CPAPtalk.com

Thanks fellers
That has just about given me enough to go on regarding buying local or importing. Perhaps something as cheap as the Puritan GN420 from US would be worthwhile. No import duty problems and won't lose a great deal if it has problems.
Only burning question, from your experience is it worth the extra dollars for an auto pressure adjust machine. I have been ok with the fixed pressure F&P for 6 years, but haven't tried anything else.
Is it as simple as the machine adjusting to incidents during the night or is the downside to it? Sorry to keep on about this, but if I can work out whether to buy auto adjust or not, narrows the options/decisions considerably

KenD
Bris

The Auto was the only device I was ever offered. You get the best of both worlds with an auto as you can set it to straight CPAP mode if you want to.

I wouldn't have any other machine myself.

dsm wrote:there are people here who say that Auto mode without EPR is a limitation but the logic to back up that argument escapes me.

I'm one of those people. It's very logical to me and makes perfect sense to me that allowing exhaling to be as "natural" feeling as possible does help many people "do" this kind of therapy more comfortably. The more comfortable exhalation can be made, the easier it might be for many people to go to sleep and stay asleep...no matter what machine they are using.

If you want to contend that all they need to do is set the minimum pressure of an autopap's range way down to where they have no difficulty breathing out, I would suggest that's not the most effective way for most people to use an autopap.

dsm wrote:The S8 Spirit & Elite both do EPR

The S8 Spirit (called the S8 Vantage in the U.S.) cannot use EPR in auto mode...only in cpap mode.

dsm wrote:Bilevel operation is the ultimate exhalation relief. Auto mode is merely a nice to have & useful every now & then to do a home evaluation of current pressure needs.

If a person has extreme difficulty breathing out, certain pulmonary problems, or if it takes pressures of 15 or above to treat them most of the time, then yes, I'd agree they'd very likely do better or at least be more comfortable using a bilevel machine.

But for many people who do want to use less pressure when they can AND who like the "double" comfort, so to speak, of using an auto that can not only provide a range of pressure, but can also give pressure relief in auto mode every time they exhale, calling auto mode "merely nice to have & useful every now and then" is rather dismissive of the benefits many find from using an autopap as their primary treatment machine.

But, we all do have our own opinions. And we all have different "comfort" as well as treatment requirements. It's good there are a variety of machine types, brands, and features out there.

dsm wrote:The PB420E mentioned by Ozij is an excellent choice & a great travel machine & IIRC is sold in Aust by Tyco Healthcare so do look into it too.

I agree the 420E is an excellent machine...not only for travel, but as the primary treatment machine at home. Its software is the most informative of any of the major brands I've used. It's also the only regular autopap that can give reliable info via its software about whether central apneas are occurring.

dsm wrote:One excellent Auto is the Respironics AutoBipap it does both Bilevel and Auto function & provides very comprehensive data (requires a datacard reader & Encore Pro software). That is a machine you might consider (can buy from cpap.com).

It's the Respironics BiPAP Auto with Bi-Flex. It probably is better not to call that machine an "Auto" or place the word "Auto" incorrectly first in its name, since that sounds like it's being called an autopap that happens to also have bilevel capability.

A picky distinction, perhaps, but I think it's important since that machine cannot be used exactly like an autopap. And I realize you know that, Doug. However, calling it an "Auto" or sticking the word "Auto" out of sequence at the beginning of its name could cause newcomers to mistakenly think that machine is a fancy autopap and can be set to work just like any autopap.

The BiPAP Auto with Bi-Flex is first and foremost a bilevel machine that happens to have a function called autotitration that can be turned on, or not, while it continues to use separate EPAP (exhale) /IPAP (inhale) pressures. It cannot be used "just" as an autopap. It can, of course, be used like a straight cpap machine simply by setting EPAP/IPAP to the same number.

The nearest thing to feeling like true bilevel ease of exhalation is the A-Flex feature in the Respironics Auto with A-Flex M series machine. Extremely comfortable at most pressures. If I needed quite a bit of pressure most of the night, I'd opt for the Respironics BiPAP Auto with Bi-Flex.

Thanks for the comprehensive reply RG
My 6 year old F&P 221 has none of these features we are discussing and as far as I know, it is does the job ok for me. I still feel more tired than I think I should at times, but as we get older it is hard to know what is normal. Last year I trialled a mandibular splint for three months and thought it worked ok, but a sleep study indicated it didn't. I noticed an improvement in energy level and lack of tiredness after about a week of returning to the cpap.
I am used to the constant pressure (11cm) and am wondering if people have found they struggle to adapt to the changing pressure of auto.
Like many, I am on a budget and am reluctant to spend the extra on an auto model and then find I need to turn the auto off.
Regards
KenD
Bris

Ken,
You're asking a financial question that you will have to answer on your own - and thinks are even more complicated:

The three different autos have different algorhithms, meaning that the way they change pressure, and whatever drives those pressure changes is different for each machine. You may discover that the specific algroithm of the auto you have bought is not good for you - and yet another may have been excellent.

You've been using the same fixed pressure machine and mask for 6 years - and it's quite possible that you need more pressure now. Finding that out can be done perfectly on a fixed pressure machine. However, for some people, higher pressure means painful gas swallowing (aerophagia) - and auto machines can relieve that for many people because you can set them to deliver the highest pressure necessary only when its needed, instead of the whole time.

Auto machines are rarely used to good effect when the range is wide open. But even a narrow range may be better than fixed pressure -as is the for me.

Batterywise you're right, the machine will need less battery power at lower pressures.

If you have to decide whether to buy an auto, or a new mask (or mask seals) go for the new mask.

The bottom line is that you have no way of knowing if the auto you buy will be good for you or not - maybe there's a way for you to trial the various machines. You'll never know if you're missing anything if you don't try it - but you may find yourself eventually setting the automatic machine on fixed mode.

O.

I

countman88 wrote:I have used a Fisher and Paykel HC221 for the last 6 years and found it ok. Now need a machine to run from 12v while travelling in my caravan

Since you are already well adapted to fixed pressure CPAP treatment, for best bang for your buck, buy an Resmed S8 Lightweight and a Resmed DC-12 adapter and drive off into the sunset!

countman88 wrote:Wondering whether the Auto pressure and C/AFlex or EPR functions are worth the cost.

I now have an S8 Autoset Spirit (since I got a great deal on one), after several years of succesfully using Resmed S7 and S8 Lightweights. I used APAP mode for several months, carefully trying various settings, but found that it gave me worse sleep than on CPAP, so I now run the S8 Autoset Spirit in CPAP mode. The only difference for me from the S8 lightweight is that I now have data that I can monitor, which is moderately useful but by no means essential.

APAP, EPR, */Flex, BiLevel etc etc were all developed to extend PAP treatment to users who could not cope with CPAP treatment. There's no point in paying for them if you don't need them.

Cheers,

Bill

The nearest thing to feeling like true bilevel ease of exhalation is the A-Flex feature in the Respironics Auto with A-Flex M series machine. Extremely comfortable at most pressures. If I needed quite a bit of pressure most of the night, I'd opt for the Respironics BiPAP Auto with Bi-Flex.

And I'd take the S8II as there is ZERO resistance breathing out at any pressure - My maximun is 15btw.

countman88 wrote:I am used to the constant pressure (11cm) and am wondering if people have found they struggle to adapt to the changing pressure of auto.
Like many, I am on a budget and am reluctant to spend the extra on an auto model and then find I need to turn the auto off.
Regards
KenD
Bris

I have no struggle adapting to the changing pressure of three different brands of autopaps. What matters for most people in using an auto is setting a range that suits them, particularly having the minimum pressure up high enough to ward off most events from the get-go. And with the PB auto, knowing (via software) whether a setting called "IFL1" needs to be turned off or can be left on.

That said, since you are on a budget and have not been bothered by a straight pressure of 11, all you probably need is a cpap machine that can use software to let you get a better look at your nightly treatment.

People in this study were able to set their straight cpaps to an effective pressure for themselves -- without the benefit of using software or even any info from the LCD:

"Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?"
Link to a study that concluded, "yes."
http://ajrccm.atsjournals.org/cgi/reprint/167/5/716

Ken, there can be many other health issues, including med side effects, that can make us feel tired or sleepy, even if "cpap" is doing its part of the job fine.

the 420E is a great little machine for travel, runs directly off of 12volt DC, you can run it in the same mode as your current machine or in Auto mode, if your pressure of 11 has changed it will tell you that with the Silverling software, then you can adjust your other machine.

rested gal wrote:

dsm wrote:there are people here who say that Auto mode without EPR is a limitation but the logic to back up that argument escapes me.

I'm one of those people. It's very logical to me and makes perfect sense to me that allowing exhaling to be as "natural" feeling as possible does help many people "do" this kind of therapy more comfortably. The more comfortable exhalation can be made, the easier it might be for many people to go to sleep and stay asleep...no matter what machine they are using.

If you want to contend that all they need to do is set the minimum pressure of an autopap's range way down to where they have no difficulty breathing out, I would suggest that's not the most effective way for most people to use an autopap.

dsm wrote:The S8 Spirit & Elite both do EPR

The S8 Spirit (called the S8 Vantage in the U.S.) cannot use EPR in auto mode...only in cpap mode.

dsm wrote:Bilevel operation is the ultimate exhalation relief. Auto mode is merely a nice to have & useful every now & then to do a home evaluation of current pressure needs.

If a person has extreme difficulty breathing out, certain pulmonary problems, or if it takes pressures of 15 or above to treat them most of the time, then yes, I'd agree they'd very likely do better or at least be more comfortable using a bilevel machine.

But for many people who do want to use less pressure when they can AND who like the "double" comfort, so to speak, of using an auto that can not only provide a range of pressure, but can also give pressure relief in auto mode every time they exhale, calling auto mode "merely nice to have & useful every now and then" is rather dismissive of the benefits many find from using an autopap as their primary treatment machine.

But, we all do have our own opinions. And we all have different "comfort" as well as treatment requirements. It's good there are a variety of machine types, brands, and features out there.

dsm wrote:The PB420E mentioned by Ozij is an excellent choice & a great travel machine & IIRC is sold in Aust by Tyco Healthcare so do look into it too.

I agree the 420E is an excellent machine...not only for travel, but as the primary treatment machine at home. Its software is the most informative of any of the major brands I've used. It's also the only regular autopap that can give reliable info via its software about whether central apneas are occurring.

dsm wrote:One excellent Auto is the Respironics AutoBipap it does both Bilevel and Auto function & provides very comprehensive data (requires a datacard reader & Encore Pro software). That is a machine you might consider (can buy from cpap.com).

It's the Respironics BiPAP Auto with Bi-Flex. It probably is better not to call that machine an "Auto" or place the word "Auto" incorrectly first in its name, since that sounds like it's being called an autopap that happens to also have bilevel capability.

A picky distinction, perhaps, but I think it's important since that machine cannot be used exactly like an autopap. And I realize you know that, Doug. However, calling it an "Auto" or sticking the word "Auto" out of sequence at the beginning of its name could cause newcomers to mistakenly think that machine is a fancy autopap and can be set to work just like any autopap.

The BiPAP Auto with Bi-Flex is first and foremost a bilevel machine that happens to have a function called autotitration that can be turned on, or not, while it continues to use separate EPAP (exhale) /IPAP (inhale) pressures. It cannot be used "just" as an autopap. It can, of course, be used like a straight cpap machine simply by setting EPAP/IPAP to the same number.

The nearest thing to feeling like true bilevel ease of exhalation is the A-Flex feature in the Respironics Auto with A-Flex M series machine. Extremely comfortable at most pressures. If I needed quite a bit of pressure most of the night, I'd opt for the Respironics BiPAP Auto with Bi-Flex.

RG,

BipapAuto vs AutoBipap vs Bipap Auto with BiFlex

Hmmmm, bit of a worry when we begin insisting a machine has to be described only one way But if it helps - yes the reference was to the Bipap Auto with Biflex - I am not sure what other model you think it can be confused with ? - the one I used last week worked very well but as I said when reporting on it I personally like a bigger epap ipap gap that 1.5 CMS / 2 CMS

Also on this never ending debate over EPR can't be any good because it doesn't work in Auto mode. RG I tell you again it isn't needed in auto mode EPR turns the machine into an easy to set bilevel with up to a 3 CMS range between breath-in and breath-out. That is as much as any cpapper needs. I really believe you must know this but to admit it means admitting the Resmed did something good and that seems to me to be where the problem really is .

But as already said elsewhere, the new Easy Breathe feature now adds an even more sophisticated EPR capability. No matter what some think of Resmed, they do make some interesting and very effective innovations. So do Respironics & so do F&P & so do Puritan Bennett.

Re Auto machines, I would take a bilevel any day - but that is my personal choice just as I think it is yours to promote Autos. Most people who use Autos over time will narrow their range & often down to a 5 CMS start / peak range. The experienced among us know that Autos set to big ranges cause more problems than they solve. Autos were introduced as a less expensive (than bilevel) way to provide therapy - self titration was a side benefit for those who understand how to do it. Bilevels have now dropped in price and thus have become increasingly popular. Sophisticated Bilevels like the AdaptSV & BipapSV may well become the new standard for therapy once prices drop just as bilevel prices eventually did. Autos still only provide one CMS pressure & thus the designers had to add things like flex to provide a justification for why someone would persist with one. I am of the opinion that Autos as we know them will be brushed aside by variations of SV machines.

But, a bilevel set up correctly provides effective & consistent therapy to most people. I am convinced that bilevels offer the best relief from aerophagia, far far better than an auto (even with x-flex on). I am also convinced that people (ignoring for this point, those people with respiratory complexities) on higher pressures gain vastly superior therapy with a bilevel.

You push Autos, I push bilevels but as is the case, everyone has to make their own choice in the end.

RG I do enjoy our debates on some of these topics, they do add color to the forum

Cheers

DSM

_________________

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dsm wrote:RG,

BipapAuto vs AutoBipap vs Bipap Auto with BiFlex

Hmmmm, bit of a worry when we begin insisting a machine has to be described only one way

You can call it anything you want to, but when you say this kind of thing in a topic that has been predominately talking about "autopaps":

dsm wrote:One excellent Auto is the Respironics AutoBipap it does both Bilevel and Auto function

That does make it sound like that machine is another kind of "autopap."

I know you know what it is. You know I know what it is. But, Doug, there are many new people reading this message board every day, trying to sort through the different types of machines, confused by the model names and what the different machines do. That is the only reason I think it's good to be a bit more .... ummm.. precise... in calling that machine by its name. A name which tells what kind of machine it really is -- a bilevel machine, not to be confused with an "autopap" (autotitrating CPAP) machine.

dsm wrote:But if it helps - yes the reference was to the Bipap Auto with Biflex - I am not sure what other model you think it can be confused with ?

Doesn't confuse me, but yeah...referring to it as "One excellent Auto" could confuse new people into thinking you were talking about yet another autopap.

dsm wrote:Also on this never ending debate over EPR can't be any good because it doesn't work in Auto mode.

"never ending" perhaps because you happened to bring up your opinion about it again... LOL!!! After which, I gave my opinion. Surely you don't mean that your opinion is the final word about it and no one else should then state a different opinion.

dsm wrote: RG I tell you again it isn't needed in auto mode

You say it's "not needed" in auto mode. That's your opinion.

My opinion: IF a person wants (and/or needs) to use an autopap in Auto mode AND wants (and/or needs) exhalation relief every time they breathe out, an exhalation pressure relief feature that can be turned on when using an autopap in auto mode can make the difference between doing this kind of treatment comfortably...or, for some people...at all.

dsm wrote: EPR turns the machine into an easy to set bilevel with up to a 3 CMS range between breath-in and breath-out. That is as much as any cpapper needs.

"that is as much as any cpapper needs." Wow. That's quite a far reaching conclusion for any one person to make about what any other cpap users might need. Seriously, I sure hope you just fired that off from the hip and don't really mean that.

What you seem to be missing (perhaps because you have preferred using a bilevel machine) is that some people do like, and/or need, exhalation relief if they are going to be using an autopap in auto mode. That can be so whether their use of an autopap is from having been prescribed an auto-titration trial, or simply because they prefer (and/or need) to use an autopap in auto mode as their permanent treatment machine.

Speaking of "EPR turns the machine into an easy to set bilevel with up to a 3 CMS range between breath-in and breath-out."

dsm wrote:I really believe you must know this but to admit it means admitting the Resmed did something good and that seems to me to be where the problem really is .

I have no problem at all with recognizing when any manufacturer does something good (or bad.) For example, I've said many a time before that resmed got it right when they designed their LCD data display to break down AHI and to show the last session data instead of just a running weekly/monthly average. Also, having EPR for cpap mode is better than nothing.

Leaving EPR out of auto mode was not so good, imho.

And having EPR not drop the pressure the full setting (1, 2, or 3 cm drop) when a person FIRST STARTS to exhale is not so good, imho. EPR (in my experience, anyway) doesn't give pressure relief when it is most desirable...when a person tries to get an exhalation STARTED.

EPR is better than nothing, though, and does give comfortable exhaling as the exhalation progresses, but that's a far cry from giving the type of exhalation relief of a true bilevel if EPAP is set for 1, 2, or 3 cms less than IPAP. A true bilevel drops the pressure immediately when inhalation stops...the lower pressure for exhaling is already in place to allow the person to get an exhalation started easily. Very different from the resistance a person feels when starting to breathe out against an EPR setting.

dsm wrote:But as already said elsewhere, the new Easy Breathe feature now adds an even more sophisticated EPR capability. No matter what some think of Resmed, they do make some interesting and very effective innovations. So do Respironics & so do F&P & so do Puritan Bennett.

Yep, resmed's coming out with "Easy Breathe" sounds very similar to what users of Respironics Auto with A-Flex have already been enjoying quite comfortably for quite some time now.
Seriously, I do agree that each manufacturer has its own strengths, weaknesses and innovations. I'm always glad to see each one working on improving their designs.

dsm wrote:Re Auto machines, I would take a bilevel any day - but that is my personal choice just as I think it is yours to promote Autos.

There are specific reasons that have nothing to do with my own personal choice of what machine I use most nights, for my frequent suggestion of the Auto with A-flex:

1. A-Flex feels more like natural breathing to many people than no relief, than EPR, and than C-Flex. A-Flex is available only in the auto with A-Flex...soooo.

2. To get a bilevel machine (including the BiPAP Auto ) a person would have to have their Rx changed to "bilevel." To get an autopap (like the auto with A-flex) a person has at least a chance of convincing a DME to give them an autopap set to operate as straight cpap per the Rx for "cpap." Or, if the person's finances allow, that simple cpap Rx would let the person buy the Auto with A-Flex from an online store like cpap.com.

3. Encore Viewer software (used by Respironics machines) is readily available for users to buy.

At home, I happily and comfortably actually use my BiPAP Auto more often than the Auto with A-Flex which is equally comfortable for me to use. My Auto with A-flex is often out on loan.

dsm wrote: Most people who use Autos over time will narrow their range & often down to a 5 CMS start / peak range.

Wow, again. "Most people" "often down to a 5 cms start" Again, another very sweeping generalization about your opinion of what "most people who use autos" and, I'd add... who set their own machines range themselves... do.

dsm wrote: The experienced among us know that Autos set to big ranges cause more problems than they solve.

"Big ranges" "cause more problems than they solve"... another sweeping generalization. Especially when "big ranges" could mean anything. If you mean leaving an autopap set at 4 - 20, I agree that's not a good way for an autopap to be set (imho)...not even for an temporary auto-titrating trial. As for when an autopap is used as a permanent treatment machine, I think it is NOT the wide open UPPER setting that is a problem for most people. "Narrowing the range" in the most effective way possible, to me means getting the lower pressure set up high enough to prevent most events from the get-go.

So, in the interests of venturing my own sweeping generalization... LOL.. I'd bet that for people using an autopap as their permanent treatment machine, setting it at 9 - 20 or 10 - 20 would give them their most effective treatment while using "auto-titration."

dsm wrote:Autos were introduced as a less expensive (than bilevel) way to provide therapy - self titration was a side benefit for those who understand how to do it.

Again, a "never ending debate", and again, simply because you have brought this up again...your opinion of why autopaps were first developed. I agree that there have been further uses for them as time has gone on, and the further uses are reflected in marketing blurbs from all the manufacturers.

But, I still think (my opinion) that the main reason autopaps were FIRST introduced was to use not for "therapy" per se, but as a way to do a home titration for people who were perhaps to ill to be in a sleep lab for a full PSG, or for whom a sleep lab PSG titration was ambiguous, or who didn't achieve enough titration sleep time for a good titration.

In other words, "autotitrating cpap" was developed to take up the slack, if necessary, when a trip to the sleep lab was out of the question. That's also probably the reason Respironics designed (at what point, I don't know...from the beginning, or as an added feature later perhaps) the "split night" mode that still remains in their autopaps today. Split night mode being to gather diagnostic data about events first at as minimal a pressure as possible, and then to titrate the remainder of the night. A cheap ersatz sleep study.

I don't think autopaps were originally designed at all with the primary intention of providing "less expensive therapy" than from using a bilevel machine. Nor do I think anything about the later designs of autopaps was to give "less expensive therapy" than with a bilevel machine. That is absolute apples and oranges thinking, imho, since bilevel machines are really intended for specific respiratory needs (which can include a struggle to breathe out against incoming pressure) that have nothing to do with needing autotitration.

dsm wrote:Autos still only provide one CMS pressure & thus the designers had to add things like flex to provide a justification for why someone would persist with one.

ROTFL!!!!!! Sorry, Doug, but I really did burst out laughing at that. Could it possibly be that since designers saw that C-Flex did make a comfortable difference for people using straight CPAP, that it occurred to the designers, "Hey, that might make using the straight pressures delivered by an autopap more comfortable, too?" So, they put it in the autopap to help people...not, as you would have it, "persist" in using an autopap vs trying to get a bipap. As if the general users of machines out there even know there are other types of machines.

I think we all forget that people on the message board who are tweaking settings and trying different machines are the MINORITY. We are not who the designers are looking at when they design machines. They are looking at (and designing for) the vast majority of people who will never see an apnea message board and who wouldn't even WANT to change a setting or decide on their own what machine they should have.

dsm wrote: I am of the opinion that Autos as we know them will be brushed aside by variations of SV machines.

That day may come. I wouldn't hold my breath quite yet. Simple "autotitration" may always have a place, especially with the advent of Medicare allowing portable home testing... after the testing is done with Type II and III devices, I wouldn't be surprised if there's a whole slew of autopap Rx's being written to follow the more extensive portable home test up "now let's find the pressure needed."

dsm wrote: I am also convinced that people (ignoring for this point, those people with respiratory complexities) on higher pressures gain vastly superior therapy with a bilevel.

Well, I'd call it more comfortable therapy, which could indeed make such a difference for them that it was the only way for them to get effective therapy at all.

dsm wrote:You push Autos, I push bilevels but as is the case, everyone has to make their own choice in the end.

Well, you call it "pushing" on my part. I call it suggesting getting two machines in one as well as a comfortable machine for exhaling -- and most importantly -- the most likely machine other than "straight cpap" the person could most likely actually get, since most people are given a Rx for "cpap"...not for "bilevel."

I do agree that if a person wants comfort exhaling, and if any of the "flex"'s in a cpap or autopap leave them still struggling to breathe out, a bilevel machine is definitely worth talking to one's doctor about. Doug, your enthusiasm for "bi-level" is understandable. I like bi-levels too... they are very comfortable. So is Auto with A-flex at the pressures well below 15 that work for me.

dsm wrote:RG I do enjoy our debates on some of these topics, they do add color to the forum

Yup. Differences of opinion, politely stated, are always interesting.

RG,

Peace


(Am away for this week - family crisis in NZ - happy to pick up when back on deck - cheers Doug

Wow, I feel I have provided a forum for a few people to continue past discussions/arguments. I have received some useful information but my head is starting to hurt from trying to follow much of the later posts.
My last sleep study said I would be ok with 9cm pressure but I have increased it to 11cm over the past month to see if it makes any difference, and I knocked it up to 13cm last night to see if I had any problem coping with that. Had no problems at all. Will put it back to 9cm for a while and see if there is any noticable difference in energy/tiredness. Not very scientific, but will see whart happens. Thanks for the article RG, will have a good read of it in the cool of the evening, so to speak.
I think I will probably stick to a basic cpap this time and the Goodnight 420 looks a good low price option for my 12v travel requirements.
Feel free to continue the discussion.

KenD
Bris

countman88 wrote:My last sleep study said I would be ok with 9cm pressure but I have increased it to 11cm over the past month to see if it makes any difference, and I knocked it up to 13cm last night to see if I had any problem coping with that. Had no problems at all. Will put it back to 9cm for a while and see if there is any noticable difference in energy/tiredness. Not very scientific, but will see whart happens. Thanks for the article RG, will have a good read of it in the cool of the evening, so to speak.

Sounds like you're going to do very well, Ken.

countman88 wrote:I think I will probably stick to a basic cpap this time and the Goodnight 420 looks a good low price option for my 12v travel requirements.

Good choice, imho. I think you'll be very pleased with that machine for cpap treatment.

First let me apologize to Countman88, I am not trying to highjack your thread. I just need to put my two pennies in here.
I must say, that I have to agree with Rested Gal on several of her opinions. This one for instance:

Rested Gal wrote:

I don't think autopaps were originally designed at all with the primary intention of providing "less expensive therapy" than from using a bilevel machine. Nor do I think anything about the later designs of autopaps was to give "less expensive therapy" than with a bilevel machine. That is absolute apples and oranges thinking, imho, since bilevel machines are really intended for specific respiratory needs (which can include a struggle to breathe out against incoming pressure) that have nothing to do with needing autotitration.

Here is my situation: I was dx'd 9 months ago with OSA, put on 17 pressure on a Respironics M Series Pro with CFLEX. I also have COPD. I struggled so hard for 6 months trying to breathe out against the high pressure of 17, using the cflex of 3. Cflex helped, but I still would wake up gasping for breath because I could not breathe out against the high pressure. I had gotten to the point where I would just throw the mask in the floor and say "forget it" and try to go back to sleep (only to keep waking up again). I went to my doctor and talked to him about this. I specifically asked for and tried very hard to get a prescription for a BiPap Auto machine. For the simple reason, so I can breathe out more comfortable against the high pressure. I could not get one with out another sleep study and I cannot afford another one. It had only been a few months since I had one. He suggested the Auto and asked would I be interested in it. I said "definitely, yes, if it will help me breathe with my machine easier". That was the best decision that I have made in a very long time. Not only has it made Cpap easier for me and I have been 100% compliant , but my pressures have stayed in the 90% range of 15 the majority of the time, I have it set at 14/17. And my event numbers went from 1.9 to 0.2 the majority of the hours spent sleeping. And I have not had to pull my mask off at all since I started using the Auto machine and have slept all night an average of 7 to 8 hours a night. Before it was like 4 to 6 hours with my waking up and getting up at different intervals.

I would still love to have the Bipap Auto, for the same reasons, but for now, I will stick with my MSeries Auto.

BTW RG, I liked what you said, "My Auto with A-flex is often out on loan. ".....