Need Advice on CPAP Machine - Two Days to Decide

[zzz1]

I'm in my first month of CPAP therapy with the Dreamstation.  Instead of waking up every hour, I'm starting to sleep for longer periods and getting more comfortable with my mask.  I have lots and lots of SWJ because of how often I'm up.  During this time period, my AHI was usually between 6.X and 7.X (and higher) with a few real outliers at 11+.

A majority of the time, I might have 1-2 Centrals flagged, 2 -4 Apneas, and the rest are a large amount of hypopneas.

I found out today that because I'm in my compliance period that I could probably switch the Dreamstation out for a new Resmed Auto 10. 

Here's the dilemma.  I'm still adjusting to everything and most of the hypopneas being flagged by the machine are after arousal periods while falling back asleep.  The same is true for the periodic breathing.  Because of all of this I don't yet know what my true numbers are and at the same time my window to swap out the machine is closing fast.  

I have started to feel pretty good the past three days with the Dreamstation.  My no good, crazy awake more than asleep night last night (kid fell out of bed, etc) showed an AHI of 15.5, but I felt well rested.

Do I ask the doctor to write a prescription for the Resmed or stay with the Dreamstation?

I can post data if needed - I just don't know which days would be meaningful.

[Sleeprider]

My bias towards a Resmed Airsense 10 Autoset runs deep, and it's justified. Your results and sleep will improve by changing.

[Thumper68]

My bias towards a Resmed Airsense 10 Autoset runs deep, and it's justified. Your results and sleep will improve by changing.

I have to agree with Sleeprider on this. In my limited experience with CPAP I find the Autoset machine superior to the Dreamstation. I used a Dreamstation almost 5 months, and just switched to a Autoset "for her". The difference is amazing. My AHI has been under .5 since using the autoset. On the Dreamststion my 5 month average was around 1.8. To be fair I was averaging under 1.5 for the last 3 months on the Dreamststion. 

I find the Autoset to be more quite, gentle pressure, and faster to respond. I am seriously considering getting a second Autoset for a backup machine even thou I have the Dreamstation for a backup now.

[txrpls]

Not being argumentative, just curious. I have the autoset 10 and the travel version on the DreamStation Go. While I agree with the statement on the quietness of the 10, it appears to me the DreamStation just reports additional and different event flags, nine versus seven. Could this be the cause of the higher AHI numbers? Last night was 4.3 on the Go (traveling) and my normal on the 10 is between 1 to 2.

[Sleeprider]

Not being argumentative, just curious. I have the autoset 10 and the travel version on the DreamStation Go. While I agree with the statement on the quietness of the 10, it appears to me the DreamStation just reports additional and different event flags, nine versus seven. Could this be the cause of the higher AHI numbers? Last night was 4.3 on the Go (traveling) and my normal on the 10 is between 1 to 2.

Although Dreamstation reports RERA, VS, VS2, Flow Limitation, BND and some other parameters as "events", the AHI still consists of apnea (central + obstructive) and hypopnea. The Resmed actually graphs flow limitations and snores which tends to be a much more accurate approach of relative severity.  I think Respironics uses a lower threshold of flow reduction to flag a hypopnea, but the bilevel EPR of Resmed machines actually treats flow limits and hypopnea, while the Philips seems comparatively unresponsive.

[txrpls]

Thanks for the clarification.

[zzz1]

Thanks for all of the information! I'm going to see about getting the process started for swapping the Dreamstation for a Resmed Airsense 10 Autoset. My DME told me that it is possible if I'm within my compliance period.

[Hydrangea]

Not being argumentative, just curious. I have the autoset 10 and the travel version on the DreamStation Go. While I agree with the statement on the quietness of the 10, it appears to me the DreamStation just reports additional and different event flags, nine versus seven. Could this be the cause of the higher AHI numbers? Last night was 4.3 on the Go (traveling) and my normal on the 10 is between 1 to 2.

I do believe something like this must be true.

I sleep better with my DreamStation Auto, and consistently get 1.x AHI.  With my ResMed Auto (not For Her), I get a .x AHI, but my sleep apnea symptoms come back.  (I am doing better with ResMed's "soft" setting, thus I think a For Her would probably be best for me.)  Thus, I prefer my DreamStation.

[zzz1]

Not being argumentative, just curious. I have the autoset 10 and the travel version on the DreamStation Go. While I agree with the statement on the quietness of the 10, it appears to me the DreamStation just reports additional and different event flags, nine versus seven. Could this be the cause of the higher AHI numbers? Last night was 4.3 on the Go (traveling) and my normal on the 10 is between 1 to 2.

I do believe something like this must be true.

I sleep better with my DreamStation Auto, and consistently get 1.x AHI.  With my ResMed Auto (not For Her), I get a .x AHI, but my sleep apnea symptoms come back.  (I am doing better with ResMed's "soft" setting, thus I think a For Her would probably be best for me.)  Thus, I prefer my DreamStation.

This is part of my dilemma.  Physically I've started to feel pretty good and I'm wondering if it's a numbers game where the Dreamstation is more aggressive in what it's flagging.  It seems to be flagging a fair number of events as hypopneas, but the respirations are not close to being flat line even if they don't appear to be SWJ.  I wonder if this is part of the algorithm's retrospective look back.

Of all nights, last night I had my second night with the F30 mask and second night after having changed Cflex (2) to Aflex (2).  After 4.5 hours of sleep and being interrupted by a marauding child at 4 am, my AHI was 2.3.  I've only ever been under 5 once in this first month of CPAP therapy.  I suspect the AHI would have gone down further had I been able to sleep longer.

Now I am really on the fence about switching from the Dreamstation.  The problem is I don't have real numbers yet because being a new user this has been a big adjustment month, but at least last night shows it is possible for me to get lower AHI numbers AND physically feel good with the Dreamstation.

[DanGagner]

My son in law has used the autosense for a couple of years now. When I put his SD card in Sleepyhead, which he'd never used, his AHI is consistently 0.0 to 0.5. My dreamstation for me is usually about 1.6-2.5. We both feel good in the morning. We (cleaned) and switched machines, not masks, for a couple of evenings when he visited once just to try a different machine. We changed settings to our own for those evenings.

My AHI dropped to 0.0 His moved to 2.6. We switched results when we switched machines. At first I thought that his machine was doing a better job. But our wives indicated that we still had noticeable air sucking, obstructive episodes a few times that they noticed when they were awake. Maybe a couple in an hour. So....if we are having episodes I'm thinking that the dreamstation might be giving a more accurate reading? Or it could be some other reason.

That was awhile ago. He still indicates that his AHI is usually 0.0 each night but he knows that not to be the case from observation.