New ResMed Machines - Are they here yet?

The last report I showed my pulmo-Doc/Sleep Doc yesterday at my 6 month app't. was an interesting one. I was up amongst the big drippy trees and herds of peacefully grazing banana slugs in Washington at my wife's place when the power went out around 11-ish. I woke up with a start, like someone clamped a hand over my mouth. First time I had ever experienced an outage on the hose. With all that standing timber, it only takes a gentle breeze to topple a big mossy tree over power lines. Power was out until 0700. During that time I slept downstairs, wife and cats retreated upstairs. She said my snoring rumbled the floor. I bet it did, 'cause I didn't sleep worth squat, and when power came on I woke up feeling horrible, sore throat, headache, aching in chest. So I immediately grabbed my mask, plugged in, turned on, turned over and tuned out. Woke up about 0930 feeling much better.

When I downloaded my data, ResScan showed a period of about 45 minutes during which I had what looked like periodic breathing, punctuated by numerous OAs and CAs. Things eventually settled down, but it was a striking pattern. Never seen anything like that before or since.

I showed the pattern to my doc yesterday and he explained that when the power came on and I started up the machine, pressure almost immediately rose to the 13 cm maximum limit I had set and stayed there. He said he thought the machine over-reacted, and he'd bet the events marked as Centrals were actually artifacts of the (for me) high pressure. He said that's his gripe about having machines trying to score a night's worth of data. The machine can't tell the difference between a CA and a non-obstructive apnea, so it scores it as a CA. And that gets rolled into the AHI calculation. And he said he's not convinced that the 4Hz pressure pulse really can detect whether the airway is open or not all the way at the end of a narrow 6 foot hose that might be twisted into the shape of a pretzel filled with very compressible air.

Lots to think about. I'd really like to see more validation of these claims and less marketing hype. FWIW, I really like the article from DeVilbiss that I referenced above. That seems to be written in a cautious, healthily (if that's a word) skeptical tone. Certainly DeVilbiss has their own spin that they are going to put on the differences between the machines, but I like what I read.

They will be here with all the gizmos, look like an executive machine and wont be loud and wont have a cool LED light anymore like the older ones. But they will cost a lot and wont be able to be titrated to even a remotely close prescribed pressure. If you can get into within about .3 or .4 points of your prescribed pressure you will be doing good. Yet the machines will cost you a bunch. And come with a bunch of junk gizmos you dont need.

Mikey