Important Jason/AXG video

This is a good one... he's hammer-down on getting doctors involved. We've been left out in the cold by our physicians, techs, and DME's for too long. See what you think.

https://www.youtube.com/watch?v=MLp-amlTa2w

I won't/don't watch. Sorry.

Once a sleep doc writes the Rx, he or she has basically done his or her job in the U.S. He or she has likely never used PAP personally and so has little to no idea what it is like or about in practice.

The techs are for testing, not for treating.

Unfortunately, the average breathing "experts" at DMEs generally know diddly-squat about sleep. The other drones at DMEs are glorified crutch salesmen.

The system is broken. Yes. But I am unaware of any real paid role or position in medicine in the U.S. for people who are actually experienced in helping others make PAP work.

Patient helping patient in forums is what seems to be working for those who have issues. And teaching patients to understand machines reporting full data is the thing that matters.

My primary doc has chosen to educate herself on PAP. And my dental hygienist is also well-educated to the point that she knows more about making PAP work than most sleep docs or DME drones.

There are decent sleep centers with good followup and helpful people, but that isn't really where the money is at or where it seems to be going in the U.S. "Sleep Coach" isn't something I see a lot of ads for on Linkedin. And the YouTubers seem much more interested in getting subscribers and racking up views with their entertainment and overblown fake-controversy hype than in educating anyone.

End of my negative, uncooperative rant.

Same here.
My sleep doc shuffled me off to staff years ago.
I go in order to keep the Medicare bean counters from effing me up.
This forum has been 100X more helpful.

My experiences exactly. My GP roomed with someone getting some degree in cpap related and she is more helpful than anyone at my Healthcare sleepcenter.

Very informative video indeed. It's one of the reasons I just ordered a Lowenstein Prisma20A.I'm hoping the exhalation relief provided by the Lowenstein machine (softPAP) will better help control UARS with less pressure. The below video argues that the Resmed EPR causes a higher pressure when used. I want the best results at the lowest pressure. Keeping my fingers crossed.

https://youtu.be/GaXA0ZIWj1Y

I’m hoping the same! My lowenstein shipped today! I’ve tried almost every setting and I’m hopeful the algorithm of softpap will help me better than resmeds!

MurrayNevada wrote: ↑

Thu May 09, 2024 12:29 pm

The below video argues that the Resmed EPR causes a higher pressure when used. I want the best results at the lowest pressure. Keeping my fingers crossed.

https://youtu.be/GaXA0ZIWj1Y

I believe Nick says the exact opposite... if you have EPR turned on your effective support pressure is *lessened*... to compensate we are directed to *add* iPap cm for cm of EPR.

And I fully agree with both Jason and Nick that EPR/Flex is not as good as bi-level. Any time you have the opportunity to get a new machine hold out for going bi if you can. For me, pumping the inhales works better than dipping the exhales... nice rounded wave tops.

Not the first time I've gotten things mixed up. And certainly not the last. I did get that he doesn't like Resmed EPR.

I’ve been on EPR 3 since I got my airsense 11 two years ago. I tried each setting and found each to add too much air to my therapy. Kept coming back to EPR 3. Right now my range is 9.2-10.4 with epr of 3. For the past year my 95% pressure was 10.4 and my range all night stays within my set range now so I have it dialed in. I will say the resmed epr probably isn’t great because when I need pressure the most, it dips 3 below and fails to keep up to add it when I need it.

I was prescribed bilevel and used autobilevel for years. But once ResMed perfected their EPR, I switched to APAP with EPR. Why? Partly for cost reasons, partly in reaction to weight loss, and partly because I like that EPR suspends when no flow is detected and because I really like the reasoning behind that aspect of the feature--an aspect that is not, at least as I understand it, available in bilevel.

Not everyone reacts well to EPR. But many do. And I am one who reacts well. So I love it. I think it was brilliantly sneaky that ResMed found a way to bring much of the comfort of bilevel to non-bilevel users.

If someone finds true bilevel more comfortable or more effective than EPR, more power to them. However, I don't see that as any reason needlessly to alarm the many people who are getting great sleep and low AHI using a ResMed APAP with EPR.

Hey, just me. And mainstream normality has never really been my strong suit here in my personal wheelhouse. In fact, at present, I use APAP with EPR when at home and use an old S8 bilevel when I travel.

As my dad used to say to my mom, "I think there may be something very wrong with that boy."