What biPAPs do you use or recommend? Any models to stay away from?

[staceyburke]

Let me put in one other thought. All pap machines are about equal, they just blow out air at set pressure. The difference comes in the programming of the machine. The ResMed machines have better programs so they are the better machines.

The very first Cpap machine had no program and just pushed out air. It was described as a vacuum cleaner with the hose hooked to the other end.

https://www.okoa.org/articles/know-who-i...ap-machine

[SarcasticDave94]

Sometimes few choices are better for you. I have been on Apnea Board for over 3 years now. I have heard very few that regret being on a ResMed AutoSet CPAP or the VAuto BPAP. I hear more complaints of issues with discomfort, poor therapy, or machine break downs on Respironics. Yes there are a handful of users that like Respironics better. I would look at the purchase like this, if you had need to buy and the best available was there, would you not make that not only your first but your only choice?

As Sleeprider pointed to your pressure of 18, that is what I was stuck on with my straight CPAP. I found that with no exhale relief it was nearly impossible for me to use it. I failed compliance and the machine went back to the DME. You should do yourself a few favors. 1 is fight to get the VAuto. 2 if you cannot get that, the AutoSet is your next choice. 3 to get either, list all your sleep complaints and symptoms. Put these before Dr. Dolittle constantly. You become a broken record of sleep complaints. No sarcasm, you tell the doc over and over, my CPAP is not comfortable. I cannot sleep with UARS. Etc. You tell the doc this constantly until his ears bleed or he gets you a script for VAuto. Make certain the doc puts on your script ResMed AirCurve 10 VAuto, Patient Choice of Mask, Dispense As Written! The DME cannot play the switcheroo game, they cannot substitute then or it maybe is a legal matter as they didn't obey the script.

[AlgebraicMisery]

Alright, thanks for the advice and information all

[AlgebraicMisery]

Hi,

Thanks for linking me to that thread. I read through it but honestly can't understand the graphs at all. The only part I know about is the big number next to RDI which is probably not a complete picture of what is going on since the RDI numbers don't seem to change that much. Do the graphs show improvement after switching from APAP to the bilevel, and how dramatic is this improvement? If I understand correctly RDI is the average per hour of all those types of events, but it seems like it was pretty decent while on the APAP (between 2-4), similar to the VAuto? The numbers underneath (obstructive, hypopnea, airway, etc.) also seem like they're pretty similar between machines. It also looks like the pressure on the ResMed is higher on average. I'm guessing I'm missing/ignorant on a lot of the info though. 

If all works out though I'll be getting a VAuto in at least a week though, pretty stoked for that

[Sleeprider]

I think you are referring to my link to Johnnyde94's therapy thread http://www.apneaboard.com/forums/Thread-...ssure-APAP He is a 25 year old new member that arrived on the forum with a CPAP machine and a prescribed pressure of 18. Sound familiar? Unlike you, his CPAP had data and much more capability, but it was inadequate for his needs, and he was upgraded by his doctor to the Aircurve 10 Vauto. Once again, the point of having you read that thread is to show you someone else in a similar situation to your own. Eventually you too will have some graphs and we will help you to understand them. The bottom line that you need to take away from Johnnyde94 is that his therapy has changed his life and saved his job. His pressure is quite high, but it's working and he is comfortable. We worked with him to get there, but along the way, he made his own decisions and is very satisfied.

[Johnnyde94]

Johnnyde94 here! Yes I would say that the Vauto is much better than the APAP for my self and for others who are in a simlar situation with uper airway resistance. I did not realize you machine does not have the option for data output, as that would be helpful to prove the point. For me even thougnh i am young like your self and not super overweight my untreated AHI was 84 (my RDI would have easly been over 100 but they did not report that) and my lowest 02 satuation was 64. I had my APAP set to a range of 12cm-20cm and my 95% average pressure was 20cm, maxing out that machine. An indication you need a more advanced machine is when you have to have pressures nearly maxing out the machine. The Vatuo has a max pressure of 25cm, and my average pressure is aroung 23cm. Im lucky that i can withstand the higher pressures, in fact my min pressure is 15 because A) I dont mind the higher pressure with the Bilevel and B) because i would have events right when i fell asleep.

I was def felling better with my APAP but I feel significantly better with the bilevel machine, specificaly the resmed Vauto. I would agree with other members, if your insurance is stubborn and will not pay for the bilevel you have two options, 1) buy out of pocket or 2) get the resmed airstart APAP because its basicaly a nerfed bilevel. I would however try to lobby the insurance if you can, in my case i had to go out of pocket because the insurace was taking too long and i got into a car accident waiting to get a unit. I would say if your parrents can afford the bilevel but are on the fence, have them read though my thread so they get an idea of the improvment i have made with the new machine and tell them that your data matches closely with my issues including age. I DMed you some more info but feel free to reach out.

[AlgebraicMisery]

I hear you guys like data! This is a screenshot of my first night on the dreamstation APAP my doctor gave me. Hopefully the ResMed will arrive soon.

[Johnnyde94]

It looks like your not in APAP mode but in trial mode, that will slowly ramp up therapy I believe. I would probably start my changing some settings. Change the mode from trial to APAP mode, take off ez-start. I would say if you can handle it change the minimum pressure to like 6-8 (higher better) and crank the max to 20 so your machine has full headroom. You can look up how to enter the clinical menu online to access these settings. Don’t take my settings as gospel because there are much more knowledgeable people on this forum then my self.

Basically, your machine is being nerdefed. Your min max is 4 and 12 the machines full range is 4 to 20. You want to keep the lower number as high as you are comfortable to have it and that makes it so your at a good starting point. I would also say make sure your ramp settings are off if you can handle it. Your max is staying at around 8 and I’m not sure if your maximum is tied to how much headroom you have.

[SarcasticDave94]

A little messy, but there's data. Your 95% EPAP was 6.5 on this session, while you maxed at 9. Technically it was 8.9, but neither Respironics or ResMed does pressure settings in x.9. Now that you have a bit of data and a bit of usage on a PAP, how do you feel? Did the machine make any difference? So yes the Doc gives you the trial mode to see what happens. Real therapy on a ResMed will feel a bit different, and the charts should clean up quickly once we help dial your therapy in.

[AlgebraicMisery]

Definitely feels better than my previous CPAP, but still not phenomenal. Still a bit sleepy. Probably need more data though.