Picky, Picky

Just to make sure that you're NOT confused, the EPR on the ResMed S8 Vantage is NOT available in AutoSet mode. Respironic's C-Flex IS available in both constant (CPAP; CPAP, CFLE) and auto-titration (APAP; APAP, AFLE) modes.

I will offer a slight disagreement with an important point that has been raised here, with all due respect. The auto-titration alogorithms VARY CONSIDERABLY between the various different manufacturer's machines. Each manufacturer embraces a different treatment and design philosophy for its auto-titrating CPAP units.

For example, ResMed's algorithm provides a VERY RAPID attack of flow limitations that it believes are pre-cursors of an impending SDB event. Many appreciate this rapid attack. I found that it lead to arousals that fractured my sleep.

Resprionic's algorithm provides a more temperate attack, and a more rapid return to baseline pressure. Many, including myself, have enjoyed this more gradual increase in pressures. Others complain that the REMstar Auto is too slow to adequately treat and prevent SDB events.

So, if you want to be sure to get the MOST EFFECTIVE treatment that you can muster for yourself, and you're considering an auto-titrating CPAP, forget LCD displays, expiratory pressure relief and the rest, and INSIST that you have the opportunity to have fair trials with the machines of the variety of manufacturers until you find the one that SUITS YOU BEST!!!! Its simply not the case, in my opinion, that you will get equally good treatment from any of the APAPs available today. I know for myself that my treatment experience turned completely around AS SOON AS I switched from an S8 Vantage to a REMstar Auto, and I was and am a real fan of ResMed because of their scientific candor.

So, as I've said here too many times, TRY BEFORE YOU BUY!!!

Good luck!

Chuck

P.S. I have NO experience with Puritan-Bennett's PB420E. Many sing its praises though.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, C-FLEX, CPAP, auto, APAP

GoofyUT wrote:... For example, ResMed's algorithm provides a VERY RAPID attack of flow limitations that it believes are pre-cursors of an impending SDB event. Many appreciate this rapid attack. I found that it lead to arousals that fractured my sleep. ...

It just occurred to me that perhaps the reason I'm waking in the morning very aware of many of my dreams during the previous night's sleep is because I'm being aroused by ResMed's rapid increase in pressure.

On the other hand, I also remember many of my dreams even when using straight CPAP?

... just trying to understand the relationship between my PAP treatment and my beloved dreams.

Eventually, I plan to get the RemStar auto pro set up ... but I will have to wait a year or so since I will have to pay out of pocket for that one ... Chuck is right, it should be mandatory for treatment to include the trial use of both machines in order to determine the optimum treatment system.

- roberto

NyNurse33 wrote:Thanks DSM and Laura

The only problem I can foresee with choosing the vantage over the M series, is that I am more interested in using the apap feature than I am EPR, and with the vantage you can use both together, but with C-flex you can. Am I correct in saying this. So while I am not currently having any difficulty exhaling now, I would not get the vantage just because it has a better exhale feature. If I ended up needing help with exhaling I would think it would be beneficial to get the machine that can do it with auto. I'm not sure if I'm right or not, but trying to understand this all. I just think I need auto over exhaling assistance, b/c I am not a back sleeper, but was titrated while laying stiff as a board on my back @ the lab. I sometimes have aerophagia, I know I will get my energy back and go back to the gym to lose weight.

I am just comfortable with the resmed machine, even though I am still a newbie, but I love my respironics mask. Any thoughts on whether or not the M series would be louder than my current escape. Mind you my current machine is so generic and does nothing special to even make a peep!! Is it true that if you use c-flex your breathes have to be quicker? I'm just making a guess here and saying that if I have no problems currently exhaling on 10 then hopefully apap would allow lower settings and I still wouldn't have a problem. I agree with RG in saying its nice to have the feature now.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, resmed, C-FLEX, newbie, auto, APAP, aerophagia

Melissa,

The Vantage has EPR but this is like a Bilevel mode & doesn't apply to Auto mode.

In Auto mode the Resmed, has no extra exhale relief. But the Remstar M does have cflex and the Remstar can activate the Cflex in both cpap and Auto modes.

As RG has explained the Remstar M does display on the LCD (IIRC through a menu) the AHI data for the night.

My understanding of the Vantage is that as with the Remstar M, it can display the AHI data BUT, IIRC it also gives HI & AI Hypopnea Index and Apnoea Index. HI on the Vantage is Resmeds indication of breathing slowdowns (IIRC 50% reduction in your airflow over ten seconds) That scores as an HI event. An AI is when the Vantage registers an obstruction which will score as an AI event. The AHI is the total of both scores added together. I don't know if the Remstar M gives AI and HI as additional display data.

Your Escape should display this data ? Let me take a look at mine tonight & I will refresh my memory as to what it shows in the display & how to get at it.

The Escape is a nifty lil ole machine. I use mine only for travel.

and with the vantage you can use both together, but with C-flex you can.

Revised: and with the Remstar you can use both together. While on the Vantage it is: Auto or EPR or CPAP.

Yes.

On the M series, you can turn the c-flex off while using it in auto mode, right?

Yes.

Is it true that if you use c-flex your breathes have to be quicker?

Not normally. But some people on high Cflex settings & in particular cms ranges, have said they experience a speeding up of their breathing. This is usually fixed with some cms & cflex tuning. This is not what I'd call any big issue.

Any thoughts on whether or not the M series would be louder than my current escape.

If the M series is as quiet as the prior Remstar Auto it is every bit as quiet as the Escape.

I'm just making a guess here and saying that if I have no problems currently exhaling on 10 then hopefully apap would allow lower settings and I still wouldn't have a problem. I agree with RG in saying its nice to have the feature now.

Agree

Cheers

DSM

Thanks DSM for breaking it all down for me. My escape does not show any data, other than being able to change the pressure, ramping, reminders, etc., nothing clinical.

Goofy, TY, and yes I understand that with vantage, I can only have EPR in cpap mode. How I wish we all could "try" our equipment first before committing.

I have a feeling that I might try for the Remstar M series auto w/ c-flex. Hopefully my MD, DME and Insurance will concur, but we all know that's a seperate topic that's been addressed and I will come prepared, thanks to all of you here.

rested gal wrote:
Actually, there are two autos now that show AHI data on the machine's LCD screen. The Vantage that Wader mentioned and the new "M" series Respironics REMstar Auto with C-flex.

The Vantage breaks the AHI down and can show it as an overnight, weekly, or monthly average.

The REMstar M Auto shows the AHI without breaking it down, as a weekly or monthly average.

I think both brands also show a pressure (95th and 90th percentile pressure, respectively) and average leak rate via the LCD window.

Rested Gal,

You would have thought I'd have know that but that little detail completely slipped by me.

That certainly makes the M series auto a machine to very seriously consider... although the bi-pap like EPR of the S8 is also a great reason to go that way (that is if you're OK with a fixed pressure)

dsm wrote:

NyNurse33 wrote: Is it true that if you use c-flex your breathes have to be quicker?

Not normally. But some people on high Cflex settings & in particular cms ranges, have said they experience a speeding up of their breathing. This is usually fixed with some cms & cflex tuning. This is not what I'd call any big issue.

The only thing that I'd have to add here, is that if you have breathing problems, for example asthma you may experience what feels like hyperventilation. I had to turn my cflex off in specific ranges because I would feel like I was hyperventilating.

I started out using EPR. After switching over to the Vantage, I really did not feel a need for the exhalation relief.

I don't know if I just got used to the PAP pressure or if the relatively low pressure(s) I'm being treated with minimizes the benefit that persons seem to have with higer Rx pressures and EPR. As I understand it, those with high Rx pressures generally prefer or require Bilevel PAPs and as some have stated, EPR is like a mini BiPAP ... perhaps suiting well for those with Rx pressures in between low and high?

- r

Yes, Melissa. The Remstar M Series Auto is the machine that shows the 7 and 30 day averages.
_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, C-FLEX, CPAP, auto[/quote]

Is it the Remstar Pro M series or just the plain M series? Neither one tells me that it has LCD DATA.

DreamStalker wrote:...

It just occurred to me that perhaps the reason I'm waking in the morning very aware of many of my dreams during the previous night's sleep is because I'm being aroused by ResMed's rapid increase in pressure.

On the other hand, I also remember many of my dreams even when using straight CPAP?

... just trying to understand the relationship between my PAP treatment and my beloved dreams.

Well DreamStalker, I imaginge everyone's experience is different, but I noticed when I was untreated I recalled each and every dream VIVIDLY, I assume because I was constantly waking during each dream. I had a diagnosed AHI of 59, so about once a minute I was waking/stirring.

Now that I am successfully treated (AHI nightly range 2-4) I can say I HARDLY recall any dreams at all. I can only assume it is because I am easing into and out of REM sleep gracefully.

(I am on straight CPAP - 14 CM/H20 with EPR of 2 CM.)

Has anyone else noticed a similar 'reaction' to successful treatment?

John

I almost never remembered dreams pre-CPAP and even as a child. If find with CPAP nothing has changed dreamwise.

Maybe some of us are destined to remember dreams and others are not.

Frankly the few that I can recall were the nightmare type so I am just as happy the way things are!!

Well DreamStalker, I imaginge everyone's experience is different, but I noticed when I was untreated I recalled each and every dream VIVIDLY, I assume because I was constantly waking during each dream

That's me! I had very weird, very frequent dreams pre-cpap and now verly seldom. I believe for the same reasons you do.

Remstar M Series Auto C-Flex CPAP is the only respironics
auto/c-flex with LCD data available, correct? Everytime I look I am overwhelmed with many products with similiar names...lol. By the time I make it to see the MD, I will be blubbering fool. I think I will print off the product page from here to show her what I would like. I hope if the MD actually allows me to change machines and whether or not my current DME doesn't give me a hard time, there isn't any lapse in having a machine. If I stick with the current DME, providing they will work with me, then that shouldn't be a problem, I'll return my current machine, when the new one is ready. But if they don't work with me and I have to go to another DME and they don't have what I want in stock....ARGH!!!!

Mellissa,

Sorry, I can't give you that answer since it's obvious from my previous post that I'm not "UP" on the M series machines. Have you checked the Respironics website?

As I've told you, MANY times before, I believe that the Respironics M series Pro and Auto both display limited efficacy data (AHI) and leak in 7 and 30 day averages on their LCD displays. But you're right. The M series Auto is the ONLY M series AUTO that will display efficacy data.

C

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, auto

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, auto