Newbie trying to make an educated decision

Hello All!
I'm brand new to the forum and was hoping you might be able to offer some advice.
I was diagnosed with 'OSA hypopnea syndrome' in 2007. A sleep study back then documented a respiratory disturbance index of 55, oximetry nadir 87% and4% apnea hypopnea index of 14.5. That was a split night study with incomplete response to CPAP at14 cm. Subsequent titration demonstrated efficacy of BiPAP at 13/8.
I was compliant for over a year,just never felt any better, and gave up. I would use it sporadically, at my husband's urging.
I decided to try again, and I just completed a split night study (using a Respironics wisp nasal mask) at a Boston hospital a few weeks ago. The diagnostic portion documented an apnea hypopnea index of 104. Description of the study as follows:

The time in bed for this study was 419 minutes. Lights on at 6a.m. There were 200 minutes of supine sleep. Sleep efficiency was 93%.
Sleep architecture was notable for emergence of slow wave and REM sleep after initiating CPAP.
Respiratory monitoring included a nasal pressure transducer and oral thermistor. respiratory events were scored for apneas or hypopneas leading to EEG arousal or oxygen desaturation. The were a total of 192 respiratory events scored, 106 of which were obstructive hypopneas. The apnea hypopnea index was 104 with a respiratory disturbance index of 105.
CPAP was started at 4 cm. Additional pressure increases were prompted by breakthrough hypopneas which were controlled at 10 cm. the final increase to 11 cm eliminated residual snoring.
Oximetry demonstrated a sleep related nadir of 78% with 31 minutes of sleep spent below 90%. The nadir was 93% at 11cm.
The patient should begin CPAP at 11cm. A prescription will be forwarded to North Atlantic.

No. Atlantic has left me 5 messages over the past week - their website offers three choices: F&P Icon Series, ResMed S9' or PR System One '60 Series. I' leaning towards the PR System One'60 Series, but have asked to have my prescription mailed to me first. Also need to check with my insurance ($350 annual out-of-pocket; CIGNA) regarding rent/purchase. I'm struggling to understand my numbers and don't want to rush into the wrong machine.. Thanks very much, in advance, for your help!

Find out EXACTLY which model machine they are wanting to give you. Model and not just brand name.

For the S9 Resmed machines....exactly which model name. Avoid any model with "Escape" anywhere in the model name.

For the PR System One 60 series..exactly which model number. Avoid anything below 460 model number.

For the F & P Icon....model name I think but I haven't seen one of their machines to be certain.

Personally I would stick with ResMed or PR S1 brands....those are the 2 main players in the cpap market and lots of people here to help you with either and software is easy to get and use for both.
See this link. Not quite up to date in regards to the 60 series machines but otherwise current enough.
http://maskarrayed.wordpress.com/

Heddy, during the year that you were using the bipap machine, aside from generally not feeling better were you comfortable sleeping with the machine?

Hello Pugsy, Hello kaiasgram!

Thanks for reading my post and for responding. Seven years ago, I lived alone and I had no idea that I snored until I took a trip to Italy with my grown daughters and they recorded me while I was sleeping. They were almost as tired as I was at the end of that trip and they decided if we ever traveled together again, they would not share a room with me!
After my first sleep study, I was prescribed a CPAP (maybe Puritan Bennet Good Knight?) with a nasal mask at 14 setting and used it for about 3-4 months (?) I was having difficulty breathing out and after no improvement, I had another sleep study and was prescribed a ResMed biPAP machine and classic comfort nasal mask at a 13/8 setting. I really tried, for about a year, and never was comfortable with the mask or the machine. I was aware that I was waking up multiple times during the night, with the mask leaking, or else I was trying to pull it off my head. If I did NOT use the machine, I would honestly believe that I had slept just fine and could not recall waking up at all during the night (but of course that's not really true).
I was never happy with the DME provider -- the same place that had done the sleep studies. They would call me to schedule periodic appointments, tell me to try a different nasal mask, make the straps tighter, lose weight (5'9"/180 lbs), try a chin strap, use nasal spray, try a full face mask, etc. Back then, I was not aware of any data in my machine other than compliance hours, which only a technician could access. I had NO IDEA what the results of my sleep study even meant (a respiratory disturbance index of 55, oximetry nadir 87% and 4% apnea hypopnea index of 14.5) and I'm afraid I still don't. Then the company suddenly folded. I think I was glad. I stopped using my machine and the man in my life (who later became my husband!) persuaded me to think about getting a fresh start and having another sleep study done. I was unable to get any copies of my records for a long time and was not sure where to go for testing. This means that to this day, I usually end up sleeping in the guest room at some point during the night because my poor, sainted husband can't get a minute's peace if I'm in the same room!
I will sometimes dust off the old Bipap machine if, for example, we go away on vacation or to stay with our kids. Three months ago, we were headed to Hilton Head for a week and the night before we were leaving, I discovered my nasal mask was moldy and wouldn't clean. I packed the full face mask I had tucked away in a closet, instead. First night in the hotel, I learn that the mask did not work with the Bipap because the hose kept blowing off. I have no RX for a new mask, my old Sleep Center is out of business, and I wondered about going to a walk-in clinic or a hospital ER to get a new mask. My husband inquired at the front desk about the cost to get an additional room for the remainder of our stay. Oh my! Then, in desperation, we got electrical tape and taped the hose securely to the machine for the rest of the week - and that worked.
All of this prompted me to have my Primary Care get me into a hospital sleep center three weeks ago and get this resolved once and for all. So I'm not just going to let some medical equipment company call me to set me up with what they think will be good for me. I want to learn how to interpret my latest numbers/findings and take an active part in my therapy going forward. And get out of the guest room, for pity's sake! The PR System One '60 Series is model #DS560TS Remstar auto with heated tubing humidifier or with just heated humidifier. I think that's what I want, mostly so I can access all of the "charts and graphs?" to see what kind of progress I'm making. Can you give me any idea what my latest test numbers mean, in layman's terms? 7 years ago:respiratory disturbance index of 55, apnea hypopnea index of 14.5. NOW: respiratory disturbance index of 105, apnea hypopnea index was 104. Is this severe/moderate/not a big deal....... I need to get a much better handle on all of this. Patience is a virtue, right?

The model 560 is a great machine. Heated hose capable (which you may or may not need but if you do need it then it's worth its weight in gold).
SleepyHead and Encore software easily available.

Apnea/hyponea index 104....that's way into the severe category. Severe is like 30 and above per hour.

This may help you understand a little better
http://adventures-in-hosehead-land.blog ... -test.html

It's bad...and patience is a virtue... Something that I don't have a big supply of myself.

Heddyho wrote:The PR System One '60 Series is model #DS560TS Remstar auto with heated tubing humidifier or with just heated humidifier.[/b] [/u][/u]I think that's what I want, mostly so I can access all of the "charts and graphs?"

that's a good machine, the other option is a 36005 S9 autoset from resmed. both are good, I have a preference for the S9 machines, myself, but other people prefer the respironics

Heddyho wrote: 7 years ago:respiratory disturbance index of 55, apnea hypopnea index of 14.5. NOW: respiratory disturbance index of 105, apnea hypopnea index was 104. Is this severe/moderate/not a big deal....... I need to get a much better handle on all of this. Patience is a virtue, right?

that's severe, it means you have some kind of respiratory disturbance 105 times an hour, on average, so you're not getting rest, even though you don't remember snoring and snorting and gasping for breath all night long.

From the Stanford University website:

Apnea Hypopnea Index (AHI) or a Respiratory Disturbance Index (RDI)
Abnormal breathing is summarized by either an Apnea Hypopnea Index (AHI) or a Respiratory Disturbance Index (RDI). The terms are very similar but have slightly different definitions.
Your AHI is the average number of apneas and hypopneas per hour of sleep and is calculated by taking the total number of apneas and hypopneas and dividing it by the number of hours of sleep. Your RDI is the average number of abnormal breathing events that occurred per hour of sleep, so it may include abnormal breathing events other than apneas and hypopneas such as Respiratory Effort-Related Arousals (RERAs). The higher your RDI or AHI, the more severe the disorder.

Oximetry nadir is the lowest blood oxygen saturation recorded during the study. 87% = not good In your first study it was 78%.

Ooops! I thought I had posted this around 1 a.m. this morning, but my sleep-deprived brain wasn't operating so well, I guess..........

Thanks, all of you, very much!!! I am delighted beyond measure at your
helpful responses. I have lots of reading to do tomorrow, so I think I had
better turn out the lights here (in the guest room ) and try to get a teeny
tiny bit of sleep before that alarm clock goes off in just 6 hours. Thanks so
much for sharing your time and experience with me.