Best Machine for UARS?

[patrickbateman]

I have UARS (<1 AHI, 10 RDI). Wondering what the best machine would be for me? Currently considering either an AirSense 10 AutoSet for Her or AirCurve 10 VAuto. Also open to other suggestions. I have a prescription for CPAP/APAP, but not Bilevel, so if I went with the AirCurve I would need to purchase on the secondary market. Insurance doesn't cover anything, so either machine will be fully out of pocket.

[slowriter]

Without question, the VAuto; gives you much more flexibility.

[patrickbateman]

Without question, the VAuto; gives you much more flexibility.

Hey I actually saw that you posted elsewhere that you got the For Her model in July 2019 and that you were initially encouraged. What was your experience like with it, and why did you end up switching to the VAuto?

[slowriter]

It's a long thread I don't necessarily recommend slogging through, but to summarize:

I just wasn't sleeping well on the autoset, and was feeling pretty exhausted.

I now pretty consistently sleep through the night, after moving to the VAuto, and surely also just adjusting to the therapy.

When you have UARS, the key variable you need to dial in is the gap between inspiration and expiration. 

With the autoset, this is called EPR, and is limited to whole numbers of 0-3.

With any bilevel, this is called pressure support (PS), and the VAuto give you a wider range of setting options there, as well as fine-grained control (0.2).

My in-lab titration study showed I needed a PS of 6.

If you get the VAuto, you won't be constrained like you would on the autoset.

[patrickbateman]

Okay that makes sense. I'd hate to buy the For Her only to realize I need more PS and end up buying the VAuto anyway. I see that Second Wind is offering "gently used" VAuto machines for $799. Is that a good deal? Would they accept my CPAP/APAP prescription?

[slowriter]

You can find for cheaper on the second hand market, but you pay for that in time and higher risk. Give them a call and ask?

[Sleeprider]

With Secondwind you know what you're getting, and they do provide a good warranty and support. I think you can get a Vauto with a CPAP prescription, but they can also just call your doctor for approval. There is no reason the doctor should not approve bilevel other than the insurance hassle.

[patrickbateman]

Sounds good, I'll get in touch with Second Wind. I saw that one advantage that the For Her model has, that the VAuto doesn't, is that it tracks RERAs. Is that something important, especially for someone with UARS?

[slowriter]

I saw that one advantage that the For Her model has, that the VAuto doesn't, is that it tracks RERAs. Is that something important, especially for someone with UARS?

In theory yes. 

In practice no.

The machine doesn't have an EEG, so can't know if you arouse.

You can use the FL data in OSCAR to get some input into whether you have breathing restrictions that could lead to RERAs.

[patrickbateman]

Thanks. Which mask do you recommend? I hear a lot about the P10 but I see you use the Bleep Dreamport. I usually start sleeping on my stomach, then roll onto my sides and back during the night.