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Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 7:59 am
by Veridor
You're right, John, I probably took it the wrong way. Having been diagnosed just a couple weeks ago, I'm still new to all this.
Just got off the phone with the DME rep, who tried to tell me that no machines allow user access to the efficacy data, and that they can get all they need from data download card on the Escape II Auto, which is a load of crap, as everything I'm finding on that machine says it doesn't store efficacy data. Waiting on a call back from the sleep doc now.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:06 am
by LinkC
Maybe, maybe not. Consider it "tough love"...
The decision whether to go Auto or not is (or should be) towards the end of the process. You were getting "experience and knowledge" before your whole story was out there. Your number of Centrals didn't even come up until page 2. I'm not faulting you for that, but that one little tidbit changes things significantly.
At this point, your Dr is the one you should be consulting. HE has the complete picture. No one here does. That's all I'm saying.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:29 am
by JohnBFisher
LinkC wrote:... but that one little tidbit changes things significantly. ...
Let me explain why, and why it's important to keep your doctor in the loop at this point.
With the known tendency to have central apneas your sleep doctor will be less likely to recommend APAP. And anyone here in your shoes, who knows about how this works, would also tend to use straigt CPAP. Why? Well, if you have a tendency toward central apneas, an increased pressure can actually trigger MORE central apneas. It can make things much worse. In such cases, it is usually best to use a set, static pressure in CPAP or BiPAP mode.
Rather, as LinkC notes, you do want to monitor you therapy. Just not vary it a lot at this point. You might want to read through Rested Gal's
Links to Central Apnea:
viewtopic.php?p=457468
I also added a long list of key scientific papers that are somewhat readable and help explain the wheres and whys of central sleep apnea. As you get a machine that shows the continued number and frequency of various apneas, these articles may come in handy.
As long as you don't try to tell the doctor what's wrong, but use those to show that you are trying to understand your situation, most doctors respond positively and are willing to help teach as well. They don't have a lot of time for it (insurance just don't pay for that). But it often helps.
But first things first, you need to be able to track your therapy. For example, you need to be able to sort out mask leaks from apneas as a cause for not feeling as well as you could.
Hope that helps.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:34 am
by Veridor
Agreed, so now I just need to convince the DME I need a machine with that tracking capability. For now, I've left the Escape II Auto in CPAP mode at 12 cm as originally prescribed.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:39 am
by Veridor
Just got a call back from the DME and they are going to swap me for an S9 later today. At least this way I'll have data tracking, but I'll leave pressure and such alone until I speak to my doc.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:43 am
by Wulfman
Veridor wrote:Agreed, so now I just need to convince the DME I need a machine with that tracking capability. For now, I've left the Escape II Auto in CPAP mode at 12 cm as originally prescribed.
Exactly.
For new users, doing this therapy
WITH an APAP
WITH data-capabilities can be challenging enough. You have the worst of all situations......ESPECIALLY since you're apparently having Central Apneas. Your "medical professionals" may be questionable, regarding their competency.
Den
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 8:50 am
by Wulfman
Veridor wrote:Just got a call back from the DME and they are going to swap me for an S9 later today. At least this way I'll have data tracking, but I'll leave pressure and such alone until I speak to my doc.
Good.
Den
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 9:12 am
by LinkC
That's great news!
Eventually, you'll want to get the capability to read the card yourself. Until then, your DME should be able to read it and print the report for you and/or your Dr. (They may charge for that...or not.)
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 9:14 am
by Veridor
LinkC wrote:That's great news!
Eventually, you'll want to get the capability to read the card yourself. Until then, your DME should be able to read it and print the report for you and/or your Dr. (They may charge for that...or not.)
Indeed, that's my next step: getting the reader and software.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 9:39 am
by ozij
A comment about central apneas:
There are central apneas induced by pressure --
Ther are central apneas that are a result of a Central Nervous System problem
There are Central apnea the come as a response to obstructive apneas: you have an obstructive, gasp, take a few deep breaths to catch up on oxygen, and the stop breathing as a direct result of those cathing up breaths.
I have no idea which of the three is true of you. But if it's the latter, then pressure taking care of the obstructive events will also solve the central ones.
If you can find your psg (sleep study) report and post it, we will all be much wiser, since we will know what happened during your titration.
Erase your name and the doctor's from the study before you post it.
O.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 9:58 am
by JohnBFisher
Great summary by ozij (as usual!). It is also why I wondered about the results from the CPAP portion of your sleep titration.
And it is GREAT news to hear about the S9. All too often they will try to provide the lowest cost unit and hope they can walk away with the money. All too often it results in a patient who gives up on the therapy.
Here's hoping it goes smoothly for you. I would LOVE to see you have no further issues with central apneas. I would not wish this on my worse enemy! So, here's hoping your therapy will continue to go well, improve and you have the data you need to help guide it.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 10:09 am
by Veridor
ozij wrote:A comment about central apneas:
There are central apneas induced by pressure --
Ther are central apneas that are a result of a Central Nervous System problem
There are Central apnea the come as a response to obstructive apneas: you have an obstructive, gasp, take a few deep breaths to catch up on oxygen, and the stop breathing as a direct result of those cathing up breaths.
I have no idea which of the three is true of you. But if it's the latter, then pressure taking care of the obstructive events will also solve the central ones.
If you can find your psg (sleep study) report and post it, we will all be much wiser, since we will know what happened during your titration.
Erase your name and the doctor's from the study before you post it.
O.
Unfortunately, I only have my PSG results in hard photocopy and don't have a scanner handy.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 11:25 am
by DreamOn
Veridor wrote:Just got a call back from the DME and they are going to swap me for an S9 later today. At least this way I'll have data tracking, but I'll leave pressure and such alone until I speak to my doc.
Excellent! You did good, Veridor!
Just so you know, there are two S9 machines: S9 Elite and S9 AutoSet. They're both fully data capable. The Elite is a straight CPAP, and the AutoSet is an APAP. If you're going to be using straight pressure (CPAP) either will work fine for you. The AutoSet can be run as either straight CPAP or Auto, so it is more flexible that way.
It's my understanding that the ClimateLine hose is optional. If you want to learn about that, here it is at cpap.com:
https://www.cpap.com/productpage/resmed ... ntrol.html. I believe the machine will come with a standard slimline hose.
I sent you a PM with some more information about your machine.
Sleep well and prosper,
DreamOn
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 11:34 am
by Veridor
Thanks. I wondered about the climateline hose, and I did have rainout with my current humidifier at 3, but it went away when I changed it back to 2.
Re: Is changing S8 Escape II Auto from CPAP to APAP bad?
Posted: Mon Mar 22, 2010 6:03 pm
by Veridor
Got the S9 Autoset now. Onward to tracking/charting glory.