Two months in

Hi all:

The higher pressure does not bother me at all that I am aware of. I am going to tweak up the lower pressure in 0.5 increments over the next few nights and see what happens. I do want to explore all options to maximize what I can get out of this machine before I switch to BiPap, plus my next doctor's appointment isn't until March. Although I can probably get in earlier if necessary. Felt like I was trucking along pretty well until I got floored by this respiratory illness. I do, however, suspect Pugsy is spot on that I am going to need a different machine. Kind of amazing to me the sleep doc that reviewed my study thought a steady pressure of 6.0 was going to fix me, although I realize they have a small data set to work with. Seems I am maxing out the present machine and have gotten AHI from high 30's to single digits on most nights. So that is some progress. And probably enough to get my medical clearance back for my job. Overall, other than being sick, I feel better. My need for naps is reduced, and my alertness during the day is increased. My need/desire for caffeine is greatly reduced. And my heartburn and reflux issues have been completely cured. So this has been a blessing. But I still want to absolutely maximize my therapy and if possible get that AHI to near zero. Which may require the new machine. I also may need to new machine so I don't have to worry about sleeping on my back. I tend to change positions several times/night. It is uncomfortable for me to stay in one position for extended periods of time because of old back issues.

Thanks for all of your help so far.

I know you say you aren't particularly bothered by the higher pressures...I wasn't either.
But the very first time I got to try a bilevel device (it was used and for a friend who wanted me to test it all out first) it only took me about 90 seconds to think "I gotta get one of these"
I tested it for 3 nights and I was hooked...slept better for some reason even though I didn't have the pressures quite tweaked enough and felt great...and I sent the machine to my friend with the stipulation that if she didn't like it that I wanted to buy it back. She used it the first night and when I asked if I was getting the machine back the response was "over my dead body".

There's a little saying that those of us who have made the switch to bilevel, for whatever reason, have...once you try bilevel you won't ever want to go back to single pressures.

Long term I found out that I was sleeping about 45 minutes on average longer with the bilevel than I had been doing with the single pressure apap with no other changes to anything and for me that extra time usually meant I felt better in general. I never could figure out why I slept more but I did and it was a happy thing to have happen.

My situation was similar to yours in that I was having some really ugly clustering that seem to require pressures in the 18 cm neighborhood. In my situation though I knew exactly what the cause was as it was well documented on my sleep study...REM stage sleep where my OSA is about 5 times as bad as it is in non REM and it came with a significant change in pressure needs.

Pugsy, do you recommend a particular brand/model of machine? I definitely want one that allows me all the monitoring options I have currently with Sleepyhead. I will see about getting an earlier appointment. I want that freshly "washed" feeling I experienced after my sleep study. LOL.

I have used both brands of bilevel machines...Respironics PR System One BiPap Auto and the ResMed S9 VPAP Auto. I have not had a chance to see or test the latest models in each..the DreamStation (Respironics) or AirCurve (ResMed).

To be honest it was a toss up especially since the PR S1 760 offered a minimum and maximum individual setting for the PS (Pressure Support which is simply the difference between inhale and exhale) because I preferred around 4 cm PS and the older PR S1 machine defaulted to 2 cm PS but could go to 4 but when it did I was already asleep and I wanted it while awake. Minor thing for me but my awake time was important to me.

If you stick with the Respironics you could simply get a new blower unit and still use your existing humidifier and that may be what your DME will want to do.

I do think that the ResMed machines are little bit less noisy in general but I am talking only a tiny bit here...and my husband says both were silent...it's a joke between us because I will tell him I want a new machine or a different machine and use the "it's less noisy" argument which doesn't fly really because he says he can't ever hear my machines anyway.
They all have a little bit of noise...Respironics seems to be on inhale more and ResMed on exhale but neither is bad enough to be a deal breaker IMHO.

The algorithms are a bit different and you might like one better than the other but I think most people would do well with either.

There are other brands of bilevel machines but I wouldn't consider any of those. Respironics has long been the leader and ResMed caught up real fast. Both are great machines.
I like the Respironics heated hose because I can get 90% humidity and not get rain out but I can get real close to that with the ResMed and their heated hose.

ResMed responds per their algorithm probably a little more aggressively than Respironics and some people might not care for it but I sleep through it all so I don't care

With the new models from each brand...there are some minor cosmetic and feature differences but the overall algorithm or how the job gets done didn't change...

Finally...given that SleepyHead is not yet compatible with the new DreamStation machines and SleepyHead is...I might lean towards ResMed for that reason but there is software available for the DreamStation machines but it isn't SleepyHead and it's a bit of a bitch to deal with compared to SleepyHead.
Should you end up with a DreamStation bipap...I can help with the Respironics software that will work with it.

Our DME happens to be great friends of ours, so I can probably get whatever I want. Unless they just carry the one, Respironics, brand. It's a decent sized company. I am going to give it a week or two, let this illness and its side effects wear off, then call and see if I can get an earlier appointment. The doctor already indicated she would write me a prescription for the other machine. So I should be good there.

It's worth mentioning that a patch to fix Sleepyhead for DreamStation machines is being worked on. Stay tuned as that may make the newer machine a lot more attractive.

You'll love bilevel. It makes all the difference, especially with higher pressures, and to resolve RERA.

That is good to know!