Thanks to all Now it's decision S8 Auto or PR ONE

[tactical logic]

Good Evening All,

Add me to the list of satisfied forum members who said no to their DME for trying to provide a ResMed Escape II as my best and only choice. My doctor has sent the paperwork to my new online DME and they are going to set me up with either the S8 Autoset or the PR One auto unit. I know that there are strong opinions about no patient software yet for the PR One.

Question 1: Am I correct that there IS software for the Doctor available from Respironics?
Question 2: Is there more data items available in the PR One system over the Resmed Auto II?
QUESTION 3: LET ME HAVE IT- the good and the bad to help me make my final choice of machine.... You guys have machines, experience, and ideas. S8 Autoset or PR ONE

...and Finally...
Q4: I have a mirage Quattro that seems to have sealing issues, and I an getting leakage at nose bridge (Eyes are OUCH), and some lower due to a protruding chin structure. I have always thought of myself as a night mouth breather, but maybe a chinstrap? The full face mask seems to keep some pressure below lower lip and mouth seems to stay shut. I really would like to try a nasal unit over the full face choice... MASK IDEAS WELCOME here.....

The new guy appreciates your help- this is happening fast.

Sincerely,

Bruce

[Muse-Inc]

Welcome Bruce! I love my ResMed AutoSet II with EPR. It offers more data on its LED than other mfg's machines: leak, pressure, AHI, AI, HI, hrs of use; more info is revealed using the software (which ResMed will not allow sales of the software in the US, we are not their customers, sleep docs and DME are their customers). The machine has a MASK FIT feature that helps you learn what an excellent fit is, maybe not the most comfortable fit (what mask is?) but at least not leaking. It also has a humidifier water warmup cycle and the easiest, most adjustable humidifier settings. You can get a card reader or USB connector or the ResLink that collect the data to be imported into the software for additional data; the ResLink allows data collection from a recording oximeter (I do not have all the details but still I lust after this gadget ).

Respironics has not released any software for users for their new machine. Some report they will, but I wouldn't hold my breath. Seems they have the same idea as Resmed as to who their customers are.

I wear the RespCare Hybrid full face mask that covers my mouth and has nasal pillows as I lose therapy air via loose lips, annoying puffs of air that is no longer stenting open my airways. Pretty comfortable mask. Comes with 3 sizes of oral cushions, 3 sizes of pillows that sit at 2 different heights -- makes getting a leak-free fit fairly easy.

PS I had the older Escape...so congrats on evading that profit-driven scheme!

[rise&shiner]

I agree 100% with everything that Muse-Inc. said. I love my resmed Autoset II. I haven't used the new respironics machine but I did have the the latest model before that-- the REspironics Series M with Auto A-Flex. That one had tons of problems and was also on the recall list. My DME gave me the choice of getting the new model REspironics or switching to the the Resmed. I decided that I would go with the Resmed and have been a very happy camper with my decision.

I am very happy with my F&P Forma mask it is really comfy and I really haven't had any real leak issues. If I do get leaks in the middle of the night they are very easy to fix fast and I go right back to sleep. I give it a rating 4.8. I would give it a full 5 but I think they could of put on better velcro on the headgear and may be put an adjustment wheel on the upper nose bar as an added feature. But concerning how many masks I had to try to find something that I would work for me I think 4.8 is stellar.

[timbalionguy]

Everyone seems to like the Resmed Autoset II. After Respironics forced online dealers to raise all prices up to list price with no discounts for anything, the best way to protest this is not togive them any business unless there is some feature you absolutely musty have. Sooner or later, their bean counters will notice the lost sales and change their policy back.

Although I agree with Muse-Inc that the Hybrid is a great mask, I wonder how it will work for you if you have a pointed chin. You may want to take a look at the Fulllife mask.

[rested gal]

Lack of obtainable software (yes, there's Encore Pro 2 for doctors and DMEs, but no place for the user to buy software) and lack of USEFUL-to-the-user data (there's no "overnight" info without resetting each time) via the little window on the machine would be my two reasons for NOT buying a PR System One machine at this time.

[Autopapdude]

There is no software for the PR system. Also, from what a couple of friends told me (they are users of the PR), it isn't substantially different in terms of therapy from the M series. So, I think your choice is clear. People like the Autoset II here a lot ( I am a rebel in using the Intellipap), but you can't go wrong with the S8 auto. It is a reliable, user friendly machine, and software isn't an issue.

[carbonman]

Ditto everything mentioned already.

Easy-Breathe-EPR

These are just better machines.....
in so many ways.

[Wulfman]

What is your prescribed pressure?


Den

[tactical logic]

Prescribed pressure is 12.

Bruce

[neverbetter]

Hybrid would probably seal better than a regular mask for a pointed or fat chin, I would think, because it goes under the chin, too.

[Wulfman]

Prescribed pressure is 12.

Bruce

OK. I just wanted you to be aware of the limitations of the ResMed A10 algorithm pursuing apneas above the pressure of 10 cm. unless they are preceded by snores or flow limitations. Those types of apneas are called "frank" apneas......they just occur out of the blue with no leading events that the algorithm looks for. ResMed wanted to ensure that their Auto machines didn't cause "pressure-induced" Central apneas......and their research showed that 10 cm. was the threshold for when those might occur, so that's the "safety feature" they built into it......hence the name "A10" algorithm. If you still had snores or flow limitations preceding the apneas, then the machine WOULD attempt to pursue the apneas above 10 cm.
In your case, if you were to use the ResMed Auto, you would want to set your minimum pressure in the Auto to where it eliminates almost all of the events (presumably 12 cm.).

As with almost every Auto, there are limitations with regard to them being able to chase down apneas in a timely manner.....they typically change pressures fairly slowly......so ANY Auto you'd wish to use should have the minimum pressure configured in the manner I described above.

Each company has their own particular algorithms with regard to how they address "events" and it's a good idea to be aware of the advantages and limitations of each of them........just so you're not disappointed if/when your therapy isn't as good as you thought it might be.


Den

[carbonman]

...well, I guess Slinky is going to have to make room for
me on her soap box......she is responsible for this curiosity, so....

I was titrated at 8cm. With my Mseries auto, over the course
of ~4mths, I found my sweet spot to be 12cm.
For a year, I got excellent therapy w/the Mseries auto.

Ever since I started this therapy, if I thought I could get
better therapy w/different equipment, I got it......
because this is my life and I figure I'm worth it.

I read and listened and read and listened and anguished about
this A10 thing and a Resmed. Finally decided I had to know.

What I found is much better therapy, because it does not
chase the events that the M did.....result.....
undisturbed sleep....better therapy.....feel better.

Add in the EasyBreathe-EPR and I was able to switch to
straight cpap, at 12.2cm.

Life is so good.

Each company has their own particular algorithms with regard to how they address "events" and it's a good idea to be aware of the advantages and limitations of each of them........just so you're not disappointed if/when your therapy isn't as good as you thought it might be. Den

...and w/all cpap equipment, it is totally subjective to each person.
Mask type, mask fit, HH setting.....machine algorithm......
you'll never know for sure til you try it.

Place your bets....the ponies are coming to the post.

[rested gal]

Prescribed pressure is 12.

Bruce

I'm not a doctor and this is just my non-medical opinion. If I were prescribed a pressure of 12, and I got a ResMed autopap,
and I used it in auto mode, I'd set the pressure range this way, depending on what degree of "full time" EPR I set it for:

EPR off
min pressure 11
max pressure 20

EPR 1
min pressure 12
max pressure 20

EPR 2
min pressure 13
max pressure 20

EPR 3
min pressure 14
max pressure 20

It's always a good idea to give CPAP mode a try, imho. In fact, I'd try it in CPAP mode first before using the auto settings above. But I know how hard it would be to resist using a new autopap in auto mode right off the bat, so that's why I went into what "auto" range I'd use first.

If I set it for CPAP mode, I'd use these settings -- again depending on how I set "full time" EPR:

EPR off
pressure 11

EPR 1
pressure 12

EPR 2
pressure 13

EPR 3
pressure 14

After looking at the overnight separate AI (apnea index) and HI (hypopnea index) for several nights using one setting or one "set" of settings, if I saw the AI was below one and I saw that by mentally cutting the HI in two, the HI was below 5.0, I'd figure the treatment was effective.

That's just me, and that's the way I'd go about titrating myself with a ResMed machine.

I think it's important with any autopap being using in "auto" mode to use the minimum pressure setting in a way that helps the machine perform its job -- that job being to prevent apneas; not letting an apnea happen in the first place.

Best way to help an autopap do that is by setting the minimum pressure up high enough to prevent most apneas right from the get-go.

In other words, I like to set the autopap's minimum pressure almost as if it were a straight CPAP. The higher maximum pressure setting can then provide a margin of mostly unused pressure up above if needed occasionally, but for the most part the machine will be able to keep the airway nicely open with just the minimum pressure.

That is, if the minimum pressure is set high enough in the first place.

Just my opinion.

----------------

Some links to my thoughts (not that I'm right) about minimum pressure with autopaps:

Results: 1st night with Auto A-Flex (topic started by TSSleepy)
Two nights graphs posted using pressure range 4 - 20 and 10 - 20
viewtopic.php?p=348963#p348963

November 2008 Just got an APAP (topic started by turbosnore)
viewtopic.php?p=319619#p319619

October 2008 Turning off Aflex and Cflex (topic started by DoriC)
viewtopic.php?p=307265#p307265

September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
viewtopic.php?p=294319#p294319

Wulfman, DreamStalker, and ozij explain why autopaps make changes slowly.
December 2008 Why adjust APAP. Isn't it auto? (topic started by oxygenium65)
viewtopic.php?p=323218#p323218

---------------------

And my thoughts about the minimum pressure setting when using EPR:

Nov 2008
viewtopic.php?p=310021#p310021

Aug 2008
viewtopic.php?p=289264#p289264

[Wulfman]

...well, I guess Slinky is going to have to make room for
me on her soap box......she is responsible for this curiosity, so....

Oh SURE.......blame it on Slinky......


Den

[carbonman]

Oh SURE.......blame it on Slinky...... Den

........not blame.....credit.