I need help choosing a CPAP unit

[Duermo]

I was diagnosed with apnea (40 per hour/ 73% oxygen) in December and have been using a trial CPAP (pressure set at 8cm) since early January. It's time to decide on which machine to buy. I've been using a Remstar Pro M series. I like the ramping device that goes from 4 to 8, and the pressure release feature. The split humidifier is handy for cleaning. The technician also suggests the ResMed Escape.
The thing is that my neurologist/sleep doctor is not interested in gleaning any data from the CPAP. He says it's unreliable. He says that the if I'm not snoring and there is no gasping for breath during the night (to be noticed by my sleep partner) it's working fine. So I don't need a machine with reportable data. Is there such a thing?
What are the advantages/disadvantages of the Remstrar Pro M series and the ResMed Escape?
Is one quieter than the other? the Remstar seems to "breathe"; it's not a continuous white noise.
I have to have a machine with a built-in humidifier in order to comply with the Ontario government Assistive Devices Program.
Thanks for any help you can give me...I've learned so much from this website in the last month. It's been invaluable.

[DreamStalker]

Your neurologist is afraid that you will learn more about your treatment than he does ... making it harder to make the payment on his jag.

It is YOUR treatment, YOUR life on the line here. Most likely it is also YOUR insurance and YOUR money.

Take control of your treatment and get a data capable machine, prefereably an auto CPAP machine. Even if your doc doesn't know how or doesn't want to read the data, you can use it yourself as it should be done. This condition requires patient participation in the form of monitoring and managing your treatment just like diabetics do.

Best of luck with your treament.

[Patrick A]

Your neurologist is afraid that you will learn more about your treatment than he does ... making it harder to make the payment on his jag.

It is YOUR treatment, YOUR life on the line here. Most likely it is also YOUR insurance and YOUR money.

Take control of your treatment and get a data capable machine, prefereably an auto CPAP machine. Even if your doc doesn't know how or doesn't want to read the data, you can use it yourself as it should be done. This condition requires patient participation in the form of monitoring and managing your treatment just like diabetics do.

Best of luck with your treament.

I second that motion.
Welcome to the Forum and the "World of Hose Worship"

[torontoCPAPguy]

Welcome to the forum! Here you will find plenty of educated and wise help... I know, I have been on here for two weeks and have learned more than the last six months since coming out of hospital after a near death experience with acute pneumonia resulting from H1N1. CPAP/APAP for me is a life/death matter. My breathing gets so shallow entering REM sleep that it never happens... I usually wake up. Either way I wake up drenched in sweat apparently as a result of blood pressure shooting sky high - I was warned that without CPAP I could pop an Aorta "He died peacefully in his sleep, what a shame".

I started with the ResMed S8 Escape II prescribed by the sleep clinic. Crapola. Masks? Crapola. Pressure titration? Crapola. All in all a pretty good experience eh?

I have since purchased a ResMed S8 Autoset II, learned a whole bunch about sleep apnea of various forms and other breathing issues and their consequences and more than anything else I have gone out and purchased the best mask for ME and that has made all the difference in the world as well.

To those that have been supporting me.... I am in tears, literally. I finally decided to try the Autoset II in Auto mode last night, set it at what I thought was a good range, installed the accessories I bought recently and put on my Mirage Activa LT mask in Large WIDE size. It rests on my cheeks and makes a solid seal. All night. No alarms (the unit will alarm if the seal is broken!) and slept right through the night. Hurray! Yippee! I had loads of REM sleep I am positive as I had tons of dreams for the first time in a half year. I awoke wanting more sleep but refreshed.

If I were recommending a setup for YOU I would, of course, recommend what I am using myself. But that's not my job. Not at all. You need a TEAM and EDUCATION to get there. It won't take long if you use the online resources and spend some time at it. Start with the ResMed Clinical Manuals and read them thoroughly several times. Anything that you think needs an educated guess.... get help from your RT or Respirologist or better yet, from someone who knows.... the gang online here. They have been through the ringer and back. I will attenst to the fact that the sleep clinics and RT's would probably like to offer better info to you but they simply cannot do both... that is make scads of money and offer education. YOU are going to have to educate yourself and there are loads of references on this board. Follow them and study them. Read the threads from start to finish. Make notes (I have a 2" binder and am about to start a second one).

In the end, if you are Graced by your God, you will have something of an epitphony. A light bulb will come on. It did for me at midnight last night as I entered the numbers into my Autoset and selected options. Must have done something right. This morning I found it pumping just like always and I had the best night of sleep ever. You can too.

Having said all of this, I have a relatively simply problem and that is that I take in less air than I need and I have very mild sleep apnea related to snoring. An easy one to be sure. There are plenty of complicated situations and if yours is one of those then you really need the medical team around you to tell you that what you are doing is correct for YOU.

But start by educating yourself. In the end it will, I promise, pay huge dividends. And impoove life too.

[torontoCPAPguy]

[quote="Duermo"]I was diagnosed with apnea (40 per hour/ 73% oxygen) in December and have been using a trial CPAP (pressure set at 8cm) since early January. It's time to decide on which machine to buy. I've been using a Remstar Pro M series. I like the ramping device that goes from 4 to 8, and the pressure release feature. The split humidifier is handy for cleaning. The technician also suggests the ResMed Escape.
The thing is that my neurologist/sleep doctor is not interested in gleaning any data from the CPAP. He says it's unreliable. He says that the if I'm not snoring and there is no gasping for breath during the night (to be noticed by my sleep partner) it's working fine. So I don't need a machine with reportable data. Is there such a thing?
What are the advantages/disadvantages of the Remstrar Pro M series and the ResMed Escape?
Is one quieter than the other? the Remstar seems to "breathe"; it's not a continuous white noise.
I have to have a machine with a built-in humidifier in order to comply with the Ontario government Assistive Devices Program.
Thanks for any help you can give me...I've learned so much from this website in the last month. It's been invaluable.[/quote]

Forget the Escape. Get a data recording machine so you can see what's happening every day. I went for the Autoset II. Difference in cost is minimal. Benefits are huge. You can take charge of your own health instead of depending on them. Pressure of 8cm is minimal. Apnea, looking at your pic, is caused by weight and airway shutting down most likely... part of my issues as well. 40 per hours means you are snoring like the dickens. 73% O2 is OK but not desirable. 90+% is much better and will keep your blood pressure down so you don't die of a popped Aorta or whatever. I have friends who live during the day with 50% O2 and no machinery.

The statement that the data is unreliable is utterly BS. A machine like the Autoset will provide almost as much data as a sleep study according to the white papers I have been reading. And it is always current! It will sense snoring by the vibrating air patterns and it will sense APNEA EVENTS by the lack of inhale/exhale in a jiffy. In fact, if an apnea event lasts for more than ten seconds it will sound an alarm to wake you up! Did they do that at the sleep clinic or tell you about it? Don't think so.

Ontario is where I live and it is a rip off. I don't have an answer... but I walked out of MediGas with a $1700 visa bill and an Escape. And the government kicked in a grand to boot. Big graft there I think? The Escape, by the way, stateside, is $389 and the mask/hose/etc. is about $89. That is it. Done. Out the door. The ResMed Autoset II is only $555 stateside. Looking at your picture, I am going to suggest that you may want to try out the Mirage Activa LT in Large WIDE size so it will rest on your jowels like it does on mine and make a solid seal. Forget the pillow type units like the Swift LT as your nose and mine are going to crush the canulas the moment we touch the pillow with our schnozolas and guess what? No air flow. escape II? No alarm. You will awake gasping for air or will dream you are being smothered. Autoset II? Ten seconds and an alarm will go off to awaken you. You leearn and you grow... you and only YOU can be your own advocate if you want to live and be healthy. If you are married, as I am, bring your wife into the learning circle and SHE will also be your advocate. I have no doubt that I would not be alive today after my spell in the hospital on life support and in a coma for the month of June if I did not have my wife to advocate for me.

As far as the assitive devices programme is concerned, you are probably best to find out if they would be happy and pay out to you directly if you were to purchase from an authorized dealer stateside.. and then you go and buy yourself BOTH an Escape CPAP and an Autoset II APA/CPAP and accessories to last three years. It will cost you less for two machines and supplies for three years from our sponsor (but you have to pick them up stateside; have them shipped to your hotel or mailbox). And there you go; you have not only a great machine in the Autoset with the ability to read your own data.... but you have a backup or travelling machine as well that you can set tot what you need. One other thing I would suggest is that you get yourself a computer UPS at any computer store. $150 and it will run the machine should the power go off at night.... so you won't be awakened and can sleep right through it. And while you are ordering get yourself the 12VDC cord kit so you can run it on batteries in the event of a long balckout.

So much to learn. So much excitement at taking control. The MediGas price for my mask that is $89 stateside by the way is over $300 with taxes. That's out of YOUR pocket. Order from CPAP.com or one of the other suppliers. And spend time on getting educated!

Good luck. You are on your way to better health and comfort. You will feel better than you have felt in ages in a short while and sleeping through the night has one other advantage for us big folk.... we don't have a chance to snack at 4 a.m. Seriously. Dead serious.

Good luck. We are all here for you.

[ozij]

A Resprionics Pro M reports data on the LCD -- if you don't see it, someone here will tell you how.
The ResMed Escape does not report data, the Elite is a fixed pressure ResMed machine that does.

Do your best to try both -- I can't tolerate Respironics' version of exhalation pressure relieve -- called CFlex or AFlex. Other thrive with it. I fine ResMed's exhalation pressure relief -- called EPR -- marvelous. Others dislike it tremendously. You won't know till you try.

And on the ResMed, my oxygenation shows a fantastic correlation with AHI. Maybe your doc doesn't know enough about the machines. Ignore him, and get a data reporting machine with software.

O.

[rosiefrosie]

Get a machine that reports data.

When I was 1st dx'd with sleep apnea, I went and got my machine and went happily on my way. Never even realizing that there were different machines that did different things. I was given a ResMed escape. Later I found cpaptalk.com and discovered the error of my ways. It was too late by that time to exchange my machine but I did do allot of complaining to my DME about not being given a choice and it was my right to make those choices. So anyway I bided my time and did get a ResMed Autoset 11 and love it. I also obtained the software and reader and have been tweaking my therapy ever since and am finally seeing good results. You need to take charge of you own treatment because if you don't who will?

rosie