Is cpap compliance better with newer machines?

[jkline]

Hi Everyone,

I have mild sleep apnea.   Dammit.  52, athletic and fit, and annoyed that sleep no longer brings me pleasure.   I never did anything about it until an orthodonitic buddy gave me a home sleep study.  My airway closes about 12 times/hour.  My right nasal passage is fairly constricted, having about 25% of the size as my left.  He made me an appliance which was a life changer.   I wore it religiously until it moved my teeth to such an extent I had to go back into braces to eliminate the protrusion/malocclusion of my incisors.

In the meantime, until we get my occlusion back to normal, I'm flying solo (i.e. no doctor) with a cpap machine bought off ebay-- a Philips Respironics REMstar Pro C-Flex plus humidifier.    The two month journey has been interesting and challenging.  The nasal pillows fit ok (small and medium), but Sleepyhead says I have times of significant leaks.  I am unaware of these.  Jet-lagged I can sleep with it on for 5 or six hours, but usually I've had about all I can take after 3 hours-- I'll wake, either from dry mouth or needing to relieve the bladder, can't get back to sleep with it on, so side-sleep without it for the rest of the night.   The more I can wear it, the less tired I feel in the morning.

I started at a 7 pressure level, and have since increased it to where I seem to have the best results at a constant 14, no ramp.   I seem to have my worst readings on an auto pressure setting, even if it is little as a minimum 12 and max 15 setting.  The cflex setting I have at 3-- tried 2 last night and didn't like it.  I have the humidity level at 2, but sometimes wake up with a dry mouth no matter the setting-- mouth breathing I suppose.  Most of the time I get an AHI that Sleepyhead says is under 5, usually under 3.  Last night it was almost 1.  I guess you could say my apnea right now is technically treated, when I use the machine.

Long story long and to the point:  I'm tempted to put this machine back on ebay and try something newer-- like an Aircurve 10 Vauto, because I am wondering if my compliance might be better with a newer machine.   Thanks for any advice.

[mesenteria]

No.

If both a new and a used machine can operate within prescribed parameters, they being the ones needed to treat you, then neither should present problems.  Assuring oneself that the used machine is capable of delivering the prescription is another matter entirely.  However, it sounds as if you are adapting to the machine, and it to you. If your AHI count routinely rests between 2 and 'zero', you are in darned good shape.  

After that, it becomes a matter of how ill-at-ease you are over your PAP experience.  If its face validity, or how you think it seems to work at an intuitive level, is low, if you still feel about the same as prior to treatment, maybe you need to adjust settings, change form factor for masks and headgear, or revisit some other part of your treatment.

[Sleeprider]

I disagree. An Airsense 10 Autoset not only gives you faster automatic pressure response, but it include EPR and full data. The ability to see your therapy issues and target them in a strategic way with one of the best CPAP machines available is motivating. You will be drawn into the experience as an active participant and decision-maker. So more effective, more comfortable, more motivating...how can that not improve compliance if you are motivated?

[jkline]

Thanks for the replies.  I'm not ready to give up on what I'm using, but it is the exhale pressure that gets me sometimes, especially if my sinuses might not be 100% open.  I was expecting, fool that I am, that a CPAP would breath like a scuba regulator.  Bottom line is that these are part of my life now.  If I can't get used to this one, the cost alone of a better unit might be enough incentive to be compliant.

3 hours of good sleep and 3 hours of light just doesn't cut it.

Thanks again,

[Sleeprider]

The comfort difference of the Resmed is significant. Feel free to post a chart, and we might be able to identify why you are having problems with comfort on the current machine. While CFlex does help to transitions pressures during exhale, it is not anywhere close to the true bilevel pressures for inhale and exhale provided by the Resmed.

Interesting comparison for SCUBA. Pressure demand regulators provide much higher pressure during inhale, and compensate for depth with higher pressure as you descend, but do not provide any positive pressure or flow unless there is an inspiratory demand. This conserves the air volume in the cylinder(s). A CPAP is of course constant positive air pressure to keep the airway open during both inhale and exhale. The positive pressure during exhale is particularly important to prevent obstruction ahead of the next inhale. Very different feel and function.

[jkline]

As I said above, after 3 or 4 hours I just can't stand the cpap and take it off, and have an uneventful graph with an AHI usually less than 3.   Last night I made myself wear the cpap through most the night, and my results were quite poor.  It seems after awhile I have difficulty breathing through my nose, sometimes I'm vaguely aware of this happening, and then shut the cpap down.  Last night, after a break I put it back on.   It was a horrid night's sleep.   I do much better when I sleep through the night half with the cpap and half without.  Thanks in advance for any advice.

[CreativeChrisNYC]

Hello!

I went from a Dreamstation auto to the Redmed Aircurve and the difference is night and day.  They respond much more quickly to events and having the drop in pressure is much more comfortable.

On my worst nights my AHI is maybe .6 tops with the Aircurve.

[jkline]

Thanks.  I'll be there someday.  I'm researching that machine, and the airsense, amongst others.

j

[Sleeprider]

Charts really need to display Events, Flow, Pressure Leaks and Snores. The respiratory charts are not very useful in this case. It would be very helpful to see a close-up of your Flow rate. A 2-minute segment would show the actual shape of the respiration and help us understand why the machine thinks your inspiration time is 3-times longer than expiration. That is impossible and is probably the key to understanding your comfort problem.

[jkline]

Thanks.  I'll try to get those uploaded... in a place with dodgy internet through the weekend.

J