CapnLoki wrote: ↑Tue Aug 27, 2019 5:38 am
The DreamStar appears to be from a different company that I've never heard of. The paper was published before the DreamStation was released, and since it was funded be ResMed I doubt they had early access to a DreamStation. They do include a "System One" which I assume was a Respironics 560.
I believe that you and others have had success with ResMed, but in the forums we only see a tiny fraction of the users. And with roughly half of those diagnosed with Apnea successfully using a cpap, I tend to think many of the problems are more mundane than the complex issues that sometimes get more attention. I wonder how many folks were discouraged by large leaks. I found leaks rather annoying but they did not happen frequently so I didn't give up. Fortunately, I realized my bad clusters of events were from supine sleeping and they went away went I forced myself to side sleep. But so many people don't have forum support or sleepyhead and give up too soon - I wonder if the most aggressive treatment always serves the greater good.
We see mostly the people who come here with problems....the people who start cpap and never have a problem ...they aren't going to need or want to go finding help.....and there are lucky people like that.
There are of course people who have problems and don't get the help they need if they run into trouble and don't find us.
This forum wouldn't need to exist if the medicare care people would do a better job helping their patients....but they don't.
The more responsive the auto adjusting algorithm doesn't equal leak issues for all people...heck people on fixed pressure have major leak issues. People on ASV machines or bilevel machines with a big PS don't always have leak problems either and there can be some huge pressure changes with those machines with every breath and not just over a few minutes.
Leaks can be highly annoying when they wake us up. Trust me I understand it....got a good dose of it last night when my Bleep came loose off my nose a little bit last night. It wasn't related to the machine doing its job...it was related to my lazy ass not using the alcohol on my nose like I know I should have done. I washed my face good and thought "that's good enough" and didn't do the millisecond of work to wipe with alcohol. I paid for my laziness last night.
I haven't looked at my data yet but I know they weren't big leaks though...just enough air blowing around my nose to wake me up several times. Not enough to affect therapy itself but sure enough to affect my sleep quality which is already extremely fragile anyway. Dumb ass move on my part.
I still say that if I am going to have to used this damn machine...I want to use a machine that will deal most effectively with my OSA as best as is possible and if in its doing is job leaks become an issue...I deal with the leaks. My most important goal is treat the OSA first.
Sub par therapy is a last resort...still better than nothing but I won't accept that unless absolutely no choice between sub par or no therapy.
For the people who do have leak issues when the pressure goes higher and maybe stays higher...they need to use a starting higher pressure when fitting the mask in the first place. If the changes themselves are a huge problem..heck, use a fixed pressure.
There are ways to deal with leaks that don't involve sub par therapy for parts of the night.
I did see that the System One was used in that study above...and to my knowledge the algorithm itself didn't change when they did the DreamStation so I would assume the DreamStation results would have been the same as the System One. The System One didn't fair so great in that test either. I do realize this study was funded by ResMed and those sorts of studies where the funding party's equipment comes out on top always make me take a sideways look at things.
I actually hate the way ResMed does just about everything they do...but they do make a quality product that does a damn good job. I am not going to cut off my nose to spite my face because I hate almost everything about ResMed but their machine. I am not that stupid or hard headed. I am pretty hard headed
but not in that area.
I do realize that Respironics makes a good product and it works well when the settings are optimal and when given a decent head start in auto mode so that it's gentler response can still do the job it was designed to do. Remember I used one for several years and did quite well with it. I am not going to beat anyone up for getting a Respironics machine. I won't bad mouth them universally.
Let's face it...there are some people who do better with the Respironics algorithm and there are people who do better with the ResMed algorithm and there are people who it simply doesn't matter....they might do well with either or do horribly with either.
When asked for my opinion though...I have to give an opinion based on my own personal experience as well as what I have learned from the experiences here on the forum that get reported and what I have seen. It's what everyone does...recommend whatever it is that we personally have had success with...be it mask or machine or humidity setting. It's in our nature to do that even though we know about that YMMV sticker.
To me not to recommend a ResMed machine just because a few people might have leak issues is simply not something I am going to do.
Not everyone has leak issues for one thing and the leaks aren't necessarily always from the more responsive algorithm either and even if it was...there are better ways to deal with it than just use a machine a different machine with a slower response time.
First priority...kill the apnea stuff...deal with any problems the killing might cause if/when they pop up.
Finally....in my experience...if the higher pressures were a big factor in leaks...all my overall numbers in terms of pressures reach are less with the ResMed. If I got leaks at 15 with the Respironics but I don't with 13 and the ResMed doesn't ever need to go above 13...which is a better alternative? If it is the increase or change from a lower pressure to the higher pressure itself that is the problem...start the minimum higher or mask fit to higher so the change isn't so much to lessen the change effect on leaks.
And again thank you for all you do here to field the off grid battery stuff. I simply still can wrap my head around all that stuff.
I may have to RISE but I refuse to SHINE.
