So, I've been diagnosed with...

[getafix]

Hi Everyone,

This is my first post here. I wanted to share the process that I went through to get to this conclusion and also ask some questions to all the people who are more experienced in this then I.

The reason I ended up doing a sleep study was because I was always tired and yawning during the day. One of my co-workers noticed this and mentioned that I may have problems with sleeping. He mentioned that I should get a sleep study done.

I talked to my doctor and scheduled a sleep study. During this first sleep study I ended up having an RDI of 36.4 with a sleep efficiency of 40% (didn't really sleep well there). Then during the follow up appointment, the doctor discussed multiple options,one of them being a CPAP device and scheduled for another sleep study with a CPAP machine. For this second sleep study, they prescribed an Ambien to me so that I could sleep through the study and they can gather enough data on me. During this study, there were two Central Apnea events and multiple obstructive hypoapnea events.

When I got my prescription, I was expecting to get a prescription for a CPAP machine but I ended up getting a prescription for a Bi-Level machine. I don't know much about the Bi-Level machines.

So, I wanted to ask you guys,
* based on the prescription, which machine would you recommend?
* Are there any upcoming machines that would be better than the ones that are available currently?
* Does this prescription indicate only compliance data or does this mean that the doctor is requesting a machine with detailed data feature?

The Prescription that I received is as follows.

Bilevel with IPAP and EPAP specified,
Data Card/Memory feature with AHI and leak values : Yes
RAMP enabled: Yes
Heated Humidification: Yes

Please reply to this thread to weigh in your input.

Thank you.

[jweeks]

Hi,

A BiLevel machine is slightly more advanced than a traditional CPAP machine. With CPAP, you get a single pressure level. The problem is that it is hard to exhale if your pressure needs are high. In fact, it can trigger central events. The BiLevel machine has a lower pressure on exhale. Not only is this more comfortable, but it can help prevent centrals from being triggered.

The two machines that I have tried are the Respironics M-Series BiLevel Auto with BiFlex, and the ResMed S8 VPAP Auto 25. Both are good sturdy machines, and both are fully data capable. Both companies have newer lines of machines out, but neither has a BiLevel machine in their new lines. Either machine should work well for you.

Don't delay treatment waiting for a new machine to come out. You do have the option of renting, but it could take a year or two before the new BiLevels come out, if they are even in the pipeline. Renting is expensive, so it doesn't really save you anything. A better idea would be to look around for a used machine, then keep it for a backup machine if you buy a new machine later on.

-john-

[Slinky]

Yup, you are getting a fully data capable bi-level. Congratulations!

I just spoke to our local Resmed Rep the other day. He expects that a new S9 VPAP Auto will be available w/in the next few months, it won't be as long as a year or more as I had figured would be the case.

There are some PR SystemOne Auto BiPAPs out. Maybe not many as I am sure the local providers want to clean out their old inventory on their shelves first.

[getafix]

Hi,

Thank you jweeks and Slinky for replying to this thread and answering my questions.Your responses are very much appreciated.

Since I made my first post, I talked to a couple of DMEs in the area and then choose (for no special reason) to go with one particular DME. After talking to them, I'm getting a feel that I'll be getting one of these following machines:

* PR Systems BiPAP Pro
* PR Systems BiPAP Auto
* ResMed S8 VPAP S/ST
* ResMed S8 VPAP Auto 25

Among these machines, which one would you recommend, based on your personal preference and experience? Should I be holding out for more elaborate machines like Respironics BiPAP autoSV or Resmed Adapt SV?

[Slinky]

DEFINITELY hold out for either the PR SystemOne BPAP Auto w/Bi-Flex or the Resmed VPAP Auto 25, no question.

You won't even have a choice of the S/ST unless you NEED that S or ST and THAT would be indicated right on your equipment order (script). They are an entirely different device for a specific problem w/sleep disordered breathing.

I have the Resmed VPAP Auto that was released 6 months before the VPAP Auto 25 was released. Its a great device and I get good therapy w/it.

I am currently fortunate to have a loan of a PR SystemOne BPAP Auto w/Bi-Flex and feel like I'm getting good therapy w/it. Unfortunately, I am not very 'puter literate and I've run into a snag trying to install EncorePro 2.2 and my 'puter guru who usually installs programs for me is tied up all this week. *sigh*

Going by how I FEEL w/the therapy from each of these devices I'd say it would be hard to go wrong w/either one. My preference for the Resmeds all along has been the easy access to and amount of data available via the LED screen. I'm very frustrated right now that I haven't been able to access my data via the LED screen on the PR SystemOne until just yesterday and even then the data is limited to a 7 day average. FRUSTRATING! On the other hand, it looks like MAYBE I need 2 cms less IPAP than w/the VPAP Auto. So .... until I get the software installed and running I won't know for sure if I'm getting "better" (for me) therapy OR equal therapy w/the PR S1 than the VPAP Auto. I'm definitely FEELING like I am getting AT LEAST as good therapy.

The PR S1 is the newer device. The Resmed VPAP Autos came out in January and July of 2008. The PR S1 BPAP Auto was just release w/in the last few months. The first models of the PR S1 released were released last August (2009) and were the straight CPAP and the APAP. According to our local Resmed Rep the Resmed S9 VPAPs will be released sometime later this year but defnitely before year's end.

[getafix]

Thank you Slinky for your input. That helps me narrow down the choices between the PR S1 BiPAP Pro and Resmed VPAP Auto 25.

Ideally, I would like to try that Resmed S9 VPAP device, but I won't wait that long. I'll post my updates here in this thread on how things go.

[Slinky]

Why the PR SystemOne Pro instead of the PR SystemOne Auto?? I'd go for the Auto rather than the Pro ANY day of the week!!!

[getafix]

Thank you. I'll update that. That is the list I'm taking with me to the DME within a couple of days . I'm looking forward to getting one of these machines and trying them out.

[JohnBFisher]

... I talked to a couple of DMEs in the area and then choose (for no special reason) to go with one particular DME. After talking to them, I'm getting a feel that I'll be getting one of these following machines ... Should I be holding out for more elaborate machines like Respironics BiPAP autoSV or Resmed Adapt SV? ...

Greetings, just wanted to comment on the machine choice. Since you only had a couple central apnea events you really don't need anything more than a BiPAP unit at this point. The S/T type unit and an ASV unit (the BiPAP AutoSV or the VPAP Adapt SV) cost much more and are not warranted. It's not really any different than an obstructive event. Essentially, if you have an AHI of greater than 5 and most are central events, then insurance companies will consider it. And doctors generally won't prescribe it unless there is some other significant factor present (periodic breathing and/or complex sleep apnea). And it's GREAT to hear that you do not have to struggle with that.

However, since you did have a couple central apneas, you probably will not be prescribed an auto BiPAP, since an increase in pressure might trigger more central apneas. And that's appears to be exactly why your doctor prescribed:

Bilevel with IPAP and EPAP specified,
Data Card/Memory feature with AHI and leak values : Yes
RAMP enabled: Yes
Heated Humidification: Yes

By the way, it's great your doctor wants you to have a data capable machine!

Hope that helps explain why just a straigt up "BiPAP" is what was prescribed.

[getafix]

Thank you John for clearing that up. Being new to XPAP treatment, all this information is immensely useful.

Between the PR S1 BiPAP Auto and the S8 VPAP Auto 25, which has better data capability? I read somewhere that the Encore Pro software did not work well with the new PR System One machine. Is this true?

[JohnBFisher]

... Between the PR S1 BiPAP Auto and the S8 VPAP Auto 25, which has better data capability? I read somewhere that the Encore Pro software did not work well with the new PR System One machine. Is this true? ...

Not sure. I think it will be some time (a few months) before Encore Viewer will read / display data from the PR System One units.

I *really* like the ResScan software, but getting an official copy might be an issue. Talk with your DME / doctor. You might be able to get an official copy from the DME.

I also *really* like the feel of the ResMed units. Their "Easy Breathe" technology is based on the work they did with the VPAP Adapt SV units. And it is easier to breathe with it than with my older Respironics M Series REMstar BiPAP Auto with Bi-Flex.

Hopefully users with PR System One BiPAP and S8 VPAP Auto 25 units can provide answers about the data capabilities.

[getafix]

I went to the DME and talk to the Resp. Therapist. She highly recommended the PR System 1 BiPAP Auto machine. So, I ended up getting the following setup:

PR System 1 BiPAP Auto
PR System 1 Humidifier
Mirage Activa LT Mask.

I got a Resmed Easy Life Mask as well on a loaner just to see if it works for me or not. For some reason it leaks heavily for me. So, I've been using the Mirage Activa mask regularly.

I've been using this setup for last four nights.

1. In the morning when I wake up, I'm still tired although things are not as bad as they used to be before I started using a BiPAP machine but things are only marginally better.
2. I'm averaging 3.2 AHI, although at this point I don't have a means to get the detailed information.
3. When I wake up in the morning, it feels as if the pressure that I have set up 17/13
4. I've noticed that the machine data is off by one day. I know that I've used it for four days but it says that days-of-use is 3 days and so on.

I'll be calling my RT and see if there's a way these issues can be resolved.

So, that's where I'm at right now. Just wanted to share here this process that I'm going through.