Posted by Bird Watcher on September 02, 2008 at 11:53:12:In Reply to: UARS & Auto CPAP posted by Herman on September 02, 2008 at 09:19:55:
I've been diagnosed with UARS since 1995 and use AUTO's as treatment now. All the current Auto-CPAP's on the market respond (in some way) to flow limitations and not just apneas. Respironic's first Auto-CPAP, called the Virtuoso, back in the late 90's, only responded to snoring vibrations and full apneas. The Virtuoso is long since pulled from the market, but somehow, the specs of it's limits are still stuck in the minds of some clinicians who should be keeping up with markets trends more than they are. DME's and doctors don't generally have a good background on autos for the most part.
The 420E is a good auto. As with ALL autos, success comes more often when the limit feature is used and one doesn't program their machine to be wide open at the machine's mechanical limits, i.e. 4-20 cm. These machines are capable of 4 to 20 cm for a wide range of patients, not any one patient. A good reasonable limit is something like 5 cm DIFFERENCE between the upper limit and lower limit of the pressure need, such as 7-12 cm. Using that idea can make for a better night's sleep. Along those lines too, I read of many on user forums who like to have that lower limit at 4 cm for comfort, but that often isn't realistic. 4 cm doesn't provide a whole lot of airway support. Better to use a higher lower limit, maybe 6 or 7 cm and get the air coming at you sooner.
I should pause and remind everyone that we're talking UARS here. Severe cases of OSA with oxygen desats are usually better treated by CPAP or BiLevel.
The 420E has adjustable triggers for commanding a pressure increase for certain breathing patterns or backing off sooner when certain patterns are absent. In my opinon, this can be useful for UARS, but there is really no data on what makes up a UARS pattern in a wide sampling of people. For the individual, you just have to spend the money, get one of these machines, and try it for a while.
The most recent machines from Respironics and ResMed don't have adjustable triggers. The response you get it what the factory programs and that's it. The 420E, though, doesn't have exhale relief with auto pressure response, which the others have, which may be a factor for some people.
The larger picture in my opinion: Look past any one given machine for the long term better sleep. Sometimes dental appliances can help just as good as a PAP machine, but significant changes in diet and regular exercise can make PAP therapy even more successful. In some cases, you can get completely off the machine.
- Re: UARS & Auto CPAP Herman 15:50 9/03/08 (1)
- Re: UARS & Auto CPAP Bird Watcher 11:55 9/04/08 (0)