Questions about the new DreamStation BiPAP Autos ...

Folks,

My System One (Series 50) BiPAP will be turning 5 years old in a few months. The current machine doesn't have any serious issues, but the SD card slot is a bit flakey (it randomly decides the card is unreadable. Changing cards does not fix the problem and the card is always readable by my computer.) And the clock on my BiPAP has continued to drift farther and farther away from the real time: The clock is now 49 minutes fast, and there's no way to reset the dang clock. (At least Sleepy Head lets you make the correction.)

So I'm thinking about upgrading sometime in the next 6-12 months or so. But I haven't been around here for the last 9 months or so due to other things in my life, and so I haven't kept up with the latest info concerning the new generation of machines. And I have some questions.

1) I gather the new Dreamstations are not yet compatible with SleepyHead. But I take it JediMark is working on this? Does EncoreBasic work with the Dreamstations? What about EncorePro? If so, which version of EncoreBasic or EncorePro is needed?

2) Would a heated hose be of any use? Once upon a time SleepDoc #2 suggested a heated hose when I was still in the throes of my very difficult adjustment period. I pointed out that I had a System One, not a Resmed and that there was no heated hose readily available for my machine, and she dropped the idea. So I've never had one. I don't have problems with rainout, even though I do use the humidifier set on 5. I keep the hose in a hose cozy and run it under the covers. Even with the humidifier set to 5, I still have problems with a dry nose (not a dry mouth) at times. I also still dislike the cold, jet stream exhaust flow from my Swift FX, and the P10 just isn't as comfortable to me even though I love its diffuse exhaust venting. Would a heated hose warm up that exhaust flow so that I might not have to wear a long sleeved robe to bed every night?

3) Does the hose attach to a full swivel thingy the way it does on a System One machine? It turns out that I've really appreciated the swivel far more than I ever thought I would when I was switched from an S9 APAP to the System One BiPAP 5 years ago.

4) Is there now a min PS setting? The original System One BiPAPs like mine have a max PS setting, but the min PS is 2 and cannot be changed. I would really like to be able to raise my max IPAP to 9cm, but keep the max EPAP at 6cm. A min PS set to 3cm would do this, but I can't do that with my current System One. And the tummy still can't handle a max EPAP of 7cm for any length of time, so that's why I'm asking ...

robysue wrote:1) I gather the new Dreamstations are not yet compatible with SleepyHead. But I take it JediMark is working on this? Does EncoreBasic work with the Dreamstations? What about EncorePro? If so, which version of EncoreBasic or EncorePro is needed?

2) Would a heated hose be of any use? Once upon a time SleepDoc #2 suggested a heated hose when I was still in the throes of my very difficult adjustment period. I pointed out that I had a System One, not a Resmed and that there was no heated hose readily available for my machine, and she dropped the idea. So I've never had one. I don't have problems with rainout, even though I do use the humidifier set on 5. I keep the hose in a hose cozy and run it under the covers. Even with the humidifier set to 5, I still have problems with a dry nose (not a dry mouth) at times. I also still dislike the cold, jet stream exhaust flow from my Swift FX, and the P10 just isn't as comfortable to me even though I love its diffuse exhaust venting. Would a heated hose warm up that exhaust flow so that I might not have to wear a long sleeved robe to bed every night?

3) Does the hose attach to a full swivel thingy the way it does on a System One machine? It turns out that I've really appreciated the swivel far more than I ever thought I would when I was switched from an S9 APAP to the System One BiPAP 5 years ago.

4) Is there now a min PS setting? The original System One BiPAPs like mine have a max PS setting, but the min PS is 2 and cannot be changed. I would really like to be able to raise my max IPAP to 9cm, but keep the max EPAP at 6cm. A min PS set to 3cm would do this, but I can't do that with my current System One. And the tummy still can't handle a max EPAP of 7cm for any length of time, so that's why I'm asking ...

1. JM is working on getting SH to support the dreamstations, and it's working somewhat already in the dev versions. encore basic is what people have been recommending in the interim, latest version, though I don't know what # that is.
2. you could see about attaching some filter material over the vent to diffuse it, F&P is doing this on a number of their new masks. I don't believe that a heated hose would make that much difference.
3. it does have a swivel on top of the humidfier.
4. the 60 series had an adjustable minps, I'd imagine that the dreamstations have a minps setting also, but I haven't nabbed the manual for them yet.

robysue wrote:1) I gather the new Dreamstations are not yet compatible with SleepyHead. But I take it JediMark is working on this? Does EncoreBasic work with the Dreamstations? What about EncorePro? If so, which version of EncoreBasic or EncorePro is needed?

The last I knew Pugsy said it required Encore Pro to read the data.

robysue wrote:2) Would a heated hose be of any use? Once upon a time SleepDoc #2 suggested a heated hose when I was still in the throes of my very difficult adjustment period. I pointed out that I had a System One, not a Resmed and that there was no heated hose readily available for my machine, and she dropped the idea. So I've never had one. I don't have problems with rainout, even though I do use the humidifier set on 5. I keep the hose in a hose cozy and run it under the covers. Even with the humidifier set to 5, I still have problems with a dry nose (not a dry mouth) at times. I also still dislike the cold, jet stream exhaust flow from my Swift FX, and the P10 just isn't as comfortable to me even though I love its diffuse exhaust venting. Would a heated hose warm up that exhaust flow so that I might not have to wear a long sleeved robe to bed every night?

I'm not sure about the heated hose on the DreamStation. I have the 760 and an Aircurve. With the ResMed Aircurve a heated hose might be of benefit to you because it has both auto settings and manual settings where you can set your humidifier separate from the tube temperature which can be adjusted from 60 degrees to 86 degrees.But that's on my ResMed and you didn't ask.

robysue wrote:3) Does the hose attach to a full swivel thingy the way it does on a System One machine? It turns out that I've really appreciated the swivel far more than I ever thought I would when I was switched from an S9 APAP to the System One BiPAP 5 years ago.

To me it doesn't look like it does from the picture since it comes from the back. I don't have the Clinical Manual yet but here is a link to the user manual. http://www.hopkinsmedicine.org/homecare ... Manual.pdf

robysue wrote:4) Is there now a min PS setting? The original System One BiPAPs like mine have a max PS setting, but the min PS is 2 and cannot be changed. I would really like to be able to raise my max IPAP to 9cm, but keep the max EPAP at 6cm. A min PS set to 3cm would do this, but I can't do that with my current System One. And the tummy still can't handle a max EPAP of 7cm for any length of time, so that's why I'm asking ...

It Shows the min PS to be from 0 on this link to Clinical menu http://www.apneaboard.com/dreamstation- ... structions

The PRS1 60 Series BiPAP Auto included the PSmin and PSmax settings, so I expect the ability to set your desired EPAP/IPAP and PS settings will continue to be available in the new Dreamstation. In fact you could get all that with the older 60 series.

The newest EncorePro at ApneaBoard will work with the Dreamstation. You know how to get it.

I'd be interested to hear why you are not considering the Resmed Aircurve 10 Vauto. I was just issued one yesterday and it will replace my Cragislist acquired DS760TS. First night impressions were very positive for me. Both machines were setup similarly in auto mode with EPAPmin 9, IPAPmax 18, and PS 4 (PRS1 used a PS range of 4-6). First night Resmed AHI was low 1.07 compared to an average of 1.38 over the past week with the PRS1. That is within normal variation, so I don't expect AHI to increase or decrease with the machine change. Time will tell. The PRS1 scores more CA, and the Resmed more OA, with hypopnea about the same. The Resmed does not score RERA which is a bit of a disappointment.

Most treatment parameters are the same, with both machines recording the same average and 95% IPAP, but Resmed kept EPAP about 1.0 cm higher. Overall comfort is similar, however I am more aware of the PRS1 occasionally not syncing with inspiration and expiration. If I have a prolonged exhale with low flow at the end, the PRS1 will often boost pressure and I'll respond with an inhale. I don't get that with Resmed which is imperceptible and seems to work more closely with me.

QUIET! Resmed is far quieter, in fact the machine itself is inaudible compared to the PRS1 which can be heard changing pitch on each breath.

Just thought I'd give some early impressions in case you are considering a switch.

robysue wrote:Folks,
...
3) Does the hose attach to a full swivel thingy the way it does on a System One machine? It turns out that I've really appreciated the swivel far more than I ever thought I would when I was switched from an S9 APAP to the System One BiPAP 5 years ago.

The swivel is part of the humidifier not part of the blower unit. The illustrations I have seen show what appears to be a swivel mechanism.

JDS74 wrote:

robysue wrote:Folks,
...
3) Does the hose attach to a full swivel thingy the way it does on a System One machine? It turns out that I've really appreciated the swivel far more than I ever thought I would when I was switched from an S9 APAP to the System One BiPAP 5 years ago.

The swivel is part of the humidifier not part of the blower unit. The illustrations I have seen show what appears to be a swivel mechanism.

Yes it does look that way. I was only looking at the blower unit manual. Here is a link to the Humidifier Manual. http://www.continuedcare.com/wp-content ... Manual.pdf

Sleeprider wrote: I'd be interested to hear why you are not considering the Resmed Aircurve 10 Vauto. I was just issued one yesterday and it will replace my Cragislist acquired DS760TS.

Unless Resmed has changed its VPAP Auto algorithm, the Aircurve 10 Vauto increases the IPAP and EPAP at the same time. So when snoring, flow limitations, or event clusters start, both the IPAP and EPAP increase.

Unless Respironics has changed its BiPAP Auto algorithm, the IPAP and EPAP are allowed to increase independently of each other as long as the PS is between the min PS and max PS settings. IPAP increases for flow limitations and clusters of hypopneas, EPAP increases for snoring and clusters of OAs.

In my case: Even with 5 years of PAPing and only needing low pressures, I still have problems with aerophagia. And they're worse when my EPAP increases above 6 cm for any length of time. With my current System One, the fact that you can't change the fact that min PS = 2 means that I tend to keep my max IPAP = 8 so that my EPAP stays at 6 or lower all night. But there is some evidence in my data that I might do better if IPAP could regularly increase to 9cm and a Respironics with min PS = 3 would allow me to allow the IPAP to go to 9cm without allowing the EPAP to increase to the point where I start getting aerophagia problems.

There's also some reason to believe that I would do better if I could start the night at 7/4 instead of 6/4. (Starting at 7/5 is not particularly comfortable if I am having problems with aerophagia.

Overall comfort is similar, however I am more aware of the PRS1 occasionally not syncing with inspiration and expiration. If I have a prolonged exhale with low flow at the end, the PRS1 will often boost pressure and I'll respond with an inhale. I don't get that with Resmed which is imperceptible and seems to work more closely with me.

I had a similar problem when I was first starting out with a Resmed S9 Autoset with EPR turned on: I constantly felt the machine was trying to force me to inhale when I would notice a very subtle increase in pressure before I was done exhaling.

The PR System One's BiFlex also drove me crazy with the fact that I'd notice an increase in pressure before I finished exhaling. But when I turned BiFlex OFF and set the Rise Time to 3, I had no problems with the machine increasing pressure while I was still exhaling.