Autoset to replace Elite

[kempo]

I question your decision to replace the the Elite with the AuotSet . I could have asked for the AutoSet but decided to go for the Elite (under Medicare I don't pay extra for any) b/c:

1) The AutoSet is a dangerous machine if you run it in the APAP mode. Not only that you could goof by setting pressures but it uses new technology that is still questionable.

2) If you run it in the CPAP mode then it's exactly as the Elite but overall a more complicated machine.

So your DME talked you into an Elite? You know why? The DME made more money on the sell. That's the only reason. Now your stuck with just a cpap for 5 years while your needs may change before the 5 year is up.

I'm so glad I found this forum before I took my sleep test!

[NancyAZ]

I laughed as I read the responses. Many of you have a great sense of humor and I love to laugh. Seems that if you let it, the world can seem to be a pretty dismal place. I'd rather laugh.

I told the DME that I wanted the S9 Autoset and asked if they had that machine and she said that they did. I also specifically told my doctor what I wanted. If they don't bring that one on Monday, I'll refuse it.

Thanks for the great laugh!
Nancy

[KatieW]

Yes...the DME said they had the S9 AutSet, then brought out the Escape Auto. My husband marched him right into the bedroom, and showed him mine, and said "this is what I want".

The DME guy said "oh, aren't they the same? Escape from the Escape!

[scrapper]

I love seeing that other people are finally starting to pick up on the nonsense often posted by avi123. IMHO he's more dangerous than a troll, because newbies could believe his posts when he's not quite so far off the mark as he is in this post.

He can flame me all he wants.......as he usually does

[NancyAZ]

I'm glad so many people responded because after I saw the post saying that the Autoset is a dangerous machine, I thought, "What have I done?!!!" Thank you.
Nancy

[avi123]

I'm pretty new to the CPAP world and I received the S9 Elite and have used it almost a month. I can tell you that Pugsy IS correct when it comes to the Autoset vs. the Elite. I'm having problems with my titration pressure level and I would have known sooner if my pressure should be higher if I had the Auto Set instead. I don't like the Elite because it gives you constant pressure regardless whether it is helping you or not. Plus the Autoset, depending on what the range is, will adjust to your needs.

Reply:


I think that you're mistaken. S9 Elite will give you any pressure up to 20 cm H2O on inspiration. On expiration the EPR could drop the pressure by 3 cm H2O within one cm steps. One thing it does not do is to change pressures on its own upon detection of Apneas. Doing so (using a S9 Auto Set) you need to trust the machine to be your doctor. I would not trust it especially b/c it uses a still unproved technology. But many in this forum do. IMO, most posters who do it are sort of Sleep Doctors' impostors. Of course they can do it safely b/c they are hidden from their real names and thus are NOT legally responsible. So they are free to take stupid guesses on your life well being. Why not turn you into their Guinea Pigs?

[SnoozyQ]

On expiration the EPR could drop the pressure by 3 cm H2O within one cm steps

Unless you just turn OFF the EPR.....

[Pugsy]

I'm glad so many people responded because after I saw the post saying that the Autoset is a dangerous machine, I thought, "What have I done?!!!"

Nancy, you're comment here is exactly why I responded as I did to avi and why the others responded.
You are new to all this immense amount of information and easily influenced by what someone says. Most of what avi says isn't so far off but sometimes what he says is just plain so far off the mark that it is potentially harmful or definitely misleading. I question where he gets all this "information" and if he wants to believe otherwise, that is fine but there are many of us here that will indeed challenge misleading and potentially harmful statements.

Those of use with experience knew that the "dangerous" statement was hogwash but to leave it unchallenged would be leaving it open for anyone stumbling upon this thread (maybe another newbie) to see it and maybe get the wrong idea.

On a positive note, you will love the Autoset. You may or may not do better in APAP but you can at least try it and see for yourself and eliminate the "what if". The mind is a powerful drug and sometimes just peace of mind helps as much as anything else. This is why I tell people if they really want it, get it. Fulfilling that want eases the mind.
Silly little psycho babble but I think it does impact how we feel.

[BlackSpinner]

One thing it does not do is to change pressures on its own upon detection of Apneas. Doing so (using a S9 Auto Set) you need to trust the machine to be your doctor. I would not trust it especially b/c it uses a still unproved technology. But many in this forum do. IMO, most posters who do it are sort of Sleep Doctors' impostors. Of course they can do it safely b/c they are hidden from their real names and thus are NOT legally responsible. So they are free to take stupid guesses on your life well being. Why not turn you into their Guinea Pigs?

Do you have documentation that this is un proven? Like maybe that it was rejected by the FDA? Why should we take your word on this? This technology (Autoset) has been out in the field for years so you should be able to find legit studies to prove this. One anecdote does not make for a scientific study by the way.

[avi123]

On expiration the EPR could drop the pressure by 3 cm H2O within one cm steps

Unless you just turn OFF the EPR.....

Hi Snoozy, since you have such a small face how could you use such a large mask?
Please be careful playing with those pressures on your S9 AutoSet.


Are you interested to be adviced by this Doc:

XXXX, M.D., F.C.C.P.

INTERNAL MEDICINE & PULMONARY MEDICINE

Undergraduate: Union College, Schenectady, NY
Medical School: Albert Einstein College of Medicine, Bronx, NY (with honors)
Internship: Bellevue Hospital, New York University Medical Center, NY, NY
Residency: Bellevue Hospital, New York University Medical Center, NY, NY
Fellowship: Pulmonary Medicine, N.Y.U., NY

Membership:

Alpha Omega Alpha, Honors Medical Society
Fellow, American College of Chest Physicians
American Thoracic Society
American Academy of Sleep Medicine
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Board certified: Internal Medicine, Sleep Medicine, and Pulmonary Diseases

Dr. XXXX practiced Pulmonary and Internal Medicine for three years in central Massachusetts
prior to joining XXX in 1991.

BEST SLEEP DOC IN MY HOME TOWN!

[scrapper]

Nancy.............you quickly learn to ignore certainly members of this forum. There's not many to ignore...but you've experienced one obvious one.

Before I started with the vpap, I had both the S9 AutoSet (primary) and S8 AutoSet as backup. Both are great machines with solid reputations, with the S9 being preferable in many respects. You've chosen an excellent machine--be assured.

[scrapper]

On expiration the EPR could drop the pressure by 3 cm H2O within one cm steps

Unless you just turn OFF the EPR.....

Hi Snoozy, since you have such small face how could you use such a large mask?

Off topic:

Avi123: Why is it when you're wrong and presented with the truth, you resort to name calling and meanness? It's totally uncalled for and unappreciated. It is so childish................hard to believe that you are the educated man you claim to be. We are all wrong or misinformed at times because we are human...........but your response is totally inappropriate and immature. It goes against the very nature of this forum--people who want to educate, support, and befriend each other. It's time to either act like a man, or move on....................

[DreamDiver]

I'm glad so many people responded because after I saw the post saying that the Autoset is a dangerous machine, I thought, "What have I done?!!!" Thank you.
Nancy

Congratulations Nancy!

In avi's defense, some of the older auto machines could be a little dangerous for some people with certain SDB challenges.

The S9 is a very safe machine. Please let us know what your pressure settings are when you get the machine on Monday.

[SnoozyQ]

Hi Snoozy, since you have such a small face how could you use such a large mask?
Please be careful playing with those pressures on your S9 AutoSet.

Am I the only person on the planet with a small face? Doubt it. That's why masks are made in "sizes". I wear an extra small. But thanks for the irrelevant point.

You worry about your pressures and I'll worry about mine, 'k?

[Janknitz]

I think that you're mistaken. S9 Elite will give you any pressure up to 20 cm H2O on inspiration. On expiration the EPR could drop the pressure by 3 cm H2O within one cm steps. One thing it does not do is to change pressures on its own upon detection of Apneas. Doing so (using a S9 Auto Set) you need to trust the machine to be your doctor. I would not trust it especially b/c it uses a still unproved technology.

Avi, there are many evidence-based studies that disagree with your conclusory statement. Auto-titration IS "proven technology" and is becoming very common with the same machines we use at home. The studies show that the accuracy of auto-titration is equal to or superior to in-lab titrations and these are the machines we use. For example:

http://www.ncbi.nlm.nih.gov/pubmed/12598214

Self-adjustment of CPAP at home will provide equal or superior efficacy in the treatment of obstructive sleep apnea (OSA) as compared with in-laboratory titration.

The full article is here
http://ajrccm.atsjournals.org/cgi/conte ... /167/5/716
And it concludes:

This study demonstrates that patients with OSA are capable of effective self-titration of CPAP treatment at home.

http://www.journalsleep.org/Articles/291110.pdf

[quote]Conclusions: Home-based automat ... /1143.pdf (especially

There is also evidence that there is considerablenight-to-night variation in the CPAP pressure needed to abolish obstructive events, making a one-night titration itself relatively unreliable, however well performed (15). This is one argument used to justify the continual use of autotitration machines, and the abandonment of fixed pressure machines

)

http://www.ncbi.nlm.nih.gov/pubmed/19408029

CONCLUSION: Auto-CPAP estimate of AHI may be used to estimate residual AHI in patients with OSA of varying severity treated with auto-CPAP.

http://www.ncbi.nlm.nih.gov/pubmed/19230758

CONCLUSION: In these SAHS patients with moderate sleepiness treated with CPAP, we found no difference in effectiveness between an algorithm-based pressure and an auto-titrated pressure.

http://www.ncbi.nlm.nih.gov/pubmed/17162992

CONCLUSIONS: Home-based automated CPAP titration is as effective as automatic in-laboratory titrations in initiating treatment for OSAHS.

http://www.ncbi.nlm.nih.gov/pubmed/15282204

Autoadjusted titration at home and predicted formula titration with domiciliary adjustment can replace standard titration.

I can go on an on! Evidence based studies—try them sometime!