Old pro wondering about new-fangled tech

It's been nearly 30 years that I've been using CPAP, starting with an old Respironics machine -- straight CPAP -- there were no options. I've never had a bit of trouble adjusting to the breathing, or the pressure.

Now, after three other informally aquired used machines, I'm looking around at new equipment. It's a different world, with data gathering, auto and self titration, more complex pressure servoing algorithms, and who knows what else.

Since I'm comfortable with zero-ramp, constant pressure, keep it simple CPAP, is there value in the new technology?

-- Carl

I would say there is value in the new technology but I also think its based on different situations. I have no insurance and mild OSA so I couldn't afford a data capable machine. I just bought a travel size cpap. It doesn't do anything fancy, but it does what its suppose to. I've also wondered if Data capability is needed at this stage of my therapy. I would say trying something new is always a good thing. You can monitor your progress and the machine will self adjust for you. So basically its up to you. If you want to try a data capable machine, go for it! Some of the apap's can be used in regular cpap mode so if your don't like it you can run it like a cpap.

The value of new technology is in the eye of the beholder I suppose. You have obviously done very well for a very long time without all the little extra stuff we have now.

I have never used ramp so that isn't a big deal but pretty much all machines now have ramp. A person doesn't have to use it though. It's an option.

I think it is an advantage to have the new technology even if it is not needed at the present time. It might be needed some time in the future and it isn't like the bare bones basic machines are free.
To me it seems better to have it and not need it then need it and not have it.

Are you paying out of pocket for a new machine or is insurance helping out?

cmm wrote:It's been nearly 30 years that I've been using CPAP, starting with an old Respironics machine -- straight CPAP -- there were no options. I've never had a bit of trouble adjusting to the breathing, or the pressure.

Now, after three other informally aquired used machines, I'm looking around at new equipment. It's a different world, with data gathering, auto and self titration, more complex pressure servoing algorithms, and who knows what else.

Since I'm comfortable with zero-ramp, constant pressure, keep it simple CPAP, is there value in the new technology?

-- Carl

Well you have me beat. I thought I was the oldest around here at going on 21 years. At 30 years, you really are a pioneer. I, like you, am still straight CPAP with never having needed any ramp. I sleep like a baby. What I DO enjoy about the new technology is the ability to confirm that I am still doing extremely well with the therapy. (E.g., my AHI averages just under 1.0). Also, I enjoy the better quality C-Flex than what was availabe 20 years ago. The new equipment is significantly smaller and lighter and of course the built-in integration of heated humidifier is something that just didn't exist way back when. Other than that -- I see no advantages.

The advantage depends on your situation. I need much higher pressures when on my back than on my side, but those pressures also come with more leaks that can wake me up. So the auto adjusting model is important for me. I only get the higher pressures when I need them. Also, I'm losing weight, and that might affect my pressure needs in one direction or the other. Psychologically, I can accept things better if I think I understand what is going on, and the data is important to that process for me. Also I travel a lot, so smaller & lighter than what I understand the machines used to be is an advantage.

But you are in a different situation so there may be no value for you.

At 30 years of cpap treatment, old age is going to rear its head soon. You will want to keep a closer eye on your treatment in the future to keep it optimized without having to spend nights at sleep studies. Data will make a big difference when the body decides that things are "going south".

There are levels of features. Maybe a data capable CPAP would suffice for you. Just depends on your circumstances. Better to have a feature and not need it than to need it and not have it, unless acquiring it just on a maybe causes hardship. Then you have to weigh the value.

Carl, the new CPAP machines have a lot of advantages over the older machines. Not only are they quieter and smaller than the old behemoths, they also offer many comfort features. However, the greatest technological advantage is the information they provide you and your doctor(s). For example, with software, you and your doctor can monitor the efficacy of your therapy in great detail. In other words, you can see how well it's working. You can see if you are still having apnea-related events while you are asleep and using your machine. If your CPAP therapy needs adjusting, such information is very useful in helping you and your doctor(s) understand the underlying cause(s) and making the necessary adjustments.

I'm a diabetic and use insulin. I know my body well enough that I could eyeball (guess) how much insulin I need before each meal. However, with the technology of a blood-glucose meter, I can measure my blood glucose level and then take a more precise amount of insulin. Two hours later I can test again to see how well the insulin is working. Based on that reading, I may need more insulin; I may need to eat something; or, I may be doing just fine. Feedback from the newer model CPAP machine serves the same function. It lets you know how well your therapy is really working, and if you need to make any adjustments.

BTW, those old glucose meters were brutal, large and clunky, and slow. It hurt like hell getting a large full drop of blood, and then it took several minutes to process the results. Technology has improved the meters to the point that only a small speck of blood is needed, so testing is relatively pain free. The meters are now very small and portable, and results are given in just a few seconds.

There is a lot of pride in being a successful CPAPer for as long as you have, but technology is your friend. Yes, it will require you learning some new things, but at this stage of the game, knowing how well your therapy is working could provide you benefits for many more years to come.

It's nice having the data available in case you need it.
You don't have to look at it unless something is amiss--but it's there, just in case.
I can see all I need daily on the LCD screen.
You don't even have to understand it--the right doctor can use the data.

cmm wrote:It's been nearly 30 years that I've been using CPAP, starting with an old Respironics machine -- straight CPAP -- there were no options. I've never had a bit of trouble adjusting to the breathing, or the pressure.

Now, after three other informally aquired used machines, I'm looking around at new equipment. It's a different world, with data gathering, auto and self titration, more complex pressure servoing algorithms, and who knows what else.

Since I'm comfortable with zero-ramp, constant pressure, keep it simple CPAP, is there value in the new technology?

-- Carl

Just because you are a long term user, doesn't mean you are getting the best treatment that you can. Without a machine that can monitor your treatment minute by minute and show you with software the results, you are without a very useful tool.

Your doctor won't have any way to make informed decisions for your treatment either, you both of you may not care but many here do.
some people have special problems that require special equiptment (but not as many that get that special equiptment)! Some here think throwing money at a problem, results in better treatment, especially when it's someones else's money. Not so, K.I.S.S also works... But without data, you are guessing. Jim

My mom has been using cpap for about 20 years. She's not exactly sure when she started, but it has been at least 18 years and maybe over 20. She quit for a few years at one point and then started up again in 2010, and then quit again last year. She was frustrated with it because she never felt any improvement.

Then, last april, I had my sleep study. I felt awesome the next day, and my sleep study went great. Her sleep studies had been bad (and at another lab). Then I got my machine. Full data. My prescription was dead on correct for me. Apap of 11-17. I went from a sleep study ahi of 79 to almost every day below 2. Many days below 1. And even with my troubles adjusting (not using it the full night every night), I had clear improvement.

My mom saw my new mask and tried it on. She liked it and got one a couple days later. She was finally back to using her machine again. But she was really curious about my data. And I have to admit., I wondered if hers was really working that well. She sleeps in the living room in a recliner, and she always looks dead while she is sleeping. So, after my compliance phase was over, I let her use my machine for half a night for two nights. I am a severe night owl, so I usually go to bed between 4 and 6am, plenty of time to let her use my machine before I go to bed. The first night, I set it to straight 10, her prescription at the time. Her ahi looked good at 3.4, but when I looked at the data, I couldn't believe it. She had a cluster of 8 apneas within 10 minutes, and one of them was over a minute long. She was having some bad apneas, even with her machine. No wonder she didn't feel better. The next night, I set it for 10-13 to see what the machine wanted to do, without making it too high to make her uncomfortable. Her apneas were shorter, but it clearly wanted to go higher than 13. My mom was able to get an appointment with my sleep doctor, who prescribes the Resmed S9 Autoset specifically because he wants data and prefers that software. He was also surprised, but happy, when he saw my reports from my own computer. He didn't know that patients could access their own data, but he was pleased with the idea.

So, at her appointment, he reviewed he last sleep study from 2 years ago (medicare would not approve a new study), and then he looked at my data from the two nights. He prescribed the new machine for her with a setting of 10-15. She goes back next week, and I suspect, he will increase her setting to 11-17 like mine. Her machine is rarely going below 11. Her median is 12, and her 95% is 14.6, and it is reaching 15 almost every day, and multiple times per day. So, the machine would like to go higher.

Without the data, none of this would be possible. Her request for a new sleep study was denied. Her old sleep study and doctor said straight 10. And without data, the new doctor would have had nothing to go on, just my mom saying she was using it, but didn't feel any improvement. With data, she was able to show that she needed more pressure, and already feels better even though it is not fully at the correct setting. There is no way to know if her prescription was always too low and/or if her needs changed over the years.

I believe that data is great for helping somebody fix their problems. They can see if there is a lot of leak, if and when events are occurring. They can see how long the events are, so there is more detail than just the ahi number. They can see if their pressure is not high enough, and if it is starting too low. There is so much useful detail, and it can be viewed anytime, so that adjustments can be made.

I also believe data is really good for people who are not experiencing problems. You can check and see what your machine is doing. I think it is awesome that I can see how hard my machine is working to help me breathe better. This shows me, in an easily visible way with graphs and statistics that I *need* this machine, and it is truly working. When I had my sleep study, I felt awesome the next day. When I got my machine, I didn't feel so awesome right away. I do have some awesome days here and there, but it was a slower lead up to noticeably feeling better. That seems to be normal for some people. Others take a longer time to feel any improvement even though it really is working. It helps to see on the computer screen, data that shows it is working. It is like the machine itself is encouraging us to keep at it.

In addition, I think it is awesome to be able to print off reports showing my graphs. I can then show them to people who know they have sleep apnea, but are not being treated, or who are struggling with their treatment. I can use my data to encourage them to move forward in their treatment. I've already seen it working by helping my mom get improved treatment. I'm working on a few friends as well. What if they start getting treatment, and that helps them feel better, improve their health, and add years to their lives. That would be really cool, all because my machine had data.

I also learned recently that my mom's testing kit for diabetes can track data. They download it when she goes in for appointments. The nurse said she can download it herself too. That would be really nice to see how it varies from day to day and what kind of patterns emerge. Technology can really add a lot to our treatment and health.