respironics auto a-flex (550P) = PR1 ?

[Guest]

Hi: I have used CPAP for 10 years, but just now discovered this wonderful community. Just got the above machine. My previous machine is the VPAP III,

I know my new machine is data capable and it come with a 2 gig SD card. I too share the feeling that the software should come with the machine, instead of another
$99.00. Does anybody know where I can download? I'll be appreciated if you could email me. I would love to be empowered to know more about my sleep patterns.
Ever since my sleep study done 10 years ago, my HMO ( the biggest one) had never bothered to ask or check on me.

[cpapernewbie]

it is unrealistic to expect people in this forum to mail you. How do we know what your e-mail address is? A guest is an unknown person and we have no way to contact you except in this forum

[Slinky]

The VPAP III is a Resmed bi-level PAP.

A Respironics Auto w/A-Flex is NOT a bi-level PAP.

The previous Respironics series of PAPs was the M series. The integrated humidifer fit on the left side of the PAP. The new PR S1 series of PAPs the integrated humidifier fits on the right side of the PAP.

[kelingdun]

capernerbie: You are right. I thought I did login using my username, but I guess when I posted, I was somehow not. Hope it is OK this time.

Slinky: Thanks for your reply. My machine had the humidifier on the right side and from reading the forum, it has the standard SD card, so what I had must be the
PR1.

Love this machine already. Just used it for the first time last night. I had always been awake by 6:00 am, like a biological clock, but today, I got up after 7:00.
The machine must be working wonders.

[Janknitz]

First, are you CERTAIN it's the Philips Respironics System One 550S?

I'm a little concerned as you were using a VPAP before, and that's a downgrade. Downgrade not in quality of machine, but in TYPE of machine. The 550S is an autopap, which is good for "simple" obstructive apnea. VPAP's are used to treat central apneas and complex apneas, which require a more specialized machine. Philips Respironics has BiPAP's which I think (and I may be incorrect) do the same thing as VPAP's. They look just like the APAP and CPAPs in the System One line, so perhaps you are confused as to the model number?

If you have been switched from VPAP to AutoPAP, you should understand why. Did you have a recent sleep study that confirmed that you no longer need the higher pressures and inhalation/exhalation adjustments of the VPAP machine? Or did your DME make a mistake and give you the WRONG machine? If you aren't sure call your doctor or DME and ask. Remember, it's your therapy and your health, and you have to understand what's going on and advoacte for yourself.

[kelingdun]

Hi Janknitz:

Thanks for your reply. Long story. 9 years ago, I had double insurance. I was using the old SoloFX CPAP, and complain that it was hard to exhile. The practioner
was nice enough to suggest Bipap, simply because it allow less force during exhile. I just learn now, after reading this wonderful site, that the Bi-pap was for treating
different symptom. So I got the Bi-pap for the wrong reason. Like I said, I only had one night on the " Philip Respironics auto A-flex 550P" (yes, possitive), and I like
it already. Now I have Kaiser, I think HMO can care less, I have to care for myself. Like to get the software and understand my pattern more.

I asked Kaiser to see if I can do another study ( last one 2001 ), she said no need. the auto-cpap will auto deliver the right pressure anyway

I hear you and I am learning. So like I said, I was on the wrong machine for 9 years. But I am sure I have OSA.

[rested gal]

9 years ago, I had double insurance. I was using the old SoloFX CPAP, and complain that it was hard to exhile. The practioner was nice enough to suggest Bipap, simply because it allow less force during exhile.

The practitioner was indeed nice...and correct... in suggesting a bilevel (the VPAP) machine way back then, to give you an easier way to breathe out.

I just learn now, after reading this wonderful site, that the Bi-pap was for treating different symptom. So I got the Bi-pap for the wrong reason.

Not the "wrong reason" at all. Bilevel machines can be used for a variety of reasons, including the very simple reason of making breathing out easier and more natural feeling for people with plain obstructive sleep apnea. While bilevel machines are often prescribed for more complicated problems, a person doesn't have to have a more complicated problem or special symptoms to use a bilevel machine. A bilevel machine (BiPAP and VPAP are Respironics' and ResMed's trademark names for their bilevel machines) can be a very comfortable way for people with just OSA and no complicating factors to get effective treatment for their plain OSA.

Like I said, I only had one night on the " Philip Respironics auto A-flex 550P" (yes, possitive), and I like
it already.

Good. You have a good autopap machine.

Now I have Kaiser, I think HMO can care less, I have to care for myself. Like to get the software and understand my pattern more.

You have the right attitude!

I asked Kaiser to see if I can do another study ( last one 2001 ), she said no need. the auto-cpap will auto deliver the right pressure anyway

How effectively the autopap will be able to do that often depends on how the range of pressure is set. It's usually best, imho, to set the minimum pressure up high enough to try to prevent all obstructive apneas completely. Make it easy for the autopap to do its job well.

In other words, if it takes a pressure of 10 to usually prevent apneas for you, I'd set the autopap's minimum pressure at 9 or 10, and then set the maximum pressure wherever I wished up higher... set the max anywhere from 15 to 20.

Then, the most important bit of overnight data to look at is the leak rate. Next most important to look at is the AHI. Leak needs to be well under control so the AHI will be meaningful.

I was on the wrong machine for 9 years.

No, I don't think you were on the "wrong machine" at all during those 9 years. The IPAP/EPAP pressures might not have been set ideally for you. Or they might have been set fine to start with, but your pressure needs might have changed over those years. But I don't think it was a "wrong machine" at all.

But I am sure I have OSA.

You're doing the right thing for yourself... treating your OSA. Good for you! Please keep letting us know how it's going for you.

[kelingdun]

[ In other words, if it takes a pressure of 10 to usually prevent apneas for you, I'd set the autopap's minimum pressure at 9 or 10, and then set the maximum pressure wherever I wished up higher... set the max anywhere from 15 to 20.
]

Thanks rested gal and all. But could anybody tell me how to change the initial setting from thr default 4?

[Janknitz]

Kelly,

Phew, I'm glad they didn't mistakenly put you on the wrong machine.

I asked Kaiser to see if I can do another study ( last one 2001 ), she said no need. the auto-cpap will auto deliver the right pressure anyway

I have Kaiser too, and here's my take on it. Before I begin, let me say I am NOT an apologist for Kaiser. When my husband told me that it is the only insurance offered by his employer (I can't get my own insurance because of pre-existing conditions and I'm self-employed) I actually told him to QUIT his new job. I once said that I would take Kaiser over my dead body. But I'm still kicking after 4 years on Kaiser and I have to admit that some things they actually do quite well. I think--in general--they do handle OSA fairly well (not overwhelmingly perfect, but not too bad).

1. They do ONLY home studies and home titrations on PR S1 autopaps to my knowledge. Seems like some people MUST have in-clinic studies for complex problems, but I've never heard of Kaiser doing any that way. BUT, they use the "latest and greatest" home study devices, and I was pleasantly surprised because I think in general I did WAY better with a home study and their inobtrusive machine than I ever would have in a clinical setting.

2. As I mentioned, they use the PR S1 auto as a home titrating machine. That's why they are not too concerned about doing a new study for you, as this is how they would retitrate you in any case.

3. Kaiser does things as cheaply as possible--that is true. BUT, in the case of SA, they have figured out that untreated and poorly treated SA cost them more for treating the resulting medical conditions. So they are actually proactive in testing people, EDUCATING people (you MUST attend a 2+ hour class on SA before they will titrate you if you are new to CPAP), and treating you.

4. I’m in Northern California and my local regional Kaiser actually has a great sleep clinic staff. They do a little more follow-up than most of the private physicians and DME’s I’ve heard about on this forum. And, if any questions or problems occur, I can call them and they will absolutely work with me on my therapy—no charge to me, not even a co-pay. I’m sure this varies region to region—I have not heard such good reports from Kaiser members elsewhere.

5. The big PITA, as far as I’m concerned, is that Kaiser is also technically the DME provider, although they contract with Crapria for the actual provision of equipment and supplies. That means you get what Kaiser says you get and the ONLY supplier is Crapria. Period. They only use PR S1 machines (not bad machines at all, but you have no choice) and have a limited choice of masks on their formulary. For example, I like the Swift FX, but I have to buy it myself because it’s not on the Kaiser formulary. On the other hand, Kaiser is responsible for mask fittings, and they have a large variety of sample masks—they are happy to give you several to take home and try if you ask.

Crapria treats Kaiser patients like dirt. I was having a mask provision problem, and the tech at Crapria was complaining to me about having to provide items to Kaiser patients at a very low profit margin. Not my problem, lady! I’m quite certain that what Kaiser doesn’t pay them in profit margin is more than made up for in volume, as just the local Kaiser alone must send them around 50 new patients each and every week who are going to need a lifetime of supplies.

When I hear the horror stories of some people out there with private sleep doctors and clinics, Kaiser doesn’t look too bad. Never thought I’d be saying that