Before we throw Mamma from the Train

[NotYourMomma]

We are in the process of reestablishing compliance with a new Sleep Center after we had the usual difficulties dealing with DME and Sleep Doctor’s office.

  For the new Sleep Doctor, we want to work with him and his team to ensure we get our compliance in order. So I don’t want to upset them right out of the gates, but if I have a chance to make them a feel a little more committed to us, or at least let them know we are not total country bumpkins, I’ll take it.

On Oct 6th, we received a DreamStation APAP CPAP (500X110), Set up @ APAP, 12-16cmH2O, Ramp to be reduced as we progress. When I was getting some Oscar reports put together, for our meeting on the 23rd Oct., I noticed it had been set up on 16 Sept 2020. Initially I thought it was a calibration run or a functionality test. Now I am starting to think it was issued and possibly returned as not working properly. There appears to be breathing recorded then repeatedly interrupted by a Breathing Not Detected (BND) event.

If it is a used machine, I think we should have been notified at the time of delivery. If it was a calibration or functional test, I think it should have been recorded under notes. What does the forum think?

           

Make note of Time of use recorded.

[Sleeprider]

That is a new one on me, but thank goodness you have something you can return as defective for the better auto CPAP, a Resmed Airsense 10 Autoset. Please do not get stuck with this Philips Respironics P.O.S. The Resmed nearly always returns much better results and comfort. Ask for it, get it. Ask for it by name: Resmed Airsense 10 Autoset or Autoset For Her. If your DME has an exclusive distribution agreement with Philips and says they don't carry Resmed, return this and get the Resmed from someone else.

[NotYourMomma]

More images for consideration.

 On the previous panel I mentioned making note of "time of use" 

In the first attachment from the previous entry in the "AHI and Events Data Table" Hours use is shown as "00:23:08"
At the bottom of the left hand panel in the yellow bar it shows hours used as "1h 29m"

In the third attachment from the previous entry, at the bottom of the left hand panel under "Sessions Information" it shows   "01h 29m 08s"

In the Overview panel on this page, under "Usage" it shows "0.39 m"

Why would the time vary like this?

Do the graphs look like use with a fault causing the multiple BND or is it a calibration?

Thanks in advance, because we are going to be posting addition images of my use for your assistance.

[SarcasticDave94]

Given a few minutes for setup wouldn't account for the extra hour. Return it, stating it was used and if it's true you've been presented a new but has hours used, state this as the reason. As Sleeprider states, and I fully agree, do not accept the DreamStation. Get the ResMed AirSense 10 AutoSet or AutoSet For Her. These CPAP/APAPs from Respironics vs ResMed may be basically CPAPs, but just like there's good/great or poor/OK cars, there's OK and great CPAPs. So choose Respironics if OK is good enough or choose ResMed if you want very good to great. But whoever is to use this PAP will appreciate every night the ResMed gives great therapy, while on the other hand, there's going to be poor therapy via the ScreamStation by Respironics. Yes there is a big difference in comfort, quality, and therapy. Respironics is D+ to C+ and ResMed is A to A++++.

PS BND or breathing not detected is to mean PAP could not detect a person on the mask...AKA, BND body not detected. Dealt with same BND on other apnea forum recently.

[NotYourMomma]

That is a new one on me, but thank goodness you have something you can return as defective for the better auto CPAP, a Resmed Airsense 10 Autoset.  Please do not get stuck with this Philips Respironics P.O.S.   The Resmed nearly always returns much better results and comfort.  Ask for it, get it.  Ask for it by name: Resmed Airsense 10 Autoset or Autoset For Her.  If your DME has an exclusive distribution agreement with Philips and says they don't carry Resmed, return this and get the Resmed from someone else.

Thanks Sleeprider, I wish I had of known of this forum much earlier, I would have had this knowledge ahead of time.  From what I have seen from your previous posts, it is not just a "Ford vs Chevy" issue, it is more like '39 Ford flathead V8 vs  a 2020 anything. 

I will be posting my graphs for analysis next.

[staceyburke]

check the run hours.  If it was used by someone else it will show up here.  The hours can NOT be changed so you will know if someone returned it.  Here is a video that shows how to do that...

https://www.youtube.com/watch?v=kc4EGBGUNeI

[Sleeprider]

That is a new one on me, but thank goodness you have something you can return as defective for the better auto CPAP, a Resmed Airsense 10 Autoset.  Please do not get stuck with this Philips Respironics P.O.S.   The Resmed nearly always returns much better results and comfort.  Ask for it, get it.  Ask for it by name: Resmed Airsense 10 Autoset or Autoset For Her.  If your DME has an exclusive distribution agreement with Philips and says they don't carry Resmed, return this and get the Resmed from someone else.

Thanks Sleeprider, I wish I had of known of this forum much earlier, I would have had this knowledge ahead of time.  From what I have seen from your previous posts, it is not just a "Ford vs Chevy" issue, it is more like '39 Ford flathead V8 vs  a 2020 anything. 

I will be posting my graphs for analysis next.

Imagine buying a Chevy Vega engine, wrapped up in a 2021 Chevy Camaro, vs just getting a new Audi A4.  I can't explain why Philips has used the same therapy patented by Respironics since 1980 and just wrapped it in a new cover every few years, but that is what they have done.   With Resmed CPAPs you get a bilevel machine.  The quality issue with your particular machine is under warranty, but don't accept the same machine...get the Resmed! You won't regret it.

[NotYourMomma]

It was a long and miserable night, no different from any of the other masked nights, except on this night, we had no Large Leaks (LL).  Normally our LL would run in excess 50%, usually about 70% with the balance of time in Variable Breathing (VB) . As a result my APAP could not respond to Events recorded in the Events Table, therefore effectively making it function as a CPAP. 


     We finally were able to get the leaks tamed down enough to present this graph.

   If we were to increase the minimum pressure from 12 to 12.5 or 13cmH­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­2O would it clean up the last of the Hypopnea and Flow Limits?

What do you do for Variable Breathing (VB).

[SarcasticDave94]

I'm thinking the Respironics records variable breathing, but parameters involving what they're attempting to tell you is not defined. Just like a lot of what they do doesn't make sense, so is this as well.

[Sleeprider]

To understand Variable Breathing see the wiki. http://www.apneaboard.com/wiki/index.php..._Breathing

It's really nothing, but it became part of the Philips Respironics algorithm and it basically paralyzes the auto-CPAP algorithm. We see it in a lot of individuals, and there is nothing we can specifically recommend because it reflects nothing more than Respironic's uncertainty. We have seen VB in both obstructive and central related breathing anomalies. In your case it appears to be related to flow limitation, which is obstructive, and is readily treated by Resmed machines, but not by Philips. Go figure!