[Equipment] What to do if you HATE your Machine?

[cate1898]

...I was using a toshiba wireless SD card which enabled me to have the data automatically sent to my server which I could remotely log into an review Sleepyhead graphs - all so easy...

I didn't know such a card existed! Does it work like both an SD card and a wireless modem (for the card)?

If so, I like that idea of not having to take the card out of the machine to transfer the info into the software program. Sounds easier.

Would like to hear more about this!

[Lexxus]

If you can sell it and not come out too far behind, good luck. S9s are unfortunately rather past sell-bye date, so I am unsure how or where you might, but as I said, if it is a matter of getting the settings right, then try that before committing a lot of money for the PRS *. I am more concerned that you spend a great deal of money than anything else when it may be a simple fix and you can be happy in your sleep. Good luck either way. If you are willing to take a bit of a bath, try selling it on e-bay if it is allowed. You won't get anything near what you paid for it, but you will get something, at least.

Hello DocWils and thanks for the suggestion....I will take the machine to the store and see if we can match settings as close from the PRS to this one I have. From the sounds of it, and correct me if I'm wrong, but the S9 Auto sounds to be more configurable than the VPAP-S Model I have. I would really LOVE to not have to spend anymore $$ on another machine if this can be tweaked. I looked in the clinical and there does not seem to be much I can do, just a few options i'll have to read up on to see if they may help.

The issues I have with the machine is that when I fall on my back, the pressure does not seem to be enough with this machine to keep my airway open, but it seems strong enough to leak out (my mask is now very tight against my face to reduce the leakage). From day one the breathing algorithm felt "off" but I just attributed it to being a new machine and different model....like you said, it's like Apple & Microsoft...preference. The humidity is not enough as I'm a mouth breather and wake up at least once a night with a bone dry mouth and have to moisturize. I wake up feeling tired and I'm now falling asleep at work once again....my ahi has gone from 0.6 average to between 4.8-7.1 when I wake up.

Doc to answer your question from a previous post....why I listened to the store and not you....I only joined this board at the end of August, but I had already ordered my machine in July.....I only found out about this board through a google search for Bipap info. My store does not keep ResMed in stock so mine was a special order. Had I known about this board, I am sure I would have made a different, and more knowledgeable decision as I am learning so much from reading in here.

[eseedhouse]

I didn't know such a card existed! Does it work like both an SD card and a wireless modem (for the card)?

It's a regular looking SD card with a little WIFI transmitter/receiver stuffed in it. There are several threads about this in the software support forum.

[DocWils]

Lexxus - I am unsure if the S9 auto would be better for your purposes or not, it depends a bit on your actual condition and settings needed, however, this is a case where you need to get everything right - the settings, the mask fit, and address the condition with your on-scene experts at the DME - that the problem happens when on your back and you suddenly get mask leak sounds at least partly to be a fitting problem, but it also indicates that, like many with OSA, that back sleeping causes an increase in events (people alternately sew tennis balls into pyjama tops or get blankets and pillows to prevent them from rolling onto their backs). What I am hearing in your description is an increase in pressure to the point the mask leaks to respond to OSA when back sleeping, or alternately, the mask loses position when you sleep on your back - the question is which is it. An over-tight mask will leaks as much as a loose one, so far as I understand.

VPAPs are less forgiving that autoset machines (but treat a different set of symptoms, so often are not interchangeable) and you have to get it as right as possible or it won't work, no matter who makes it. Take your mask in as well, get everything checked out and refitted, to be sure that all is optimal for you. If even then you don't get the relief you need, then you will need to start looking at alternate devices, but only after being 100% sure that the machine you have isn't a dud - for the most part, a VPAP from one manufacturer and another will work almost identically, although with VPAP there is a bit more variance in treatment algorithms than in APAP or straight CPAP between manufacturers - this has to do with how the bi-level response understands and detects your breathing needs.

Good luck and let us know what happens.

[PaytonA]

Hello DocWils and thanks for the suggestion....I will take the machine to the store and see if we can match settings as close from the PRS to this one I have. From the sounds of it, and correct me if I'm wrong, but the S9 Auto sounds to be more configurable than the VPAP-S Model I have. I would really LOVE to not have to spend anymore $$ on another machine if this can be tweaked. I looked in the clinical and there does not seem to be much I can do, just a few options i'll have to read up on to see if they may help.

The issues I have with the machine is that when I fall on my back, the pressure does not seem to be enough with this machine to keep my airway open, but it seems strong enough to leak out (my mask is now very tight against my face to reduce the leakage). From day one the breathing algorithm felt "off" but I just attributed it to being a new machine and different model....like you said, it's like Apple & Microsoft...preference. The humidity is not enough as I'm a mouth breather and wake up at least once a night with a bone dry mouth and have to moisturize. I wake up feeling tired and I'm now falling asleep at work once again....my ahi has gone from 0.6 average to between 4.8-7.1 when I wake up.

Doc to answer your question from a previous post....why I listened to the store and not you....I only joined this board at the end of August, but I had already ordered my machine in July.....I only found out about this board through a google search for Bipap info. My store does not keep ResMed in stock so mine was a special order. Had I known about this board, I am sure I would have made a different, and more knowledgeable decision as I am learning so much from reading in here.

There are settings for the VPAP S which, if mis-adjusted can cause the machine to not follow your breathing well and feel "off". I have used the S9 and S8 VPAP Auto in S mode for significant periods of time and have had the problem of the machine seemingly fighting my breathing at times. I was able to adjust that problem away. It is a good idea to compare settings and attempt to get them as close as possible to being the same. At least make them effectively the same.

Best Regards,

PaytonA

[cate1898]

Hello everyone,
I'm a new member from Canada. I was diagnosed in June with OSA, and had used the Respironics System One 60AutoBipap Machine Model CA761TS.

I tried to do my due diligence in researching the products and saw the ResMed S9 got better reviews. So I decided to choose that knowing that the Airsense10 was not a good model for here because the wireless system was being discontinued for a new version coming in the fall.
...

I was at my DME today. The RT and I were discussing the Airsense 10 machines and I asked her what the difference was between the CPAP and the Elite models. She said nothing as far as she knows. She said the CPAP model gives more data than the S9 Escape does. She said they have never ever ordered an AirSense 10 Elite into their business before. ??!! Wow.

So I called ResMed today and was told the Elite had the following features that the CPAP did not:

-more detailed data
-CSA detection What is that?
-CSR detection What is that too?
-optional integrated oximeter

ALSO I mentioned I had heard a 'rumour' that there was a new wifi modem being installed or something changing with the wifi modem in the Canadian variant of the machine. The answer was No-No change.

[PaytonA]

CSA=Central Sleep Apnea
CSR=Cheyne Stokes Respirations

CSA detection is important for Obstructive Sleep Apnea therapy with an auto machine. Before they had CSA detection in any of their auto machines they would not let the machine respond to apneas if the pressure was over 12 cm/H2O for fear that they might be central apneas. With the ability to detect clear airway apneas they will now respond to obstructive apneas at any pressure.

Cheyne Stokes respiration is a cyclical breathing where each cycle is ended by a central apnea. One's breaths go from small progressively to large and similarly back to small and then a central apnea

Best Regards,

PaytonA

[archangle]

I was at my DME today. The RT and I were discussing the Airsense 10 machines and I asked her what the difference was between the CPAP and the Elite models. She said nothing as far as she knows. She said the CPAP model gives more data than the S9 Escape does. She said they have never ever ordered an AirSense 10 Elite into their business before. ??!! Wow.

She's a fool or a liar.

The Elite records airflow waveforms. You can see every breath through the night. You can see each apnea, when it happened, how long it too, and how complete it was. You can look at the shape of the waveform and see things like rapid breathing, slow breathing, irregular breathing, etc.

You can see how much air you are taking with each breath and when it occurs.

You can see whether you have, for instance, a number of times when you have a large leak, such as open mouth or loose mask.

For some people, too much pressure will cause central apnea. Your airway is open, but your brain isn't telling you to breathe. Increasing the pressure may cause it to be worse. Central apnea is an important thing to monitor for any CPAPer. Since it's readily available, central apnea should be monitored by EVERY doctor who is treating apnea patients.

The AirSense 10 CPAP only gives you one number per day for AHI and leaks, no daily graphs.

If you're having problems with your CPAP, an Elite will help a competent doctor figure out your problems and fix them. With the CPAP model, there's very limited information.

Here's a SMALL example of the data an Elite records that an A10 CPAP doesn't.

[cate1898]

archangle: thanks for posting that screenshot. Looks good and fairly detailed to me, but I've no experience with SleepyHead or any other software due to having a brick currently. Is the data provided by the Elite the same data as you would get with an Autoset? Obviously I understand it won't show the adjustments an Autoset would automatically make in addition to anything an Autoset can detect that an Elite cannot and because the Elite is a fixed pressure CPAP, but other than that does the Elite provide complete data?

And thanks for bearing with me through all my tedious questions!! I am sure it is obvious I am somewhat obsessed with getting the best machine and the best treatment and therapy I am able as I have no where else to go to get answers. It seems that the RT's genuinely do not know the differences between the machines as I've now dealt with 3 different RT's at my DME which incidentally is run through the hospital. They spend half their time going out in the field to patients requiring home o2 needs. So this is not their only focus, nor does it appear to me that they care how much I spend in the end.

[Sleeprider]

Is the data provided by the Elite the same data as you would get with an Autoset?

The data is identical. As you know the machine does not change pressure in response to flow limitations, snores and other events. Nothing wrong with the Elite as a fixed CPAP.