introduction, and a history of apap->bipap->central apneas?

palerider wrote: ↑

Tue Mar 05, 2019 10:11 pm

2) As far as I know, the S doesn't do flow limitations, just like the Elite doesn't. (The CPAP version of the S).

The S9 Elite does Flow Limitation graphs...see Wigsplitter's graph.
viewtopic.php?f=1&t=174717&p=1290535#p1290535

I don't remember off hand an AirSense Elite report to see if it does FL graphs.

I will go back and look to see if my AirCurve 10 ST in S mode ever did FL graphs...I don't remember.

Edit:....no FL graph on the AirCurve ST in either cpap or S mode

Pugsy wrote: ↑

Tue Mar 05, 2019 11:18 pm

palerider wrote: ↑

Tue Mar 05, 2019 10:11 pm

2) As far as I know, the S doesn't do flow limitations, just like the Elite doesn't. (The CPAP version of the S).

The S9 Elite does Flow Limitation graphs...see Wigsplitter's graph.
viewtopic.php?f=1&t=174717&p=1290535#p1290535

Corrected, thanks.

oh wow! thank you kindly Pugsy and Palerider for answering and checking for me.

palerider- I will try to get a hold of Resscan to see if the data in there is different from Sleepyhead. that idea is very helpful to me - that I can cross check things with a different software and thanks for passing it along.

Pugsy - I very much appreciate you checking your AirCurve data and responding about flow limits in the ST versus the vpap. DIdn't realize the S9 Elite did flow limits either, so learned several new things today.

thinking aloud, I think this is the final push for me to go ahead and get the vpap auto, which I recognize will have its own issues to adjust to, but hopefully I can come back here if I have any issues with setting everything up. it sounds really nice to have a machine adjust to me, instead of me guessing to adjust settings based on how I feel and sleepyhead. It feels like either I get my settings so that events are killed but I'm uncomfortable and restless all night; or I am comfortable in the early part of the night but then wake up with headaches. Almost like my pressure needs change from night to night, like nearly everyone.

It's amazing to me there are people who do fine with straight cpap.

anyway, onward to secondwindcpap.com. THanks again pugsy and palerider for your time, care and effort. I hope you both are doing well.

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

but hopefully I can come back here if I have any issues with setting everything up.

Absolutely. I've got the previous version of the machine you're looking at, and I really like it. It's just so comfortable to breathe with.

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

It feels like either I get my settings so that events are killed but I'm uncomfortable and restless all night; or I am comfortable in the early part of the night but then wake up with headaches. Almost like my pressure needs change from night to night, like nearly everyone.

Well, Not even night to night, but throughout the night. Some people have higher pressure needs during REM cycles, and many people need more (or less) pressure depending on what position they're laying in the bed.

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

It's amazing to me there are people who do fine with straight cpap.

Yeah, The only thing I can figure is either they are the lucky ones that don't need much in the way of changing pressures, or they've got it cranked up high enough to handle the higher pressure times, and just are ok with that all the time, instead of just when needed.

hi palerider - I actually ended up getting the same machine as in your profile. The gentleman I spoke to from secondwindcpap said he recommends the used or new S9 vpap over the aircuve 10 vauto because they are able to handle the S9 vpap auto issues better than the AIrCurve 10 vauto issues. I was ok with that because of the difference in cost and I wasn't able to find that there had been a huge upgrade in technology from the S9 vpap auto to the AIrCurve 10 vauto besides design aesthetics?

The person from secondwindcpap was also surprised my doctor had said vpap auto aren't worth it because they are too expensive. Even brand new, the cost isn't that much more for a vauto bilevel versus fixed. I wonder if that's a DME thing that has doctors convinced it's a huge price differential.

I hope that my experience with the vpap auto will help convince my doctor that it's not completely useless to prescribe them.

So thank you, palerider, for recommending secondwindcpap as a supplier on another post and for offering help of yourself/the board if I have trouble with figuring out my new settings for this machine. I will report back with Sleepyhead reports when I get it. Excited!

dogsarelife wrote: ↑

Wed Mar 06, 2019 3:04 pm

hi palerider - I actually ended up getting the same machine as in your profile. The gentleman I spoke to from secondwindcpap said he recommends the used or new S9 vpap over the aircuve 10 vauto because they are able to handle the S9 vpap auto issues better than the AIrCurve 10 vauto issues. I was ok with that because of the difference in cost and I wasn't able to find that there had been a huge upgrade in technology from the S9 vpap auto to the AIrCurve 10 vauto besides design aesthetics?

The person from secondwindcpap was also surprised my doctor had said vpap auto aren't worth it because they are too expensive. Even brand new, the cost isn't that much more for a vauto bilevel versus fixed. I wonder if that's a DME thing that has doctors convinced it's a huge price differential.

I hope that my experience with the vpap auto will help convince my doctor that it's not completely useless to prescribe them.

So thank you, palerider, for recommending secondwindcpap as a supplier on another post and for offering help of yourself/the board if I have trouble with figuring out my new settings for this machine. I will report back with Sleepyhead reports when I get it. Excited!

As far as I know, there is no difference between the s9 vpap auto and ac10 vauto machines, except how they look on the side table.

The dme makes a little more money on the s machine, since insurance pays the same whether it's s or vauto... So greedy DMEs push the cheaper machines.

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

It's amazing to me there are people who do fine with straight cpap.

there's a chap who comes in here from time time with the handle of wulfman. he uses straight cpap and tries to champion it to others. i don't mean he's aggressive about it, just mentions it as an option.

i don't know of anyone else on the forum who uses straight cpap.

zonker wrote: ↑

Wed Mar 06, 2019 5:46 pm

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

It's amazing to me there are people who do fine with straight cpap.

there's a chap who comes in here from time time with the handle of wulfman. he uses straight cpap and tries to champion it to others. i don't mean he's aggressive about it, just mentions it as an option.

He used to be. You'd think autos had horns!

zonker wrote: ↑

Wed Mar 06, 2019 5:46 pm

i don't know of anyone else on the forum who uses straight cpap.

I actually know more than a few people who prefer fixed cpap mode or an extremely tight apap mode.

I actually did try fixed mode myself but I quickly realized that for me and the pressure needs for my REM events (where my OSA is 5 times worse than in non REM) that using fixed mode wasn't comfortable for me.
In REM I might need 6 to 8 cm more pressure than in non REM sleep. REM makes ups 20% of the night's sleep or close.
Using CPAP fixed mode I would have to use 15 to 18 cm ALL NIGHT LONG...and while I guess I could do it if I had to...it's not much fun compared to 9 to 12 most of the other 80% of the night. Let's face it exhaling against 7 or 8 cm is a whole lot easier than exhaling against 16 cm no matter how much exhale relief you plug in.

I can make a fixed pressure work either in cpap or fixed bilevel...but I have to use a LOT more pressure all night to do a good job and I simply don't want to do that unless I have no choice.

Pugsy wrote: ↑

Wed Mar 06, 2019 5:59 pm

Let's face it exhaling against 7 or 8 cm is a whole lot easier than exhaling against 16 cm no matter how much exhale relief you plug in.

agreed.

Seems there are so many complexities involved in if you are having events in NREM versus REM, if you can withstand high pressure or not, if you have aerophagia or not.

I wonder if sleep medicine will ever evolve to the point that there is some simple feedback to tell the machine a person is in REM and thus to set a new epap/ipap for the duration of REM? For example, my friend has an insulin pump with different programming depending on the time of day, so my thought was that for some people it would be helpful at the very least to have an xpap that is programmed to have a higher minimum pressure after someone has been asleep for about 6, at which point I believe that hypnograms show when REM periods lengthen.

I understand the AutoSet for Her tries to take into account the need for increased pressure as the night goes on and so that has ended up being the most helpful algorithm for you Pugsy. Too bad it's not in the S9 Vpap auto. Too bad I can't download the algorithm from one machine, alter it so it will work for bilevel, and then upload it to the S9 vpap auto.

Anyway, just a random thought that it would be cool to have the option to customize sleep machine algorithms like my friend can do with their insulin pump algorithm.

We need machines that can accurately ascertain sleep status and cycles...right now they can't tell awake from asleep.
Bummer the limitations we have but it's still leaps and bounds better than what it was even 15 years ago.

My next machine is going to be an AirCurve 10 VAuto most likely. Given the choice between the for Her mode...or being able to use 4 or 5 PS....I will choose the PS. It affects me more while awake....the for Her algorithm thing...that affects me in the middle of the night and I am asleep and don't care. I can do just as well with the regular VAuto algorithm....I have done it before.

At least that is what I am leaning towards today. Tomorrow I might change my mind. Women get to do that you know.

I am lucky....I can be successful with any number of machines set to various settings and not have any problems. I adjust easily.
I do understand that others aren't so lucky.

And yes...wouldn't it be a sweet deal to have the for Her algorithm working in a VAuto...perfect machine.
Who knows...maybe the next ResMed will have something like that.

dogsarelife wrote: ↑

Thu Mar 07, 2019 4:01 pm

I understand the AutoSet for Her tries to take into account the need for increased pressure as the night goes on and so that has ended up being the most helpful algorithm for

Not really, what the 'for her' does is set a higher baseline if you're having multiple apneas... but that's something that *should* be done manually.

Unfortunately, it doens't remember the need for a higher baseline when you start the next session, it's always a brand new night to it.

It's 2 OAs within a minute and then it resets the baseline minimum up by 2 cm.
It's not perfect though.. is anything ever??
I have a report from a few nights ago where it did the increased baseline pressure because of 2 OAs within a minute...which was all well and good except from the looks of the flow rate there was no way I was asleep. The 2 OAs were immediately preceded by such obvious arousal breathing that a blind man could see it. Wasn't even iffy. I did have to chuckle when I saw it.
Extremely irregular flow rate...obvious not asleep central and more extremely irregular breathing with 2 OAs thrown in the mix.
But the machine did what it is supposed to do within the parameters of the algorithm.

Pugsy wrote: ↑

Thu Mar 07, 2019 6:49 pm

... from the looks of the flow rate there was no way I was asleep. The 2 OAs were immediately preceded by such obvious arousal breathing that a blind man could see it. Wasn't even iffy. I did have to chuckle when I saw it.
Extremely irregular flow rate...obvious not asleep

Mebbe they should have a little speaker and go 'pssst, are you awake?' before raising pressure

zonker wrote: ↑

Wed Mar 06, 2019 5:46 pm

dogsarelife wrote: ↑

Wed Mar 06, 2019 2:03 am

It's amazing to me there are people who do fine with straight cpap.

i don't know of anyone else on the forum who uses straight cpap.

i do