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i tried cpap 10 years ago and couldn't get any sleep.  so i went with the oral appliance, which has been okay, but not great.  now i see there is a machine, the resmend s9 auto set, that would allow me to exhale more easily, and seems more responsive to my individual needs.  is this the best product on the market for someone who hated the regular cpap machine and wants to try something new and improved? and should i go with the mask or the nose plugs?  thanks, eric

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Eric, I use a Resmed Autoset and love it, I do have to say it is the only CPAP I have ever used so it is hard to compare, I did start out using it on continuous but changed to auto. I also us a Resmed Mirage Quattro full face mask and it takes a lot of getting used too but now find it really good. With masks and pillows it is really a personal preference but if you are a mouth breather you really need a full face mask, if you are a nose breather either a nasal mask or nasal pillow. The other thing you have to weigh up with the mask is whether you mind having something covering most of your face. Finally with all CPAPs now a days they are a lot more data capable, I have my own software that I can run each day it I want to see what has happened the previous night. When I see my sleep specialist for my six monthly check up, I now tell him whats happening. Re the mask or nasal pillow, what are you using now?

i've been using a oral appliance to advance the lower jaw.  i tape my mouth shut so that my tongue doesn't dry out and fall back.  i use a breathe right and nasal decongestant so i only breathe through the nose.  i  think i can feel better.  but if i didn't do what i do, i'd be dead.

Terry Vella said:

Eric, I use a Resmed Autoset and love it, I do have to say it is the only CPAP I have ever used so it is hard to compare, I did start out using it on continuous but changed to auto. I also us a Resmed Mirage Quattro full face mask and it takes a lot of getting used too but now find it really good. With masks and pillows it is really a personal preference but if you are a mouth breather you really need a full face mask, if you are a nose breather either a nasal mask or nasal pillow. The other thing you have to weigh up with the mask is whether you mind having something covering most of your face. Finally with all CPAPs now a days they are a lot more data capable, I have my own software that I can run each day it I want to see what has happened the previous night. When I see my sleep specialist for my six monthly check up, I now tell him whats happening. Re the mask or nasal pillow, what are you using now?

Eric, the advances in CPAP have been enormous even over the last couple of years, I think you should try the CPAP again, but you would have to have a sleep study so they can work out your pressure settings.

My husband has used both the Phillips System One and now the ResMed, preferring the latter, as is such a light sleeper the Phillips sends little detecting pulses as to your airway to alter the pressure and being asthmatic, he needs good expiration relief. ResMed gradually increases/decreases the pressure, so he seems to sleep with less interruption. He could not tolerate the oral appliance and previously failed CPAP 6 years ago. Now he is fully compliant with the ResMed VPAP which provides even more expiration relief than the S9. I have used the S9 successfully from the beginning (zero last night, from a untreated AHI of 49).

what's the difference between the resmed vpap and the resmed s9 autoset?

Eric, just copied this from the Resmed site, basically VPAP or BiPap's are designed for people with more complex conditions than just SA. Auto sets are designed for patient comfort where a minimum and maximum pressure can be set and the CPAP regulates it as required. The other diffence is the cost VPAPs are much more expensive.  

  • Vsync™ technology automatically compensates for leak; the new algorithm enhances triggering and cycling.
  • VPAP’s exclusive TiControl™ (inspiratory time control) enables the clinician to manage the respiratory condition case by case.

VPAP allows you to go beyond the difference of 3 on your expirations. For example, if you are set 8-12 pressures, the S9 auto set can decrease the exhalation pressure up to 3, but the VPAP can be set to whatever exhalation you need, such as 4,5, etc...higher if you had pressures over 15. For my husband, he set his at 4, and this seems to work perfectly with his asthma. Now me, I'm the opposite, when my exhalation pressure was even 2, I was collapsing into apneas, which resolved by decreasing the exhalation pressure to 1. The VPAP is more difficult to adjust and unless someone is at high pressures, typically is not needed. I would recommend a trial of the S9 auto set first. The oral appliances tend to not completely eliminate the apneas which both of us have had with CPAP.

have you ever tried using the oral appliance with cpap, combined?

K. S. said:

VPAP allows you to go beyond the difference of 3 on your expirations. For example, if you are set 8-12 pressures, the S9 auto set can decrease the exhalation pressure up to 3, but the VPAP can be set to whatever exhalation you need, such as 4,5, etc...higher if you had pressures over 15. For my husband, he set his at 4, and this seems to work perfectly with his asthma. Now me, I'm the opposite, when my exhalation pressure was even 2, I was collapsing into apneas, which resolved by decreasing the exhalation pressure to 1. The VPAP is more difficult to adjust and unless someone is at high pressures, typically is not needed. I would recommend a trial of the S9 auto set first. The oral appliances tend to not completely eliminate the apneas which both of us have had with CPAP.

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