Close to giving up on Devilbiss Sleepcube

After deciding my first machine (Resmed S9 Elite) was long in the tooth, and wanting to try APAP, I bought a Devilbiss Sleepcube Auto. Various glitches saw it on its way back to the supplier soon after, the principal problem being noise. It came back a week or so ago and, while perhaps a bit quieter, it's still way noisier than the Resmed. I am now back on the S9 while I ponder my options.

I will most likely go back to a Resmed, but I'm not convinced I need or can get along with APAP. The first time I tried one was soon after my diagnosis, for a short trial. I struggled with the pressure when it was trying to prevent an OSA, so the clinic put me on CPAP instead and that's what I've used ever since. Because that first experience was during my CPAP baptism of fire, I subsequently wondered if I would find it easier to use now I have five years' experience, hence my purchase of the Sleepcube Auto. What with the noise and some other faults however, I didn't get to the point where I was comfortable, nor convinced it was the way to go.

It SHOULD be better though, right? I get the idea, and the prospect of spending more of the night on a lower pressure attracts me because I suffer quite significant aerophagia. I also seem to be experiencing more centrals as I get older, so again a lower 'base pressure' should be a good thing.

I'd be grateful for any personal accounts from others who have used both for lengthy periods.

Also, may I ask if the Resmed goes bonkers when it ramps the pressure up, in the way that the Devilbiss does? My usual pressure on CPAP is in the 10 - 13.8 range, depending on my weight from time to time and how much grape juice I have imbibed at weekends.

Lsat has a bilevel vauto for sale. Great price IMO.

viewtopic/t175281/New-Almost-AirCurve-1 ... -Sale.html

babydinosnoreless wrote: ↑

Tue Mar 26, 2019 9:17 pm

Lsat has a bilevel vauto for sale. Great price IMO.

viewtopic/t175281/New-Almost-AirCurve-1 ... -Sale.html

Thanks a lot, but I don't know what I shoud buy yet and insured freight from the US would be pricey methinks.

Steve of Cornubia wrote: ↑

Tue Mar 26, 2019 9:31 pm

babydinosnoreless wrote: ↑

Tue Mar 26, 2019 9:17 pm

Lsat has a bilevel vauto for sale. Great price IMO.

viewtopic/t175281/New-Almost-AirCurve-1 ... -Sale.html

Thanks a lot, but I don't know what I shoud buy yet and insured freight from the US would be pricey methinks.

Oh sorry didn't realize you were not in the US

You can run a ResMed APAP and I think the other manufacturers APAPs in CPAP mode. The latest ResMed APAP has a third mode they call 'for her' that responds to detected potential upcoming events a little differently making some (men or women) prefer that mode.

Muse-Inc wrote: ↑

Tue Mar 26, 2019 11:02 pm

You can run a ResMed APAP and I think the other manufacturers APAPs in CPAP mode. The latest ResMed APAP has a third mode they call 'for her' that responds to detected potential upcoming events a little differently making some (men or women) prefer that mode.

Yes, I know. My new Devilbiss will operate in either mode, too. That might be the way to go if I buy another Resmed, though having wasted $750 on the Devilbiss, I'm loathe to spend an extra $500 on an Autoset, over and above the $1200 the CPAP-only version costs, if I end up only using it in CPAP mode.

Here's a comparison chart of my experience between APAP and CPAP.
The top one is my settings Min 11cm - Max 13cm. The results AHI 0.49 with it going over 1.0 twice.

The bottom one, straight CPAP 12cm. Results AHI 2.45 and volatile.

My particular OSA is REM stage dependant. Straight CPAP is either too low to treat my OSA while in REM or uncomfortably high, aerophagia prone when set high enough to treat OSA while I'm in REM. There is no goldilocks zone.

It doesn't make sense that one could tolerate CPAP but not APAP. Though, I agree that one might not tolerate the higher pressures that one is receiving from APAP. But the solution is not to abandon APAP, the solution is to cap the APAP pressure prior to hitting your tolerance point.

As much as some believe APAP is pressure changes may be harsh and abrupt, they are not. Graphs suggesting they are, do so because hours of data are being displayed in a small time-frame.

The first time I tried one was soon after my diagnosis, for a short trial. I struggled with the pressure when it was trying to prevent an OSA, so the clinic put me on CPAP instead and that's what I've used ever since.

You were new, you were struggling with the new experience and high pressure. Your'e not anymore. You still have a negative association with APAP.

My usual pressure on CPAP is in the 10 - 13.8 range, depending on my weight from time to time and how much grape juice I have imbibed at weekends.

This doesn't make sense.

What are you doing, predicting what your pressure needs will be for the night and setting your pressure according to what you think you'll need.

I'm loathe to spend an extra $500 on an Autoset

$500 is a big chunk to spend all at once. Let's look at it another way.

Lets assume a lifetime of 5 years, that's an extra $100 per year or $2 a week.

As I said earlier, if you can tolerate CPAP you can tolerate APAP, just make sure your pressure is very narrow, at first.

Consider:

• Set your device to APAP mode.
• Set your device to Soft Response. This will soften the pressure changes.
• Set your pressure range to very narrow. Say your pressure is now 12cm. Set your pressure to min 11.8, max 12.2. You won't feel the difference, but this will help you get past your negative association with APAP.
• Give it a few days and and then spread your range.
• Make your configuration changes in the morning so you're not changing them immediately prior to bedtime and then laying there dwelling on them.

You want to lower your pressure to the point where your machine typically wants to be anyway. And your goal is to cap the max prior to the point where you experience discomfort or aerophagia.

I've now got my machine dialed-in where my average pressure is less than what my CPAP was, and the few times it increases it is no big deal.

And of course, posting charts to take advantage of Pugsy and palerider's expertise.

Steve of Cornubia wrote: ↑

Wed Mar 27, 2019 4:19 am

, I'm loathe to spend an extra $500 on an Autoset, over and above the $1200 the CPAP-only version costs, if I end up only using it in CPAP mode.

Maybe you should check out secondwindcpap.com

Thanks for the replies so far. My experience regarding CPAP vs APAP is rather muddled and unhelpful. The first attempt was too early, before I was even used to wearing a mask all night, and the second attempt (Sleepcube) has been spoiled by a faulty machine that, even once fixed, is inherently noisy and possibly uses a relatively crude APAP implementation (hence the way it seems to go bonkers when it tries to pre-empt an event).

Because I'm all over the place right now, having swapped CPAP for APAP, then back to CPAP, back to APAP, switched the APAP to CPAP then back to the Resmed, I have lost touch with consistent results and data. I'm going to stay on my old Resmed CPAP for a few weeks now, to re-establish a robust baseline from which I can attempt an informed switch to APAP again, though not with the Sleepcube.

One possible option is machine rental. I think my original supplier also has rental machines, so I might rent a Resmed APAP machine for a month or so, depending on cost. If significant, the rental cost might be better applied to the purchase of an APAP machine.

As for Dogslobber's question regarding varying my pressure, that's exactly what I have done in the past. Last year, I lost 10kg and my AHI dropped significantly, so I was able to successfully lower my CPAP pressure while keeping my AHI under 5.0. On top of that, I found over the years that my AHI would rise at the weekend, when I treat myself to some wine. I experiemented with dialling in an extra inch of pressure on those nights and managed to keep my AHI more or less consistent, so on the nights I imbibe, I adjust the pressure. Another benefit of APAP I presume would be that the machine would better accommodate fluctuations in AHI like that, without any intervention from me.