Confused...S9 Auto vs S8 VPAP Auto 25 vs S8 VPAP ST

jules wrote:cpap.com can't ship Resmed to Canada

to get a VPAP you need a bilevel script

to get the ST machine you need a specific script for that

if you check craigslist they don't have script requirements but of course buyer beware and who knows about using your HSA for such a purchase

cpapguy1977 wrote:So I've been on CPAP therapy for about 3 years. Started out at a pressure of 10 which was then increased to 13 about a year ago. These pressures were determined by an overnight sleep study. I have other health problems as well (awaiting kidney transplant) so I really want to be getting the best sleep possible.
Had another sleep study done recently and the recommended pressure is now 17. I had already been playing around with increasing the pressure on my own as I felt I needed more pressure so had tried as high as 18 when I had a stuffed up nose and then settled on 16. I am now going to increase to 17 as per my dr.

DSM: cpapguy1977 - the issue of your pressure going up so fast in a 'relatively' short time (2-3 years) suggests a notable decline in health. I see the mention of kidney transplant, have you gone thru a substantial weight gain in this period ? - is there any other notable medical situation ?

I want to get a new machine but I'm not sure what I should be getting. I actually have 2 different sleep doctors concurrenty - a regular sleep dr and my shrink who specializes in sleep research and ordered the latest sleep study. I had a conversation with my original dr last year about getting an auto CPAP - he said there 2 schools of thought about auto machines - those that believe it is good to have variable pressure adapting to your needs and those that think you should find the minimum pressure that eliminates the apnea and stick to it. He ended up giving me a script for an auto CPAP and said it wouldn't hurt to try.

DSM: Your Doc is pretty well right about the 2 schools of thought. I am biased towards bilevel with epap (exhale pressure) remaining at a preset pressure & a higher ipap (inhale pressure) being used to clear hypopneas etc: BUT, I am aware that some (limited numbers) of people when put on bilevel therapy, can exhibit more centrals and also for some others, bilevel can cause some PaCO2 imbalance (carbon dioxide in the blood). So, for those of us not diagnosed as CompSA sufferers, bilevel can be a very satisfying type of cpap therapy. I would always use bilevel over autocpap.

My shrink had originally mentioned the possibility of a bi-pap (before the sleep study) but now says I should hold off and try the 17 pressure for a while and see how that goes. Part of her hesitation is because we are in Canada and the machines are much more expensive, especially the bi-pap which can be around $5,000 and there are all kinds of hoops to jump through to get the gov't to pay for part of them. I'm looking at just purchasing something on CPAP.com which is some cases is literally 1/3 the cost of the same machine in Canada...it's ridiculous.

DSM: I would be *very* surprised if the current Bipaps (standard bilevel & auto bilevel) were around those prices ($5000). Both Respironics and Resmed have dropped their pricing markedly in the past couple f years. Also cpapauction.com has a variety of these at bargain prices.

I have this HSA (Health spending account) that I can to use to get a new machine but I'm not sure what to do. I currently have a Resmed S8 and am kind of partial to Resmed for some reason. They just seem to be the "coolest" CPAP's around I really like the look of the new S9 and I would get the AUTO version because an auto CPAP seems to make sense to me in theory. I'm just not sure what to do about a bi-pap - I guess I don't really have a prescription for a bi-pap right now but if I really wanted one I'm sure I could get my shrink to write me one. I'm really confused between the s8 VPAP 25 and S8 VPAP ST which is right about double the price. What is the difference between the 2 in practical terms. I understand the ST is "spontantenous timed" but what is the benefit to that? Also, I really like the look of the S9 - are S9 bi-paps coming out soon?

DSM: If you can, go for an Auto Bilevel as you can choose to activate or deactivate the auto aspect. Unless you have central apnea you don't need the S/T models. S/T is the preferred device for dealing with people who have serious central apneas (vs not serious ones such as sleep onset centrals & casual (turning over in bed / yawning etc: centrals)).

Finally, I've been reading about the Resscan software and really want to start taking charge of my therapy and using that but I can't find anywhere to buy it! I've read in all the S9 threads about people getting and using the newest version 3.10- where are these people obtaining it??

DSM: ResScan is impressive. But I will be honest & say that after the novelty of looking into your data wears off (took a few years for that to happen to me) it doesn't really matter that much BUT had it been around 5 years ago I would have gone for it without hesitation.

Sorry for the long first post! I really love that this forum is out there. My DME is useless and just try and sell me whatever machine THEY want me to have - I really had to fight to get my S8 Elite originally and when I asked about the S8 II they had no idea what I was talking about and said it must only be available in the US - it came out a month later after I bought my original S8

DSM: Yes this forum is tops

dsm wrote: DSM: cpapguy1977 - the issue of your pressure going up so fast in a 'relatively' short time (2-3 years) suggests a notable decline in health. I see the mention of kidney transplant, have you gone thru a substantial weight gain in this period ? - is there any other notable medical situation ?

dsm wrote:
DSM: I would be *very* surprised if the current Bipaps (standard bilevel & auto bilevel) were around those prices ($5000). Both Respironics and Resmed have dropped their pricing markedly in the past couple f years. Also cpapauctiondotcom has a variety of these at bargain prices.

rested gal wrote:I would not want an S/T (spontaneous/timed) machine unless I really, really, really needed it. Just for the heck of it, I tried a borrowed bilevel S/T machine for a couple of weeks; playing around with the timed mode. Since I don't actually need a "timed" backup rate, I found any timed rate other than the very lowest BPM (breaths per minute) times to be annoying...

Since you haven't been told you need "timed", I wouldn't even consider S/T machines if I were you.

Bilevel is very comfortable for many people. I don't actually even need a bilevel machine, but I use one for the comfort when exhaling.

A bilevel auto machine is handy since it can be used in just bilevel mode or in autotitrating bilevel mode. Can also be set to work like plain CPAP by setting both the EPAP and IPAP pressures the same when bilevel mode is chosen. Very versatile.