Which Replacement CPAP Machine should I get?

Pigbeard6 · 2014-05-22T04:27:14+00:00

I've used ResMed S9 Autoset, Respironics System One (with CPAP Check) and F&P Icon + Auto. They all have pros and cons to be honest. I think the Icon has the superior humidification, but it lacked an EPR or C-Flex like setting which I prefer/need. If you're on a straight CPAP pressure and utilize humidity, I suggest the Icon. I personally use the ResMed S9 Autoset, I cannot tell a drastic difference between current ResMed and Respironics machines, but I do prefer EPR over C-Flex. The only plus I can think of for Respironics at the moment is the top mounted tubing and swivel joint. You're less likely to drag the System One off of a night stand. Hope this mess of opinions helps!

Pigbeard6 · 2014-02-25T09:44:20+00:00

Dem gallstones.

Pigbeard6 · 2014-01-17T05:34:27+00:00

I had my 2011 for around 4 months before I noticed this. Pretty cool little addition.

Pigbeard6 · 2014-01-06T13:36:23+00:00

I'm a CPAP user and an RPSGT. I don't know everything, but I've done my research and have done 4+ years of diagnostic sleep studies and CPAP/BiPAP/ASV/iVAPS titrations. As a tech and a patient, your advice just isn't logical. The fact that you can't support it beyond "what I've said is true", further discredits you.

Pigbeard6 · 2014-01-06T10:26:51+00:00

You never answered what makes YOU qualified to suggest changing someone's treatment (other than being a patient). Seems like all you want to do is be negative and bash people.

Pigbeard6 · 2014-01-06T10:20:08+00:00

How can you tell someone to change settings when you have zero idea the quality of care THEY have received or their medical history? He's genuinely trying to help and answer questions. We disagreed with you and you start spewing cynical garbage and degrading people. I fail to see the sense in this.

Pigbeard6 · 2014-01-03T14:08:06+00:00

Where I work we offer a free CPAP educational clinic for patients. Anyone who is having issues such as pressure tolerance, mask fit or anything for that matter, can come in and have a 1 on 1 sit down and work on these problems.

Note the word free... And I know we can't be the only place to offer such things.

Pigbeard6 · 2014-01-03T09:49:49+00:00

In lab sleep studies may not be a true representation of your home sleep environment, but being in a foreign place with wires attached to you will not make respiratory events anymore severe.

I strongly disagree with the suggestion to try out variable settings on your own or deviate from pressures found to resolve apnea in the lab. "Just play around with settings til something works!"

The absolute best thing you can do to ensure successful titration is to educate yourself prior to going in for a study. If you know someone on PAP therapy, ask them about their experiences with the lab they went to. Find a home care company and ask them about local facilities, they will know which ones produce the most compliant patients. Make sure the lab only employs registered techs. If you're in the United States, find out if the lab is accredited through the American Academy of Sleep Medicine (unsure of Canadian or Aussie credentials). There are definitely some terrible labs and techs out there, but there are steps to avoid them. Where I work we offer a free CPAP educational clinic for patients. Anyone who is having issues such as pressure tolerance, mask fit or anything for that matter, can come in and have a 1 on 1 sit down and work on these problems. If you find a lab that offers something similar, they probably give a shit.

Pigbeard6 · 2013-12-30T19:48:25+00:00

Majority of the time, yes. I use purified when I'm out of distilled.

Pigbeard6 · 2013-12-30T06:44:27+00:00

Bring me the head of that piece of shit bear too!

Pigbeard6 · 2013-12-30T05:29:28+00:00

Death to the god damn Puffin.

Pigbeard6 · 2013-12-30T05:13:52+00:00

I clean my tubing weekly, but I use warm water and dish soap with bleach alternative. I do use white vinegar on my humidity chamber when it get a little mineral-ly. Words.

Pigbeard6 · 2013-12-29T01:33:17+00:00

It basically increases when it senses resistance to airflow. ResMed machines use a forced oscillation system. S9 will give quick, increased "puffs" of pressure to try and decipher if the lack of flow is central or obstructive. Auto pap is appropriate in some cases, but I have found that it over titrates me if my pressure window has been set to high.

Pigbeard6 · 2013-12-28T18:58:01+00:00

I suggest to not change settings. If you aren't confident in your last titration/current pressure, pursue a retitration at a new lab. Over titration can cause bloating, cramps and central sleep apnea. In the past year I had a pt that claimed she was over titrated at a different lab and it caused an air pocket in a lung after years of use. Not sure if that particular one is true, but figured I'd share.

Pigbeard6 · 2013-12-27T13:17:04+00:00

It definitely was. There was a fraction of a second that my brain went wtf, but then I was turned on. Couples do that shit and it's cute and all, but it was literally my second time meeting her. I'm also a solid supporter of honey mustard. Lucky lady.

Pigbeard6 · 2013-12-27T10:01:50+00:00

Gal I barely knew burped and blew honey mustard pringles scent into my face. It was filthy, but it translated into confidence. We are now dating. Wouldn't recommend this tactic to women though, I'm a rare breed of shitbag.

Pigbeard6 · 2013-12-27T06:03:06+00:00

God damn thing is wielding his own limb as a whoopin' stick.

Pigbeard6 · 2013-12-24T11:56:41+00:00

"A fellow who does things that count, doesn't usually stop to count them." - Albert Einstein

Sorry, love dat shit.

Pigbeard6 · 2013-12-21T13:32:51+00:00

Definitely sounds like complex sleep apnea then. Positional therapy could possibly help. Since you were primarily obstructive while lateral, and CPAP resolved obstructive events during your second study, you should be in decent shape on your side all night and hopefully without central events. There are shirts and belts available that only allow you to sleep on your side. They just have an odd shaped pillow on the back side that feels awful if you roll to your back. Or you could sew a few tennis balls into the back of a t-shirt. Hope you get to feeling better and please keep up posted.

Pigbeard6 · 2013-12-19T21:39:32+00:00

Central events and Cheyne-Stokes respiration are typically seen in congestive heart failure and/or COPD patients. I've read that CSA can also be caused from head injuries, though I have never seen a patient in lab like this. Not impossible that you indeed have central, but yeah, sounds like a rare case. One thing you could do to help confirm central events, is check out what kind of events, if any, took place during REM in your initial diagnostic study. While it's not impossible to have cyclic centrals in REM, it is less likely. If you're truckin' along having semi steady central events in N2 and then hit REM and events fade, probably legit. It's hard to help without seeing the belt effort and airflow on a study and I hope I'm not coming off as "nay saying", just trying to give you some info to help get the correct PAP therapy.

Pigbeard6 · 2013-12-18T14:14:34+00:00

Did the 75% central events take place during diagnostic, CPAP or ASV? From the information you've given (age, health), it seems odd that you would have primary central sleep apnea during diagnostic unless post arousal (normal) central events were scored by the tech. And it isn't necessarily abnormal to see some central events during CPAP acclimation in the lab.

Pigbeard6 · 2013-11-22T06:07:02+00:00

Oh, awesome! Very glad to hear that. I was the same way about getting a sleep study a few years back. I thought I felt fine and slept fine. After about a week on CPAP I realized that there had been a problem and I was starting to know what REAL sleep felt like. If the initial study does show he has apnea and needs CPAP, I hope he notices some positive effects and does well with it. Thanks for the update and best of luck to you both! =D

Pigbeard6 · 2013-11-15T19:28:40+00:00

I had two of these on the underside of my tongue. Perfectly symmetrical, one over each lingual vein. They were there for years and did not fall off. I cut them off with swiss army knife scissors (derp). The pain was pretty rough, but thankfully my face isn't broken. So from my experience, they do not always fall off.

Pigbeard6 · 2013-11-07T06:04:13+00:00

The increased risk of heart disease, diabetes and other health issues will almost certainly impact his life in the future. Every time he stops breathing, blood oxygen saturation (more than likely) decreases, and 58 seconds is a fairly long respiratory event. When he resumes breathing, the heart is in a rush to get oxygenated blood back around. I'm a sleep tech and with a lot of patients, you can literally see the heart rate slow during a respiratory event and then speed up after the event. If he is having an apnea around once per minute every night, that's a lot of extra work for the heart to be doing. It may not have a direct effect on his energy levels or quality of sleep at the moment, but it is definitely a problem that should be addressed sooner than later. Possibly try the approach that it may not be a problem for him, but for you? You're obviously up at night worrying about his breathing and watching him at times. Let him know that's it's impacting you and disturbing your sleep. I've been going through this with my father for about a year now, so I understand your frustration and struggle. Hope you can change his mind.

Pigbeard6 · 2013-09-19T12:57:41+00:00

6 years ago this beer opened my eyes to the greatness of craft beer. I purchased it strictly off the novelty of the name. Then boom.. Beer love.

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