What are reasons to NOT get an Auto machine?

JCraig · Post by **JCraig** » Thu Jul 27, 2006 4:55 am

Just had my sleep study on Sunday, don't have results yet, but of course, I'm planning out my machine purchase.

I don't know what my AHI is (tech said she isn't allowed to give out results, has to be a doctor), but I did get out of her that my CPAP pressure ended up at 13cm.

Soooo... I'm wondering, what would be a reason to NOT get an Auto machine? It seems to me that they're the best possible option. Insurance isn't an issue for me -- I'm on an HSA plan and can just use HSA funds to buy whatever the heck I want. Are there medical reasons to avoid Autos? Any other reasons? I sure don't want to buy the wrong machine.

TerryB · Post by **TerryB** » Thu Jul 27, 2006 5:31 am

In My Humble Opinion, the auto is the best option if you go all the way and monitor your own results with software or the machine display on some models. I have the Respironics Auto w/C-Flex and I'm pretty well convinced that I am must comfortable AND have the lowest Apnea figure (0.0 AHI one night) with the machine running in CPAP mode, but, my Hyponea count rises slightly with CPAP as compared to APAP. So, more research is in the works, but I have the choice available whereas the CPAP only machine wouldn't be near as much fun or offer the choice. Now if I only had an Oximeter.

TerryB

JCraig · Post by **JCraig** » Thu Jul 27, 2006 5:33 am

Yeah -- I just noticed that you can put the machine into traditional CPAP mode, disabling the Auto features. I think that decides it... No reason not to get the Auto. I'm looking at the REMstar; seems to be the line everyone gets.

Wulfman · Post by **Wulfman** » Thu Jul 27, 2006 5:40 am

No reason, except for cost or unless you needed a Bi-PAP machine for special breathing or pressure considerations.

You can always run an APAP in a single-pressure mode (CPAP).

I actually do better in a single-pressure mode, which I finally verified with an APAP.

Best wishes,

Den.

Guest · Post by **Guest** » Thu Jul 27, 2006 5:52 am

getting an autopap, you will be stealing money right out of your doctor's wallet, how will they ever be able to make their Mercedes and Porsche payments.

Brick and mortar DME's will revolt and force Resmed to raise prices by 40% all for your own good.

JCraig · Post by **JCraig** » Thu Jul 27, 2006 5:59 am

Anonymous wrote:getting an autopap, you will be stealing money right out of your doctor's wallet, how will they ever be able to make their Mercedes and Porsche payments.

I'm sure they'll manage.

DSM-Guest · Post by **DSM-Guest** » Thu Jul 27, 2006 6:27 am

As an all round easy choice - go AUTO. You can run it however you want (AUTO, CPAP) + you get the benefit of being able to access the data if you really want to.

No brainer (when the $s are taken care of)

DSM

oldgearhead · Post by **oldgearhead** » Thu Jul 27, 2006 6:29 am

APAPs cost more money.

WNJ · Post by **WNJ** » Thu Jul 27, 2006 6:33 am

Another reason for an Auto:

I too was titrated at 13 cm. I found that sleeping with that pressure was a bit bothersome.

After some experimenting, I have my Auto set at 10-14 cm. From MyEncore, I find that it stays at 10 cm almost 60 percent of the time, and is at 13 or 14 cm less than 5 percent. I find 10 or 11 cm very comfortable.

And Encore Pro reports much better AHI numbers than the titration study reported at straight 13 cm.

YMMV

Wayne

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Thu Jul 27, 2006 7:38 am

Budget constraints are the only conceivable reason not to get an Auto. It only adds function, it does not subtract function.

My opinion of course.

David

MandoJohnny · Post by **MandoJohnny** » Thu Jul 27, 2006 7:52 am

It's not just the extra expense. It is that the extra expense doesn't get you anything you need and could have a negative effect. According to my sleep doc, who is very good and who I trust, while APAPs are necessary for Central Apnea and some other conditions, they are no more effective for Obstructive Apnea and in some patients, they are worse. Sometimes APAPs can't keep up with the changes in required pressure fast enough, so people get too little pressure during critical times. It is better to keep a constant pressure at a level that is proven to keep the airway open.

BTW, I doubt my doc has a care in the world about APAPs "putting him out of business." He has a full practice, treating all kinds of sleep issues, not just OSA. Also, he doesn't care that an APAP would cost the insurance company more. That's not his part of the business. So contrary to what has been implied, I think he is just telling it like he sees it and has the science to back it up.

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roadwarrior · Post by **roadwarrior** » Thu Jul 27, 2006 9:07 am

I'd give the APAP a huge thumbs up. I was titrated at 9 in my sleep study. My new REMstar Auto has been running between 6 and 14 indicating that while it tends to settle in at 9 for the major portion of the time, both 6 and 13 have been utilized avoiding events. I love haveing the Cflex on with the APAP, and it is quiet and efficient. I formerly had a +M series CPAP. It was fine but not quite the result of the Auto. I got mine paying cash at CPAP.Com. I had just lost a job but this was very important indeed as I took back the other machine to a DME and cancelled with them. I no longer have insurance for the time being so I wanted NO further bills showing up. DME's will suck you dry. I had an interview yesterday and they are tendering a formal offer of employment today. Looking forward to it.........

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Thu Jul 27, 2006 9:28 am

MandoJohnny wrote:APAPs can't keep up with the changes in required pressure fast enough, so people get too little pressure during critical times. It is better to keep a constant pressure at a level that is proven to keep the airway open.

For those, like me, who do better on straight CPAP I can not argue with this part of the reasoning but the great benefit of the APAP is self-titration to contend with changing conditions like different interfaces, weight gain or loss, increased or decreased congestion, aging, different sleep habits etc.

I was titrated at 8cm H2O 2.5 years ago. I suspected it wasn't enough and I wasn't feeling as good as I thought I should. The APAP indicated I needed 9cm H2O. I moved it up. My AHI went down. I feel better. I could have done the same thing with a "smart" CPAP, which I didn't have until I bought an APAP, but it would have been far more tedious to do.

So I'll still stand on my contention that there is no reason not to buy an APAP other than expense. It does not subtract function (can run in CPAP if desired) it only adds function.

David

Guest · Post by **Guest** » Thu Jul 27, 2006 9:32 am

MandoJohnny, the studies show that your doctor is incorrect. The results show that autos treat apnea events just as well as fixed pressure CPAPs and they do it at relatively lower pressure levels during the sleeping period, making for better comfort and greater compliance.

Paul B · Post by **Paul B** » Thu Jul 27, 2006 9:36 am

Previous post was me.

Machine