs can be used in CPAP or APAP mode. That's about their only advantage.

[cflame1]

the only one that I wouldn't go for would be the F&P unless you were getting a 254.

The other F&P's give you no data at all.

[Muse-Inc]

...what's so special about an "Auto" machine?

APAP delivers pressure based on your preceding breaths attempting to abort potential events. it repsonds to your breathing acting preemptorily to increase pressure when it detects changes that indicate an event is likely to occur. It varies the pressure it delivers on a breath-by-breath basis instead of deliving the same pressure all the time as a CPAP does.

...Does it make it easier to exhale?

Exhalation relief is provided by several mfgs in all of their machines, you just need to check. ResMed calls it EPR, Respironics has Aflex and Cflex, not sure about the others.

...Does it adjust the pressure on its own, regardless of what it was set at?

An APAP is set to a range of pressures. It starts at the low pressure and changes as it detects breathing changes. It returns to a lower pressure as your breathing stabilizes. Typically, it does not exceed the max of the range.

[DreamOn]

Does it make coffee with the leftover water from the humidifier ?

That's hilarious!!! I wish!

Welcome to the forum, catfell! You've received some excellent suggestions from the more experienced members, so I don't have much to add. Just be aware that the model names from each manufacturer can be very confusing, so when making your choice, be sure that you are actually choosing from the three selections you wrote down.

Please let us know how you're doing once you start your therapy!

~ DreamOn

[Slinky]

DreamOn is oh so right!!!

Beware the Resmed S8 Escape II which is NOT fully data capable whilst the Resmed S8 Elite II "is" fully data capable.

Beware the Respironics M Series Plus - or ANY Respironics device w/Plus in the name is NOT fully data capable whilst the Respironics M Series Pro IS fully data capable.

Beware the Sandman Intro is NOT fully data capable whilst the Sandman Info IS fully data capable.

And I can never keep the doggone Fisher & Paykel SleepStyle model numbers straight which are and which aren't fully data capable.

Nor can I keep the DeVilbiss models straight in my head.