I am in a position where I need to make a decision on a CPAP machine soon.
Like everyone on this site and most people who have access to the internet, I have spent hours researching and reviewing information and opinions regarding what is the "best" machine to get.
I've heard and read all about the advantages of APAP vs CPAP. I spoke to my Dr. about this today and he said something that I wasn't really expecting...that APAP has a "marketing driven approach to get customers to buy and that it is not totally supported by the medical OSA field."
That leads me to a rather disappointed conclusion, that a CPAP machine with a good warranty is all I really need. I'm bummed. I so wanted to keep up with the hosehead Jones's, but now realize it would only be a waste of money.
Oh well, I think I'll use my money to be the first of my friends to have one of those cool new flat screen TV's instead.
Keeping up with the Jones's
Well now, hold on....
First off, the impression I'm getting of some doctors with respect to sleep disorders is similar to my impression of psychologists who still do ECT: They're operating on a lot of theory and very little actual hard evidence.
For him to make a statement like that... I think one reason why AutoPAP isn't supported is that if you get to really understand what it's doing and what it's telling you, you really don't have much need of the sleep clinic any more. And doctors are (in many case justifiably) skittish about letting the average person make their own barely-informed medical decisions.
Sure, everyone on cpaptalk.com is highly intelligent. (We're also good looking, charming, and we smell wonderful (well, except for the farters)). But keep in mind that the average person doesn't do the kind of research a lot of us have done, and probably wouldn't spend the kind of time we do analyzing our results.
It's similar to why I don't support privatization of social security. Sure, I think *I* could do better with my money than the government can, but I don't believe that's true of joe average citizen, and in the long run, it could end up costing a lot MORE, if by privatizing, we end up with a lot of people stupidly squandering their retirement money on risky investments.
The key here is doing your research. Since you're already here, you're already a cut above, and therefore, AutoPAP would probably work well for you. My opinion of course.
The good part is that AutoPAP can always be set back to straight CPAP mode, if you find you don't work well under Auto. The bad part is this whole idea of the different algorithms used, I have NO idea how to decide which one would be best for me.
Liam E. Coyote, Super Genius.
First off, the impression I'm getting of some doctors with respect to sleep disorders is similar to my impression of psychologists who still do ECT: They're operating on a lot of theory and very little actual hard evidence.
For him to make a statement like that... I think one reason why AutoPAP isn't supported is that if you get to really understand what it's doing and what it's telling you, you really don't have much need of the sleep clinic any more. And doctors are (in many case justifiably) skittish about letting the average person make their own barely-informed medical decisions.
Sure, everyone on cpaptalk.com is highly intelligent. (We're also good looking, charming, and we smell wonderful (well, except for the farters)). But keep in mind that the average person doesn't do the kind of research a lot of us have done, and probably wouldn't spend the kind of time we do analyzing our results.
It's similar to why I don't support privatization of social security. Sure, I think *I* could do better with my money than the government can, but I don't believe that's true of joe average citizen, and in the long run, it could end up costing a lot MORE, if by privatizing, we end up with a lot of people stupidly squandering their retirement money on risky investments.
The key here is doing your research. Since you're already here, you're already a cut above, and therefore, AutoPAP would probably work well for you. My opinion of course.
The good part is that AutoPAP can always be set back to straight CPAP mode, if you find you don't work well under Auto. The bad part is this whole idea of the different algorithms used, I have NO idea how to decide which one would be best for me.
Liam E. Coyote, Super Genius.
_________________
| Machine | Mask | |
 |  |
-
Guest
My response back to you Liam,
I am a little surprised that you would be so in favor of APAP when according to your "I give up" post, you can't find anything that even works for you.
Don't get me wrong, I do agree that the Doc's out there have a quite a deal going with this whole $2500 sleep study baloney they put us through when perhaps some diagnosis could have been done by a machine. And now of course the Docs want to "monitor" us several times a year because they are afraid of lawsuits if we should happen to fall asleep while driving and kill somebody. Yeah I feel like I am just helping to pay for his new Mercedes as s/he takes advantage of me and the insurance companies.
But still, I had my sleep study and went from 73 apneas an hour down to 2 when the right amount of pressure of air was blowing. To me, it's over. I got a severe case of OSA and CPAP does the trick. I'm going to find me a CPAP machine that's cheap and hopefully lasts well past it's two year warranty. Like I said, I got a TV to buy!
And Liam, I hope you find something that really works for you. Hang in there.
Gotta go strap on the hose. Goodnight.
I am a little surprised that you would be so in favor of APAP when according to your "I give up" post, you can't find anything that even works for you.
Don't get me wrong, I do agree that the Doc's out there have a quite a deal going with this whole $2500 sleep study baloney they put us through when perhaps some diagnosis could have been done by a machine. And now of course the Docs want to "monitor" us several times a year because they are afraid of lawsuits if we should happen to fall asleep while driving and kill somebody. Yeah I feel like I am just helping to pay for his new Mercedes as s/he takes advantage of me and the insurance companies.
But still, I had my sleep study and went from 73 apneas an hour down to 2 when the right amount of pressure of air was blowing. To me, it's over. I got a severe case of OSA and CPAP does the trick. I'm going to find me a CPAP machine that's cheap and hopefully lasts well past it's two year warranty. Like I said, I got a TV to buy!
And Liam, I hope you find something that really works for you. Hang in there.
Gotta go strap on the hose. Goodnight.
-
rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
The doctors who scoff at autopaps should try two weeks on some machines themselves, as if they were a patient titrated at 12 cm H20.
Let them try to sleep with a straight cpap at 12 for one week. It won't damage them even if they don't need cpap treatment at all. Just let them have a real taste of what they are recommending for their patients.
Then let them try to sleep with an autopap at 6-15 for one week.
Give them a Profile Lite mask - that's what they DME's the docs send you to recommend, isn't it? heh.
Oh, and let's not give them a heated humidifier to use with either machine...not necessary, ya know.
Hey, we might be doing them a favor! Many of the docs probably have sleep apnea themselves and won't admit it to themselves. Perhaps that's why some of the docs have a bit of trouble thinking straight.
Let them try to sleep with a straight cpap at 12 for one week. It won't damage them even if they don't need cpap treatment at all. Just let them have a real taste of what they are recommending for their patients.
Then let them try to sleep with an autopap at 6-15 for one week.
Give them a Profile Lite mask - that's what they DME's the docs send you to recommend, isn't it? heh.
Oh, and let's not give them a heated humidifier to use with either machine...not necessary, ya know.
Hey, we might be doing them a favor! Many of the docs probably have sleep apnea themselves and won't admit it to themselves. Perhaps that's why some of the docs have a bit of trouble thinking straight.
Well, I agree, my stance my seem odd, but...
Keep in mind, my issue is that I'm not tolerating CPAP at all. My advice to someone such as myself would be different from my advice to someone who is already on CPAP and happy with it, and trying to decide whether to buy APAP for his next machine.
You didn't ask for advice on WHETHER to buy a machine. But since you've already planned to do that, logically it seems to me to make the most sense to buy the one that offers the most flexibility. Yes, it's a few hundred dollars more, and yes that's expensive, but less so than buying the CPAP and then wishing you'd gone for the APAP, or worse yet, buying the CPAP and then NEEDING the APAP and having to buy ANOTHER machine right away.
If you're happy with CPAP, by all means, buy CPAP. It sounded like you were looking for the argument in favor of upgrading, and so I tried to provide it.
Liam, who has never hidden the fact that he has opinions on things he knows nothing about.
Keep in mind, my issue is that I'm not tolerating CPAP at all. My advice to someone such as myself would be different from my advice to someone who is already on CPAP and happy with it, and trying to decide whether to buy APAP for his next machine.
You didn't ask for advice on WHETHER to buy a machine. But since you've already planned to do that, logically it seems to me to make the most sense to buy the one that offers the most flexibility. Yes, it's a few hundred dollars more, and yes that's expensive, but less so than buying the CPAP and then wishing you'd gone for the APAP, or worse yet, buying the CPAP and then NEEDING the APAP and having to buy ANOTHER machine right away.
If you're happy with CPAP, by all means, buy CPAP. It sounded like you were looking for the argument in favor of upgrading, and so I tried to provide it.
Liam, who has never hidden the fact that he has opinions on things he knows nothing about.
_________________
| Machine | Mask | |
| |
-
Guest
My response back to Liam again,
Yes Liam, you are right, I was looking for arguments in favor of going with the APAP and was a little surprised you and rested gal were the only ones to respond.
I was hoping for more response from others who are still "on the fence" like myself. But I guess those have kinda been covered in other posts.
At the same time, the Doc makes a good point, when he comments about Marketing material. Which brings me back to my main point and that is, most people want to keep up with the Jones's, even in the on-line world of the internet OSA user groups.
Yes Liam, you are right, I was looking for arguments in favor of going with the APAP and was a little surprised you and rested gal were the only ones to respond.
I was hoping for more response from others who are still "on the fence" like myself. But I guess those have kinda been covered in other posts.
At the same time, the Doc makes a good point, when he comments about Marketing material. Which brings me back to my main point and that is, most people want to keep up with the Jones's, even in the on-line world of the internet OSA user groups.
-
Sleeping With The Enemy
- Posts: 454
- Joined: Tue Jan 25, 2005 11:54 pm
- Location: Minnesota
Another response
I'm not very good at arguments, but if you can think about the fact that the sleep study was one night. You were not in your own home/bed. It was a snapshot of one night away from home.
I started out with a CPAP because that is what MD prescribed. Found out once in my own bed, I cannot tolerate the exhaling. Switched to Remstar Plus w/C-Flex. Still didn't do well, needed more freedom to breath naturally with a machine that adjusts to me, not me adjusting to a machine blowing a straight pressure.
I guess if you want the best treatment I would go with Remstar Auto w/c-flex. I love it I just switched this week and can really feel the ease and comfort of breathing at night. Its enough that we have to wear a mask and fight with that, we don't want to fight against a machine blowing a constant pressure too, its uncomfortable.
The Remstar Auto w/C-Flex gives you several options, so if things change in the future. You can switch to straight CPAP or CPAP w/C-flex for ease in exhaling.
I like the option of having choices in my treatment.
Good Luck,
Heidi
I started out with a CPAP because that is what MD prescribed. Found out once in my own bed, I cannot tolerate the exhaling. Switched to Remstar Plus w/C-Flex. Still didn't do well, needed more freedom to breath naturally with a machine that adjusts to me, not me adjusting to a machine blowing a straight pressure.
I guess if you want the best treatment I would go with Remstar Auto w/c-flex. I love it I just switched this week and can really feel the ease and comfort of breathing at night. Its enough that we have to wear a mask and fight with that, we don't want to fight against a machine blowing a constant pressure too, its uncomfortable.
The Remstar Auto w/C-Flex gives you several options, so if things change in the future. You can switch to straight CPAP or CPAP w/C-flex for ease in exhaling.
I like the option of having choices in my treatment.
Good Luck,
Heidi
Hellooo All,
This is an interesting thread. I can see both sides clearly, since I have tried just about all of the autopaps out there.
What I have read in "Sleep", the journal full of abstracts of current research, is that Autopaps have not been found to be any more effective at treating OSA than a standard CPAP.
That being said, there is the compliance factor. It is my feeling that some people would not be compliant if it were not for autopap's and other specialty features, such as CFlex.
Perhaps your doctor is taking too narrow a view on the Auto CPAP.
Compliance is the most difficult part of the journey. This includes finding the right Mask, getting the right pressure, and finding a machine that is comfortable enough for people to use it every night.
I say, the more companies competing for market share the better. It keeps the manufacturers innovating.
Ted
This is an interesting thread. I can see both sides clearly, since I have tried just about all of the autopaps out there.
What I have read in "Sleep", the journal full of abstracts of current research, is that Autopaps have not been found to be any more effective at treating OSA than a standard CPAP.
That being said, there is the compliance factor. It is my feeling that some people would not be compliant if it were not for autopap's and other specialty features, such as CFlex.
Perhaps your doctor is taking too narrow a view on the Auto CPAP.
Compliance is the most difficult part of the journey. This includes finding the right Mask, getting the right pressure, and finding a machine that is comfortable enough for people to use it every night.
I say, the more companies competing for market share the better. It keeps the manufacturers innovating.
Ted
Last edited by Titrator on Fri Feb 11, 2005 10:04 am, edited 1 time in total.
Re: Another response
EXCELLENT point. I always hate the feeling that I was diagnosed in a situation that was entirely ABnormal. There's always the question of whether in my own bed, without all the wires and electrodes and gadgets and gizmos I'd have had readings anything at all like what they found in my sleep studies...hhunt wrote:I'm not very good at arguments, but if you can think about the fact that the sleep study was one night. You were not in your own home/bed. It was a snapshot of one night away from home.
AutoPAP gives you the chance to find out some of that. Yes, there are less sensors detecting events, but it's happening in a MUCH more relaxed and normal situation.
But you've heard my argument, in your shoes I would go with the Auto (although I'm still not sure if I'd go with the Remstar or the 420E. The one has CFLEX, the other, easier adjustability of the algorithm.)
Liam, just because he won't do it doesn't mean he won't advise someone ELSE to.
_________________
| Machine | Mask | |
| |
-
wading thru the muck!
- Posts: 2799
- Joined: Tue Oct 19, 2004 11:42 am
Guest,
Sorry I'm late to respond...my internet connection was down. Why is it that the Docs and hospitals have to spend millions on the latest MRI machines and the like, but expect us hoseheads to use the same old "tried and true", "horse and buggy" cpap machine. It burns me when I hear people say that they are going to settle for the plain cpap to save a few bucks and then overpay by using the local DME. Fact is, the best auto-pap from cpap.com costs less than the worst plain jane cpap from the local DME. Why not give yourself the option of having all the latest advances available to you. You may not need them, you may not ultimately want to use them (they can all be turned off), but you will have them, if you need them. All for a couple hundred dollars more. As one smart UK/Texan hosehead (chrisp) once said "people put more thought and money into window treatments for their house than good equipment for their healthcare" (or something like that).
If you are looking for votes in support of the auto-pap, you've got one from me.
Sorry I'm late to respond...my internet connection was down. Why is it that the Docs and hospitals have to spend millions on the latest MRI machines and the like, but expect us hoseheads to use the same old "tried and true", "horse and buggy" cpap machine. It burns me when I hear people say that they are going to settle for the plain cpap to save a few bucks and then overpay by using the local DME. Fact is, the best auto-pap from cpap.com costs less than the worst plain jane cpap from the local DME. Why not give yourself the option of having all the latest advances available to you. You may not need them, you may not ultimately want to use them (they can all be turned off), but you will have them, if you need them. All for a couple hundred dollars more. As one smart UK/Texan hosehead (chrisp) once said "people put more thought and money into window treatments for their house than good equipment for their healthcare" (or something like that).
If you are looking for votes in support of the auto-pap, you've got one from me.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
-
Its really mikesus
Well I was recently in the same situation, trying to find the best bang for the buck so to speak, but at the same time trying to hedge my bet by getting a flexible machine. I ended up chosing the Remstar because of Cflex. I don't know if I will like it use it or not, but if I have a machine that is NOT capable of cflex, I can't even try it. If your tolerate CPAP well, I would look at the 420e. It is Autopap, and it comes with the software to see how well the therapy is working. (all for around $600 or so) The main advantage to APAP that I see is that it will adjust over time. Your sleep study was one night. Many have said that when they are really tired it takes a bit more pressure than normal, and by going with just a CPAP, you would not get the therapy that you could. Conversely, if you are doing really well, you will only have full pressure when you need it, making it a lot more comfortable to deal with. Too often in life we don't have time to do it right but we always seem to have time to do it twice... Save the time and the money and get the better machine.
-
Guest
Guest,
I can't speak to what the research says about auto paps but I can speak from my own experience.
I started cpap therapy about 4 months ago. Despite not sleeping hardly at all (best I could get might be a little over an hour), feeling soooo much worse than I did before treatment, severe depression, missing work etc. I was still 100 % compliant. I kept trying to figure out what was going to work for me. I was sooo close to giving up but after reading all the postings regarding autopaps, I decided an apap might work for me and convinced my doctor to prescribe one for me. It's the best thing I could have done. I have been using it for 11 days and the worst night sleep I have gotten was 4 hours. I even slept a full nights sleep. It was such a nice experience to lay my head down and not wake up until my alarm went off.
INMO.... apap is the way to go.
I can't speak to what the research says about auto paps but I can speak from my own experience.
I started cpap therapy about 4 months ago. Despite not sleeping hardly at all (best I could get might be a little over an hour), feeling soooo much worse than I did before treatment, severe depression, missing work etc. I was still 100 % compliant. I kept trying to figure out what was going to work for me. I was sooo close to giving up but after reading all the postings regarding autopaps, I decided an apap might work for me and convinced my doctor to prescribe one for me. It's the best thing I could have done. I have been using it for 11 days and the worst night sleep I have gotten was 4 hours. I even slept a full nights sleep. It was such a nice experience to lay my head down and not wake up until my alarm went off.
INMO.... apap is the way to go.
_________________
| Mask | |
 |