Which CPAP do you recommend for me based on my info?

EDIT! nevermind, pugsy, i saw your story on another thread!

OK peeps, I went ahead and ordered the S9 Auto Set and the Humidifier to go with. All I have to say is I will be SUPER pissed if my insurance denies it for some reason cause it was expensive!! I'm excited about the new machine, though. I hope it gets here soon. I'm sure I will be on here immediately asking tons of questions about how to understand the data and set the pressure!

Thank you so much to everyone who helped me on this thread and on the other thread I started. This board has a remarkable amount of information and support.

sarajane82 wrote:Pugsy- so how does the APAP work? did you have to set it to 10, 12, and 18? or just a range? how did you realize you needed more pressure sometimes? did you have to do a separate sleep study to get the right pressures for the higher cms?

It's a long story which I will try to keep short. My prescribed pressure after the titration part of the sleep study was 8 cm. I bought my machine privately and I bought an APAP because that is what everyone explained would be the best option. Once I started on the machine I used a setting of 7 cm minimum and 10 cm maximum. Tight range around the prescribed pressure just like everyone advises. It started out at the minimum and if the machine sensed that it needed to raise the pressure, then it could go up to 10 cm.

Okay, well and good and one week into therapy I was feeling horrible. It took me that long to get the software.
Once I saw my reports I saw that the machine was staying at 10 cm most of the time and my AHI was around 10. The events were not being prevented effectively. It was an improvement over my 53 AHI during the sleep study butt not enough improvement. BTW I was documented much worse in REM sleep (which is not unusual).

So with the help of the members here I started experimenting by raising the minimum and maximum to get to where my AHI did not show the clusters that I was seeing in probably what was REM sleep. 10 cm minimum keeps the clusters broken up so I only see random events. If I go below that as a minimum the clusters return. So after I found a suitable minimum I started watching the maximum. People had said keep that range around 4 cm so I tried 10 - 14 and some nights it was fine and some nights I would peg that 14 max. So I decided to just open up the max to see where it wanted to go. Please note that pressure changes didn't seem to ever disrupt my sleep and my leaks were under control. So I started to see some nights where my pressure would go to 16, 17, & 18 and maybe stay there 30 minutes to an hour. The timing of these pressure increases sort of loosely correlated to normal REM cycles so I sort of deduced that these were REM related events that just happen to need more pressure than usual. I wasn't particularly worse when sleeping on my back which can do the same for some people.

So I came up with a 10 cm minimum pressure and 20 cm maximum range. Some nights it barely gets to 12.. Some nights I see 18 cm. I have some examples of each if you want to see them. If I didn't have the APAP machine. I would either have to use lower straight CPAP straight pressure and let those events that occur and need a higher pressure just happen or use a much higher pressure to prevent all events but would be overkill for most of my night.

If I had bought the straight cpap machine I would not have been able to follow these weird variations as easily or quickly. Probably would have gone back to doctor and he would have done another sleep study which may or may not have happened on one of my weird pressure nights.
My doctor agreed with all my experiments and results when I went in for follow up. So I have his blessing.

APAP isn't for everyone. Not everyone needs it and not everyone tolerates the variations in pressure. But an APAP can always be used in cpap mode. The difference in price is not all that much and if a person has an opportunity to get an APAP...go for it. If not, cpap will do just fine. It might take a bit more experimenting should pressures not seem ideal. Or someone could be like me. I don't sleep the same each night. Some nights I need more pressure than others. Since I never know what the night will bring it is a comfort to me that the machine will just do its job and I don't have to worry about it.

Sorry for so long but I tried to cover all bases.

No apologies necessary! I apologize for YOU for making you write it out again. But I DO appreciate it.

I found it really interesting because my pressure is 7, right near what yours started at. I didn't order any software or anything, and I am sure I will be super confused about how to read the data, but I am just excited to get the new machine. I am so exhausted at the research I have done to this point just trying to figure out all the insurance and pick a machine, so I figure one step down, now I gotta get the machine and figure out how to use it best for me!

THANK YOU THANK YOU THANK YOU to everyone!

Sara,

I just re-read your posts and I see you already ordered a machine, but I left this for you in case it was of any help.

I brought myself a PR System One auto-pap from cpapauction.com brand new for $275.

Could you try seeing if you can travel without the humidifier, just the CPAP? I think part of the reason they make them that way is so if you're travelling for only a few days you can just take the smaller CPAP only unit.

I don't know what the humidifier alone costs, but I'm considering the next time I travel putting the humidifier in my checked baggage and only the CPAP in the carry on.

You may think this is crazy, but I've also FedEx'ed or UPS'ed things back and forth on vacations so as not to have to carry them through the airport (bad back) and then you also have tracking and insurance if it gets lost or damaged. If you were going away for 1 week or more you could two-day ship all or part of your setup. Again, you may think that's crazy, but it makes some sense to me.

To the question on price, the retail prices are insane! What do some of you think about $275 for a brand new top of the line unit? I don't think that's bad at all. There's so many available because of all the people who get them and are unwilling or unable to adjust to using them! That's bad for them, and very good for us!

My regular priimary care physician, not the sleep specialist, wrote me a new script to send to cpapauction.com without any hesitation.

My old machine was a non-data capable non-auto 6 year old RemStar. I decided after what I read here to prescribe an auto-pap for myself. LOL It's more than just when you change positions during sleep, sometimes you just need a little more pressure briefly to breath the best you can. I want you to know I definately sleep better and don't wake up as often with the auto-pap. Does ResMed have something similar to CFlex/AFlex, I assume they do. CFlex/AFlex is also very helpful to sleep better.

I don't understand what you said about having to get the same type of machine in order to give them back the machine you have now? Is that an insurance thing? Are you buying this yourself or are they buying it for you?

At least consider the PR System One, it's a VERY nice machine!

I understand what was said about the ResMed LCD being the best on screen information, but I still like the PR System One machine a LOT.

Lee

Well said Pugsy. This is a big part of the reason why I insisted on getting an APAP. Pugsy's story is an excellent example of why a set level isn't right for everyone, and how easily the right technology can make it to solve your problems.

sarajane82 wrote:No apologies necessary! I apologize for YOU for making you write it out again. But I DO appreciate it.

I found it really interesting because my pressure is 7, right near what yours started at. I didn't order any software or anything, and I am sure I will be super confused about how to read the data, but I am just excited to get the new machine. I am so exhausted at the research I have done to this point just trying to figure out all the insurance and pick a machine, so I figure one step down, now I gotta get the machine and figure out how to use it best for me!

No problem. I didn't know if I had enough details in that other thread. Those that know me from 2 years ago know my story and maybe it might help a newbie that doesn't know it. I don't know how common something like my situation is.
The straight CPAP machines are great machines just as long as they are full data. I can tell you if I had not found this forum and educated myself I know that I would have likely ended up putting the machine in the closet. My first DME wanted to give me a bare bones F & P so I would never have known the 8 cm wasn't going to work all the time. Heck, maybe the titration study happened to be on one of my "good" nights. Maybe that 156 minute titration study with all the fragmented sleep simply didn't let me get to enough REM where I rock and roll with events. All I know was I felt horrible and if I had not found out why I wouldn't have continued the therapy.

Are APAP's a critical item?.....well for someone like me, yes if I want the most optimal therapy. I don't expect everyone to be like me but what if someone is?

Anyway, you have made your decision. You won't be sorry.
Software is easily available.
Look in Uncle Bob's signature here memberlist.php?mode=viewprofile&u=38643
Pick up the clinical manual while you are at it.

There is a tutorial that explains how to use the software.
http://montfordhouse.com/cpap/resscan_tutorial/

I think the Devilbiss Intellipap auto adjust is great for traveling[you can look below on my equip info; I like it because it was more quiet than my previous machine which was by Resperonics RemStar; I presently am using straight C-Pap on this machine and I can adjust it myself it comes with clinical manual [easy to understand and use]; its easy to set up
it has a nice traveling case; i was able to find room for even my mask with everything else and i also had humidifier when I traveled. there is a 3 year warranty
and what is nice is that DeVilbiss Marketing keeps us with all of us on line here, when I have questions on their machine I just pm them and they respond in
24 hours or less. If you need any further information you can just pm me and i be glad to elaborate further; I have been pretty successful with this machine
its lightweight and compact, I did buy it from cpap.com out of my own pocket in 2009. It was the best thing I did for me!

Catatrina

Thanks, everyone, especially for the link to the software. cpap.com is contacting my doctor for an Rx, hopefully they won't raise a fuss and it will go smoothly.