S9 Autoset or RemStar Auto?

I would like to purchase a new machine to replace my current "brick." I know that the 2 machines above are both fully data capable, which is what I am looking for. I am currently using cpap at 14 pressure setting but would like the option to auto titrate. With my current "brick" I have no idea how I am doing with my therapy except for how I feel, which has been mostly good, but there are those days when I would like to have the option to see if the data could tell me why I am sleepy.

Any advice on which machine to go with? Obviously I am referring to the latest models to come on the market.

Thanks to any who can offer advice...

Buying it yourself? I would stick with PR S1 so I could use same humidifier and save some money.

If software preference holds any weight I would go with the one that I liked the software the best.

Presently, I have both the flow generators sections of S9 Elite and S9 AutoSet. The humidifer fits either. They are both data capable to same degree. The Elite I have thru Medicare rental (7th month). It works only in CPAP mode and costs much less. The Autoset I bought on my own for $850 and regret buying it. I must have been owe struck by many posters in this forum as to the uesfullness of the S9 AutoSet. I have been trying it for a month and am not happy with it. The problem is this: after it meets an Obstructive apnea it raises the pressure automatically (within the range that you preset). It does It in order to suppress oncoming Obstructive apneas. But what if the next apneas happened to be Centrals? Well, it does not lower the pressure and hits the Centrals with the hi pressure and thus causes more Central apneas and Hypopneas (probably also Centrals) to emerge. So I am using the Autoset on CPAP mode and hoping to get info from a Sleep Doc next week.

IMO, I should be using a BIPAP but not Auto. In such a case I might convince my DME to take the AutoSet back and give me some money credit toward a new machine.


XPAPS DEAL WITH SLEEP DISORDERS AND NOT WITH UNDERELYING MEDICAL CONDITIONS.
MY CASE MIGHT BE DIFF THAN OTHERS.

Thank you to all 3 of you for the feedback.

I had searched but not found the previous thread (which cowlypso sent) - thank you.

The problem posed by avi23 is interesting... I would not not have anticipated the autopap "causing" more central apneas by pressure increase.

I don't feel like my sleep doctor is as informed as many on this site, so I am grateful for all input. Thanks again.

RandyJ wrote:Thank you to all 3 of you for the feedback.

I had searched but not found the previous thread (which cowlypso sent) - thank you.

The problem posed by avi23 is interesting... I would not not have anticipated the autopap "causing" more central apneas by pressure increase.

I don't feel like my sleep doctor is as informed as many on this site, so I am grateful for all input. Thanks again.

RandyJ, the S9 Autoset automatically increases the pressure within the range that I set, in order to suppress Obstructive Apneas. But afterwards, if there are no more Obstructive Apneas it slowly reduces the pressure over time thowards the lower limit in the set range. But if in the meantime it meets a Central Apnea it keeps the pressure as is without raising it. This is good. So this machine might suit someone with very few apneas events spread over time. In my case I have never had an AHI below 7. It's usually around 10, meaning that there are lots of apneas, Obstructive and Centrals, adjacent to each other. But the S9 Autoset is not fast enough to change the pressure as to not hit oncoming Centrals at hi pressure, in my case. I was told by the clinician at my DME that: If you have centrals, you should not be placed on an auto unit as that can make the centrals worse.

As to emergent Central Apneas it's occurring with any CPAP, APAP, and BIPAP. Not necessarily only with the S9 Autoset.

Check this:

•Complex sleep apnea: Central sleep apnea may emerge during titration of CPAP in patients previously diagnosed with obstructive sleep apnea. This syndrome, termed complex sleep apnea, has become a controversial topic in the sleep literature[17] and has been raised as a possible type of difficult-to-treat obstructive sleep apnea. As many as 6.5% of patients with obstructive sleep apnea may develop emergent or persistent central sleep apnea with CPAP treatment. CPAP emergent central sleep apnea is generally transitory and is eliminated after 8 weeks of CPAP therapy. Persistent CPAP-related central sleep apnea has been observed in approximately 1.5% of treated patients.[18] Similarly, complex sleep apnea can occur following a tracheostomy for obstructive sleep apnea. Central apneas have been found initially after a tracheostomy, but after an extended period, central sleep apnea decreased on repeat PSG.[19]


Source: http://emedicine.medscape.com/article/3 ... al#showall

RandyJ wrote:The problem posed by avi23 is interesting... I would not not have anticipated the autopap "causing" more central apneas by pressure increase.

That doesn't happen to very many people, but it does happen. Odds are good that it won't happen to you.

Avi, trading CA for OA is a botch, but I hope you can find settings that work for you. Are you sure the centrals are caused by the pressure? And have you started a thread about threading that needle?

Keep in mind that you can run an auto machine in CPAP mode, so, on the remote chance you have the same problem with auto as Avi experiences you can switch to straight CPAP mode. You have no options if you only get a straight CPAP.