Exhale relief on APAP?

[SharkBait]

I'll start with the question before I drone on a little about myself...

I've noticed that the S8 Vantage has EPR only in CPAP mode and it has me wondering why? The technology is already in the machine, so why not use it? Is it just totally unnecessary in APAP mode? Does part of "Auto" mean it's going to decrease during exhale? A few of the others don't even have it at any mode...

Do I really need this relief? I had a sleep study done Saturday night and while the game plan was for me to come back a 2nd night, it only took about an hour and a half (when I FINALLY got to sleep...) for them to determine I WILL be using CPAP. She put the mask on me at around 2:30 (no idea what the pressure was set at), and it was pretty disturbing at first trying to exhale against that pressure. I was just laying there for about an hour thinking, "Okay, I'll lay here awake until 6:00 because this ain't happening". But after a while I began getting acclimated and kind of learned to breathe against the thing and after an hour I started dozing off. I woke up a couple of times when my mouth draped open, but then I finally went on to sleep for good and she let me sleep until 7:00 since I was up for most of the night (even without the CPAP it was tough to get to sleep as you well know...).

So while it was pretty uncomfortable I did finally settle down (I was a bit panicky there...) and I did get to sleep... I guess I'm wondering if I'll get use to the pressure and the exhale relief won't be necessary...

When I got up in the morning she showed me the before and after picture on the computer and it was pretty amazing. I was having approx 60 apnea events an hour and they were plotted across the graph like clock work. Then once I got to sleep with the CPAP they disappeared and obviously I got into deeper sleep patterns. With I'm guessing 4-5 hours of total sleep I felt pretty darned good. I was clearer in the head, but I'm not sure if that was real or just the excitement of everything that was going on and being in a strange place upon waking...

This site has been GREAT and I'm really ready to go. I called the lab and told them I'd be wanting a copy of the report and they said it would be Thursday before they had anything and then they'd be sending it to my doctor first. I've got a huge deductible for my insurance coverage so I'm pretty sure all this will be on my nickle. My plan is to appeal to my doctor to forgo a titration study (if they try to do one) and let me get an APAP and the software and do it myself (with your help I'm sure). Either way I will be getting full data and software because that's how I roll anyway.

I'll tell you, I'm pumped. I know there will be challenges, but I read half the night anyway so I'll just read wearing a mask if necessary. I know we're all wired a little different, but it astounds me that 1/2 the folks let themselves fail. That's simply not an option. I've got a friend that went a couple of weeks with CPAP that I'm going to try to work thru this as well. It wasn't really that bad for him, he just kind of stopped using it (says he likes to sleep on his stomach and he can't with CPAP). I guess denial can be pretty powerful.

Anyway, a bit of introduction and gotta thank you guys for all you've done already. I can just imagine what I would have ended up with if I wasn't armed with so much info already...

[alnhwrd]

Welcome to the forum! It sounds like you have a great attitude and want to make this work. The Vantage does not have EPR in APAP mode, but the Respironics M Series Auto with A-Flex does. The Resmed Autoset II has EPR in auto mode, in fact it uses the new Easy Breathe which is even better than EPR. EPR is very helpful when starting out CPAP therapy. Like you, when they first put the mask on me it felt like trying to breath against a gale, but now I don't use EPR at all and I wonder if the machine is even on.

It sounds like you had a split study, with the second have being the titration, so I'm wondering why you need another full night's study? If your report has the pressure at which you stopped having apnea's, that would be your titrated pressure, the one your machine would be set at.

Be careful of the DMEs out there. Some are staffed by wonderful caring people, others will charge you everything they can and give substandard service. If you have a high deductible that hasn't been met yet, you may very well be better off paying out of pocket for your equipment from CPAP.com or cpapauction.com. Everything I have purchased from our hosts has been quality stuff as advertised and delivered quickly. For what my first DME charged for just the machine I could have bought two complete set-ups from CPAP.com. So do the math and see which works out best for you.

Good luck to you and I hope you are sleeping well soon!

[SharkBait]

Thanks alnhwrd. I'm betting I'll be buying everything from cpap.com or cpapauction... I may go to the local conglomerate hospital's supply house and do a machine rental just to make certain it's what I want, but when it comes to making a purchase there's no way I pay those elevated prices.

[Georgio]

"let me get an APAP and the software". Get it from cpap.com. Yes, that is what you want to do. Specifically what machine will depend on what shows up in your reports. You can post them here for advice on equipment. Exhalation, and inhalation relief are great things to have. I think that many that fail to adapt to cpap would have been able to with apap. It feels so much more like normal breathing.

Georgio

[KengEsq]

Welcome Sharkbait,

It appears you will be purchasing your own equipment rather than having it provided by a health insurer thru a DME. If that is so, you can buy a new ResMed S8 Autoset II with hose, case and H4i humidifier at this site (http://www.cpapxchange.com/cpap-machine ... 33129.html) for only $669.00. If you have health insurance go thru your insurer and the insurer will set you up with a DME who will also monitor your use and report the results to your sleep doctor.

Good luck.

[Wulfman]

Welcome Sharkbait,

It appears you will be purchasing your own equipment rather than having it provided by a health insurer thru a DME. If that is so, you can buy a new ResMed S8 Autoset II with hose, case and H4i humidifier at this site (http://www.cpapxchange.com/cpap-machine ... 33129.html) for only $669.00. If you have health insurance go thru your insurer and the insurer will set you up with a DME who will also monitor your use and report the results to your sleep doctor.

Good luck.

And CPAP.COM will price match.

Den

[ozij]

https://www.cpap.com, who host this forum will match any price on the internet - so do your comparison shopping first and then decide where to buy.

O.

[KengEsq]

I learn something new everyday. That's great about CPAP.com matching any other price because everything I've ever purchased on line I have purchased from CPAP.com. Now I know I could have saved money. I will make certain I get prices from other on-line sellers before I purchase from CPAP.com. Is there any thing special I need to do to get the price matched?

[SharkBait]

Thanks guys. Works out awesome because with these guys shipping same day as the order and Abilene, TX ground shipments from Houston being next day, it will be real easy to decide to support the company that provides this message board...

[nomoore]

It sounds like your apnea was bad enough that they performed a split night study where they titrate you for the cpap during the second half of the night. You will most likely not need a separate titration study.

Exhale relief is a comfort feature that makes it easier to breathe out. It lowers the pressure for exhale. Do you need it? Some people can't get to sleep or stay asleep without it. It sounds like you got to sleep eventually but do you know whether the machine they titrated you with had exhale relief turned on? I asked my sleep tech if he had it on when he titrated me and he said he generally leaves it on a setting of 2. Since you are new to CPAP I would highly recommend getting a machine with some sort of exhale relief.

As for the S8 Vantage, it does NOT have EPR in "Auto" mode. "Auto" does not mean that it has exhale relief. Only that it will adjust itself in response to respiratory events.

If you want a Resmed brand "Auto" machine with exhale relief then you need to look at the Resmed S8 Autoset II.

Some others Auto machines with exhale relief are:
Respironics M-Series Auto with A-Flex (also has C-flex, therefore two different types of exhale relief)
Respironics M-Series Auto with C-Flex (older than the A-flex model, only has C-flex)
Respironics REMstar Auto C-Flex (even older than the M-Series I believe)

[Wulfman]

I learn something new everyday. That's great about CPAP.com matching any other price because everything I've ever purchased on line I have purchased from CPAP.com. Now I know I could have saved money. I will make certain I get prices from other on-line sellers before I purchase from CPAP.com. Is there any thing special I need to do to get the price matched?

I've never actually used the "price match" with them, but I would presume that one would need a web link to the company and item in question (and probably if there had been a notification from that company of a price that was different than advertised.....in the case of MAP pricing).

Den

[alexcue]

Just a note on the price match, the original quoted machine was Autoset II w/h4i, I don't see the h4i humidifier even listed on CPAP.com.

the h4i is a great humidifier, I'm only on the 2 setting and it's more than sufficient for my needs. Seems that the h3i had output problems in comparison. Just an FYI.

Before i get berated i always check with CPAP.com for my supplies first! and have been very happy with their service.

[SharkBait]

It sounds like your apnea was bad enough that they performed a split night study where they titrate you for the cpap during the second half of the night. You will most likely not need a separate titration study.

Exhale relief is a comfort feature that makes it easier to breathe out. It lowers the pressure for exhale. Do you need it? Some people can't get to sleep or stay asleep without it. It sounds like you got to sleep eventually but do you know whether the machine they titrated you with had exhale relief turned on? I asked my sleep tech if he had it on when he titrated me and he said he generally leaves it on a setting of 2. Since you are new to CPAP I would highly recommend getting a machine with some sort of exhale relief.

As for the S8 Vantage, it does NOT have EPR in "Auto" mode. "Auto" does not mean that it has exhale relief. Only that it will adjust itself in response to respiratory events.

If you want a Resmed brand "Auto" machine with exhale relief then you need to look at the Resmed S8 Autoset II.

Some others Auto machines with exhale relief are:
Respironics M-Series Auto with A-Flex (also has C-flex, therefore two different types of exhale relief)
Respironics M-Series Auto with C-Flex (older than the A-flex model, only has C-flex)
Respironics REMstar Auto C-Flex (even older than the M-Series I believe)

Okay, that's pretty clear. I'm leaning M-Series Auto with A-Flex. I finally got to sleep, but wow that trying to exhale was pretty sucky. It seemed to get easier, but then it might have been in "auto" mode and actually was getting easier. She hooked me up, hit the switch and left the room, so unless there's something she could do from her desk...

But I did start calming down and finally got in a breathing pattern where I was getting the exhales sufficiently out. Once that occurred I finally began drifting off. The difference of before and after getting on CPAP on the graph was incredible.

QUESTION: I have always considered myself a "mouth breather", at least when I sleep. So a couple of times my mouth fell open and that freaky air rush woke me up, but I closed my mouth and fairly quickly fell back to sleep. I then for about the last hour and a half (as far as I know anyway) slept with my mouth kept close. Will this actually train me to keep my mouth closed or do I need to look at the full face masks?

Thanks again

[SharkBait]

Just a note on the price match, the original quoted machine was Autoset II w/h4i, I don't see the h4i humidifier even listed on CPAP.com.

the h4i is a great humidifier, I'm only on the 2 setting and it's more than sufficient for my needs. Seems that the h3i had output problems in comparison. Just an FYI.

Before i get berated i always check with CPAP.com for my supplies first! and have been very happy with their service.

I noticed that as well. Does that other site carry the software? It didn't offer to add it in like it did when I price compared the Respironics unit. Is one machine's software significantly better than the other?

[KengEsq]

It sounds like your apnea was bad enough that they performed a split night study where they titrate you for the cpap during the second half of the night. You will most likely not need a separate titration study.

Exhale relief is a comfort feature that makes it easier to breathe out. It lowers the pressure for exhale. Do you need it? Some people can't get to sleep or stay asleep without it. It sounds like you got to sleep eventually but do you know whether the machine they titrated you with had exhale relief turned on? I asked my sleep tech if he had it on when he titrated me and he said he generally leaves it on a setting of 2. Since you are new to CPAP I would highly recommend getting a machine with some sort of exhale relief.

As for the S8 Vantage, it does NOT have EPR in "Auto" mode. "Auto" does not mean that it has exhale relief. Only that it will adjust itself in response to respiratory events.

If you want a Resmed brand "Auto" machine with exhale relief then you need to look at the Resmed S8 Autoset II.

Some others Auto machines with exhale relief are:
Respironics M-Series Auto with A-Flex (also has C-flex, therefore two different types of exhale relief)
Respironics M-Series Auto with C-Flex (older than the A-flex model, only has C-flex)
Respironics REMstar Auto C-Flex (even older than the M-Series I believe)

Okay, that's pretty clear. I'm leaning M-Series Auto with A-Flex. I finally got to sleep, but wow that trying to exhale was pretty sucky. It seemed to get easier, but then it might have been in "auto" mode and actually was getting easier. She hooked me up, hit the switch and left the room, so unless there's something she could do from her desk...

But I did start calming down and finally got in a breathing pattern where I was getting the exhales sufficiently out. Once that occurred I finally began drifting off. The difference of before and after getting on CPAP on the graph was incredible.

QUESTION: I have always considered myself a "mouth breather", at least when I sleep. So a couple of times my mouth fell open and that freaky air rush woke me up, but I closed my mouth and fairly quickly fell back to sleep. I then for about the last hour and a half (as far as I know anyway) slept with my mouth kept close. Will this actually train me to keep my mouth closed or do I need to look at the full face masks?

Thanks again

The right mask is something not easy to find and usually requires a lot of trials of different masks. I've tried just about all for "mouth breathers." The best full face mask so far and the one I have been using with great success and no discomfort, sores or leaks is the ProBasics Zzz-Mask (full face). It is also relatively inexpensive ($89.00 at CPAP.com).