New User - Which Machine

[wildhog]

Hi to all from Western Australia. I have been using loan machines from the sleep clinic for almost a month and now need to decide which model to buy. I have tried the Philips Respironics and am currently using one of the Resmed S9 in cpap mode. I am leaning towards the S9 as I like the way the air flows and the size of the machine as I travel. Also is it worth spending the extra money and buying a machine that also has APAP? I was put on APAP for the first week on 6cm and later was swapped onto CPAP on 8cm. All the staff at the Sleep Clinic (which have been great) seem to comment that I do not need to spend the extra money for an APAP machine as I am doing well on CPAP which I feel I am, except that on the higher air flow I got some mouth leaking and have had to get a chin strap where on APAP (6cm) I had no mouth leaking.
Any comments or suggestions will be appreciated as I do want to make the right decition before I part with all that money. Many thanks

[Slinky]

It sounds like whilst you were on the APAP it was in auto mode so it was set w/a pressure range and most likely 6 cms was the lower pressure setting and can only guess at what the upper pressure setting was. But they were able to determine that 8 cms was the pressure you needed to stop most apneas.

Get the Resmed - but - do NOT accept the S9 Escape, insist on the S9 Elite - or pay the extra for the S9 AutoSet, whichever your preference there. The Elite has EPR, set the EPR to 2 and that will provide only 6 cms of pressure on exhale and that may help w/the leaks you've been getting at 8 cms.

The Escape Auto is NOT fully data capable, whereas the Elite and the AutoSet are. Personally I would not pay extra for the Escape Auto. If your only choices are the S9 Escape or S9 Escape Auto then depending how much more expensive the Escape Auto is for comfort's sake I'd go w/the Escape Auto. But before doing so I would want to try the Escape w/EPR and see if that helps w/the leaks or not.

I'd certainly prefer NOT having to wear a chin strap due to leaks w/the Escape if I didn't have a leak problem w/the Auto.

[wildhog]

Thanks Slinky for your promp reply. Yes you are right APAP in auto mode was set to 6cm as min. Currently in CPAP mode. When I first used it I had trouble exhaling so I set the EPR to 2 and it made a huge difference. What they are saying to me is that in APAP Auto I was still having average 2-3 apneas per hour, which is still alot better from the 26-28 p/h when I had my sleep study.
So is a machine in APA Auto mode set for lets say 6cm min and 8cm max going to be able to be quick enough to always pick up an apnea and ramp itself up to the higher setting or is it more certain to be in CPAP mode at 8cm??
Thanks again.

[Midas]

Get the DeVilBiss Auto, very good and dead cheap from Secondwind

[Slinky]

It sounds like whilst you were on the APAP it was in auto mode so it was set w/a pressure range and most likely 6 cms was the lower pressure setting and can only guess at what the upper pressure setting was. But they were able to determine that 8 cms was the pressure you needed to stop most apneas.

Get the Resmed - but - do NOT accept the S9 Escape, insist on the S9 Elite - or pay the extra for the S9 AutoSet, whichever your preference there. The Elite has EPR, set the EPR to 2 and that will provide only 6 cms of pressure on exhale and that may help w/the leaks you've been getting at 8 cms.

The Escape Auto is NOT fully data capable, whereas the Elite and the AutoSet are. Personally I would not pay extra for the Escape Auto. If your only choices are the S9 Escape or S9 Escape Auto then depending how much more expensive the Escape Auto is for comfort's sake I'd go w/the Escape Auto. But before doing so I would want to try the Escape w/EPR and see if that helps w/the leaks or not.

I'd certainly prefer NOT having to wear a chin strap due to leaks w/the Escape if I didn't have a leak problem w/the Auto.

Oh yeah. It can respond fast enough w/that narrow a range, Actually, it is usually recommended to set the lower pressure 1-2 cms below your titrated pressure and 2-3 cms above your titrated pressure so a pressure range of 6 cms to 10 or 11 cms would be a good starting point.

An AHI of less than 5.0 is considered "normal". 5 to 15 is considered mild OSA. 15 to 30 is considered moderate OSA. And above 30 is considered severe OSA.

[Pugsy]

How much difference in price for the S9 Elite and the S9 auto? If not a huge difference consider the S9 Autoset (not the Escape) because it can also be used in straight CPAP mode should you want to. So essentially 2 machines in one. The S9 Elite straight CPAP is only a straight CPAP. You might do better on straight CPAP or you might find that APAP works the best for you. It is nice to have a machine that will do both if that is what you want and the cost difference is not huge. Here in the US, the cost difference is not all that huge.

[Slinky]

I guess in worrying about cost and cost differences I might not have been particularly clear. As Pugsy said, depending on your finances we would recommend first choice the S9 AutoSet, 2nd choice would the S9 Elite, 3rd choice the S9 Escape Auto and last choice the S9 Escape.

[sol]

It is all depends on your budget and the insurance will pay 500 dollors towards the cost if you have one ,in Australia there is nearly 500 dollors price difference between S9 Autoset and S9 Elite unlike cpap.com where the difference is about 50 dollors ,the best place is to buy from on line supplier as they are about 500 dollors cheaper than the other ones for the same unit ,or you might want to check http://www.secondwindcpap.com for their offers .

[dtsm]

Most of us would recommend machine MUST the following features:

1. apap [auto adjusting cpap] unit
2. full data capability

Everything else is optional and of personal choice. But the two above permit you to manage your therapy....

[BanjoPaterson]

Check out http://www.gumtree.com.au as well. They have CPAPs and you can look in the Sydney area, for example, and ask them to post it to you. Note: http://www.tradingpost.com.au, like ebay, does not allow cpaps adverts. We also have craigslist in Australia, but it's nowhere near as used as in the US.

[TalonNYC]

Wowsa, I didn't even know what EPR was. I apparently (and miraculously) lucked out and got the ResMed with it enabled. I can say that it makes a HUGE difference for me. They fitted the mask with full Rx pressure and no EPR, and the 12 cm felt like I was trying to breathe in a windstorm. With EPR on (which they configured but neglected to inform me about) I didn't notice that "windstorm" feeling either while test running - i.e. while awake - it or using it while sleeping.

[FINALLYGAVEIN]

I am a fairly new user and had some issues with several machines until I recently found the perfect machine which is out of your home town: Fisher & Praykel ICON auto with senseawake - It is an apap machine that sets itself at your best pressure and gets to know your breathing and need patterns and when it senses your breathing pattern changing it lowers the pressure so you do not wake up but go back into deep sleep. It took me all of 3 days to get to be a pro on this machine which I am able to keep it on for the full night now and I don't even realize it is working. Best of luck..... you should check it out. .... I love it.

[jdm2857]

Fisher and Paykel is a New Zealand company; ResMed is Australian.

[BanjoPaterson]

Fisher and Paykel is a New Zealand company; ResMed is Australian.

Fisher and Paykel, in terms of domestic appliances, used to have an excellent reputation in Australia, but lately (??) that reputation has taken a beating of late with sub-standard dishwashers (see http://www.productreview.com.au/showite ... em_id=1155), fridges and washing machines. That particular dishwasher is one that I have, and it is terrible, and our F&P fridge, which is only a few years' old, is beginning to pack it in. Likewise, my sister's F&P washing machine's motherboard blew up within warranty, which wasn't too bad, and then outside warranty and the cost to replace it was more than to buy a new washing machine.

That said - the xPAP appliances I've seen around the Chemists which stock F&P look well built and solid. I do like the look of the Icon and, no doubt, if there were the slightest QA problem with them it would be reported here very quickly! However, my own experiences with the sub-standard household appliances from F&P in Australia has definitely tainted my perception, and given the choice I would buy any other brand before F&P.

[wildhog]

Thanks to all. I feel more confident about living with the machine knowing that there is a community like this to get help from when I need it.
I have started to play with the software Resscan 3.13. Seems to work good but have no idea how to interprete the results. Is there a site that allows one to learn how to read the graphs etc?