The Dangers of Being Lazy
Howdy all - been a few years since I posted in this wonderful forum. I've been using CPAP and APAP for 20 years more or less, and have owned a long line of machines. A couple of years ago I switched from a ResMed S9 Autoset Spirit to the DeVilbilss Intellipap DV54 APAP - and thought everything was great! AHI always less than 3 - usually 1, with very little pressure increase. The 90% and 95% numbers were usually the same - and the same as the initial pressure setting almost all the time. So, I got lazy and stopped checking the SmartCodes and sleep data - probably for a year or more. Big mistake! What I missed was that the DeVilbiss was not picking-up and proactively dealing with apneas even though it was set to be more sensitive than the factory default settings. I discovered that the hard way - just for grins, I turned off the exhale pressure relief - and woke up at 4am with the machine blowing at 17 (my base pressure is 9) - actually woke me up! So, I was lulled into complacency by actually believing that the DeVilbiss was doing its job - my bad.
So, with the seeds of doubt now firmly planted in my brain - I hauled-out my S9 Resmed from it's two year slumber and set it up. Last night, my 90% number was 11.8 (never saw that on the DeVilbiss until it went nuts night before last) with a starting pressure of 9 and EPR of 1 (same as DeVilbiss). AHI was .3. The ResScan report showed a high pressure of 14 - but I don't think that was during sleep - I think that happened when I was setting-up the machine. I'll know more tomorrow - but in the subjective world, I felt a whole lot better this morning than I've felt for a long time - and that was before looking at the sleep report. My "frog in the cauldron" complacency was costing me quality sleep - for a couple of years - and I have a used DeVilbiss for sale to be used in CPAP mode only. I now totally agree that the often-repeated critique of the DeVilbiss being insufficiently proactive as compared to the S9 Autoset is accurate - and that the S9 is a superior machine for auto-titration. Thus, one of the dangers of relying on an APAP to deal with changed pressure needs over time has become manifestly clear - don't do it unless (a) you have a known, high quality APAP, and (b) read the sleep reports and become suspicious if the numbers don't show variability from night-to-night. I interpreted the lack of variation as a good thing, when, in fact, it was the opposite.
So, with the seeds of doubt now firmly planted in my brain - I hauled-out my S9 Resmed from it's two year slumber and set it up. Last night, my 90% number was 11.8 (never saw that on the DeVilbiss until it went nuts night before last) with a starting pressure of 9 and EPR of 1 (same as DeVilbiss). AHI was .3. The ResScan report showed a high pressure of 14 - but I don't think that was during sleep - I think that happened when I was setting-up the machine. I'll know more tomorrow - but in the subjective world, I felt a whole lot better this morning than I've felt for a long time - and that was before looking at the sleep report. My "frog in the cauldron" complacency was costing me quality sleep - for a couple of years - and I have a used DeVilbiss for sale to be used in CPAP mode only. I now totally agree that the often-repeated critique of the DeVilbiss being insufficiently proactive as compared to the S9 Autoset is accurate - and that the S9 is a superior machine for auto-titration. Thus, one of the dangers of relying on an APAP to deal with changed pressure needs over time has become manifestly clear - don't do it unless (a) you have a known, high quality APAP, and (b) read the sleep reports and become suspicious if the numbers don't show variability from night-to-night. I interpreted the lack of variation as a good thing, when, in fact, it was the opposite.
