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Posted by Greg Harper on March 05, 1998 at 21:19:09:In Reply to: Choosing a CPAP machine - Do you like yours? posted by Charlie Smith on March 04, 1998 at 18:40:44:
Charlie:
If you like the Sullivan Elite, and your insurance will pay for it, then I would recommend that you keep it. The Sullivan is a good machine. It's relatively small, travels easily, and has good engineering.
To be honest though, I think that most CPAP machines are pretty much the same. I have used very expensive ones and inexpensive ones. There really is not much of a difference that I can tell subjectively. It takes a while to develop the muscular strength to overcome the extra work-of-breathing that occurs with CPAP therapy, no matter whose machine you use.
There has only been one recent study that I know of that shows that there is a difference in the different CPAP and BiLevel machines. Unfortunate- ly, it is from a European pulmonary journal and only the abstract is written in English, the rest of the text is written in German. I'm trying to get it translated.
Anyway, don't expect euphoria with CPAP therapy. You have been on it for three weeks now and you can expect some more improvements over the next two months. There has been recent research that indicates continuing improvements will occur up to four years after the start of therapy, which is as long as the study lasted.
There will probably not be another experience like the one you had after your first good night's sleep on CPAP. But, things will continue to get better...
As far as DPAP and "self-titrating" machines go... stick with CPAP for now unless you are really having problems. From experience, I don't think that they are all that they are cracked-up to be. I believe that one unit increases pressure too rapidly and fragments sleep so that you are still tired during the day. The type other changes pressures too slowly so that some apneas occur. If you are sensitive to apneas, then this type of therapy is not for you. That is, some people with severe apnea can sleep through incredible periods of apnea. Some people will have one "good" episode of apnea and will have awakenings. This can also lead to daytime sleepiness. Save your money and buy yourself a good mask.
By the way, I recommend the Monarch Mini Mask by Respironics Inc. It's small and fits under the nose, not in the nares like the Adams Circuit (nasal pillows). It has a reasonably comfortable headgear and there is no obstruction of your vision. I also feel that it is better physiologically for ventilation because it does not act as a reservoir for exhaled carbon dioxide (CO2). CO2 is a respiratory stimulant and you don't really need respiraotry stimulation when you are trying to fall asleep.
The reason that you might not have heard about it is because most sleep laboratories do not use them because they are for single patient use. They cannot be effectively cleaned and used on other patients without damaging the cushioning material that they are made from.
The only draw back to the Monarch Mini Mask that I have found is that they only come in one size. They do not seem to work with small and/or wide noses very well. Otherwise, I think that it is a great interface device.
Best of luck and continued success with your therapy!
Greg Harper, RRT, RCP
- Re: Choosing a CPAP machine - Do you like yours? Charlie Smith 3/06/98 (0)
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