Which machine to get for initial self treatment - Auto CPAP vs. BIPAP ST

[MVoltaire]

Hello, 

Following up on my last thread about my isolated sharp desaturation events with otherwise good oxygenation levels (New to the board: Pre Therapy, suspected Central Apnea | Apnea Board), I decided to go ahead on my own and make a first purchase of a Löwenstein APAP / BIPAP machine, to get a better diagnostic view on what is going on during those nights. 

Pulse Oximetry shows for a typical night : 

• ODI between 1.5 and 2.5 (measured with a non-chinese oximeter) 
  
• between 10 and 20 desaturation events in total (defined as drops below 94%)
  
• between 30 seconds and 1.5 minutes spent below 89% saturation
  

However, I am currently unsure if I should already go ahead and buy the more expensive Löwenstein 25 S/T BIPAP isntead of just 20 Auto CPAP. My idea was that this could make sense, in case BIPAP becomes necessary as therapeutic option, if an increasing number of central events is observed.   

Given that Löwenstein 20A seems to be a very good device with a software that is (at least) on par with Resmed devices - would the higher price of the optional BIPAP be justified at this point? 

[Sleeprider]

The Lowenstein devices are compatible with Oscar, and we have a good wiki written by Macka on how to optimize them https://www.apneaboard.com/wiki/index.ph...timization Your oximetry results offer very little insight as to your needs, and my suggestion is to start with the wiki article and assume you don't have a need for BiPAP with a timed backup rate.

[Phaleronic]

If it were me making this choice I would purchase the 25st (it should do standard bipap/bipap ST and cpap modes). I tried reading the manual but all of them were in german.

[MVoltaire]

If it were me making this choice I would purchase the 25st (it should do standard bipap/bipap ST and cpap modes).  I tried reading the manual but all of them were in german.

Yes, that was also my reasoning, to have both options cpap abd bipap ST available if that becomes necessary in the future. 
You can get the English Manual here on this website via Email-Request.

[SarcasticDave94]

My opinion, unless you really need it, old square wave delivery that's not smart or adaptive, would be a hard machine to get used to. Pressure up...Pressure down... Up.... Down.... Up.... Down

[Sleeprider]

The Lowenstein pressure delivery is different from Resmed, and has a different transition than Easybreath™. I don't think the square wave argument is as important here. Anyway, the BiPAP/ST is covered in the wiki I linked above.

[SarcasticDave94]

Ah ok, good to hear someone got ST that's useful

[MVoltaire]

The Lowenstein pressure delivery is different from Resmed, and has a different transition than Easybreath™. I don't think the square wave argument is as important here.  Anyway, the BiPAP/ST is covered in the wiki I linked above.

Thank you! The wiki is very helpful.
Would you consider a Löwenstein over a Resmed Machine, if they became available in the US?

[Sleeprider]

I only know the Löwenstein from its user manual and our new wiki. I know they have a lot of features, and have a reputation as an excellent PAP device, however I have many years of experience working with the Resmed Vauto and others. I'm open to trying one, but I don't see any reason to change from what I'm familiar and successful with. In general, positive air pressure therapy is effective from all manufacturers to mitigate obstructive sleep apnea, but beyond the basics, the satisfaction and comfort of therapy, seems to rely on an effective algorithm for pressure changes (if used), and an option for true bilevel pressure with a comfortable pressure transition between IPAP and EPAP, and the Resmed products have focused on these attributes throughout its CPAP, bilevel and advanced therapy lineup with the notable exception of ST.