UARS Machine Suggestions

[bdwalters]

I'm a long-time CPAP user who is in the process of getting some new equipment. Does anybody have any theories on what auto machines are the best at treating UARS?

[Wulfman]

I'm a long-time CPAP user who is in the process of getting some new equipment. Does anybody have any theories on what auto machines are the best at treating UARS?

It depends on what the nature of your UARS/SDB is. Nasal? Throat?
The operations of Autos/APAPs is dependent on algorithms (programs) and sensors to determine what is happening with the user's airflow. Since all manufacturers have developed their own algorithms, depending on which machine a person is using determines how they respond to what they're interpreting. In some cases, an Auto/APAP may generate unnecessary responses. Consequently, either a very narrow pressure range or straight CPAP (which all Autos are capable of) may be more appropriate. Some people do well with a range of pressures and others do better with straight pressure because the pressure changes can disturb a person's sleep.
If you get an Auto, you can always use it in CPAP mode if necessary.

I hesitate to recommend one brand over others because each person, their situations and their therapy is different.


Den

[tillymarigold]

What Den said.

I have UARS. My sleep doc recommended a ResMed machine for me and my issue is my throat. I got the Sandman and love it. YMMV.

[bdwalters]

Thanks for the replies.

I'm not sure what is the source of my UARS. I've had the Pillar Procedure done and didn't notice much of a difference. I've also had my tonsils removed, my deviated septum straightened, and my turbinates trimmed, which made the use of CPAP possible.

I have an M Series Auto that I usually run at a straight 12, but I set the range from 10-13.5 last night to see what would happen. My charts looked good the next day with AHI=0.7 and, more importantly, FL=0.3. But I didn't sleep particularly well, which makes me wonder if the machine is detecting all of the flow limitations. When I moved from a REMStar Auto to a Resmed Spirit Auto a few years ago, the Resmed ran at a much higher pressure in auto mode (and I did sleep better). I seem to remember someone mentioning at the time that the Resmeds used a more sensitive flow limitation sensor. I was wondering if anybody knew anything about the sensors on the current machines. Naturally, I can keep trying out different pressures to see what works best (with 12 usually working pretty well), but I'm an engineer, so I always like to have a good chart of data to review to be sure things are going optimally, and I figure if I'm going to get a new machine, I should get the one that has the best chance of giving me the best treatment.

[Wulfman]

Thanks for the replies.

I'm not sure what is the source of my UARS. I've had the Pillar Procedure done and didn't notice much of a difference. I've also had my tonsils removed, my deviated septum straightened, and my turbinates trimmed, which made the use of CPAP possible.

I have an M Series Auto that I usually run at a straight 12, but I set the range from 10-13.5 last night to see what would happen. My charts looked good the next day with AHI=0.7 and, more importantly, FL=0.3. But I didn't sleep particularly well, which makes me wonder if the machine is detecting all of the flow limitations. When I moved from a REMStar Auto to a Resmed Spirit Auto a few years ago, the Resmed ran at a much higher pressure in auto mode (and I did sleep better). I seem to remember someone mentioning at the time that the Resmeds used a more sensitive flow limitation sensor. I was wondering if anybody knew anything about the sensors on the current machines. Naturally, I can keep trying out different pressures to see what works best (with 12 usually working pretty well), but I'm an engineer, so I always like to have a good chart of data to review to be sure things are going optimally, and I figure if I'm going to get a new machine, I should get the one that has the best chance of giving me the best treatment.

Thanks for that additional information. Yes, the Autos (all of them) respond to Flow Limitations with pressure increases, thinking they're a precursor to a larger, upcoming event. Respironics machines don't count them in the AHI numbers, but ResMeds do (hence the typically higher HI numbers those users report).
Those pressure increases or bumps can disturb the sleep for many of us (me included). I also settled in on a fixed pressure of 12 cm. about 4 years ago.

Good luck with your therapy.


Den

[ozij]

ResMeds distinguish between flow limitations and hypopneas. They respond dramatically to the first, not at all to the latter, since according to the ResMed designers, what they measure as hypopneas are often breathing stops that have nothing to do with obstruction, but are rather like sighs, holding your breath when you change position, etc.

Fisher & Paykel's auto seems to respond to flow limitation even more dramatically than the S8, and Covidien's Sandman too responds strongly to some flow limitations, however, in the Sandman that response can be switched off.

There's notcomparing what Respironics count as flow limitations and what (for instance) Covidien count.

The new PR1 counts what it calls RERAs -- but it does not respond to them. I think (haven't seen info about it) that RERA's are close to what other companies consider flow limitations.

You cans see the response to flow limitations in fig. 3 of the following study.
http://www.rtmagazine.com/issues/articl ... -08_05.asp

You can see it study that the S8's response to hypopneas is similar to it's response to flow limitations -- because the stimulus the machine was given was not the type defined as Hypopnea by ResMed designers -- it was take from a real PSG.

You'll find the stimuli on this thread: viewtopic.php?f=1&t=46429&p=416819&hili ... ly#p416819

[bdwalters]

Thanks for the info. That's an interesting study. I think I've just lost all faith in the auto machines (at least when they're in auto mode)! I usually run mine at a constant pressure anyway. Maybe I should have more faith in how I feel than in what the charts show. (I have the software for my M Series).

[ozij]

Don't forget that those studie really hobble the machines, since the pattern is simply repeated, whereas under normal conditions the machines iteract with a responding human being. So you're really seeing half the story in the study.