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Permalink Reply by RockRpsgt on April 20, 2009 at 5:46pm

Unfortunately we are not allowed to tell anyone that they could die, or lose their job. We are very limited as to what we can tell them as we are not doctors or bosses. As they do not actually see one of our docs and I do not know what their companies follow up procedures are I try to educate them to the fullest of my knowledge. I am sure that these trucking companies are in some way saving money by doing this. That does not mean that this is not a good thing for these drivers. I also stress the importance of finding a good sleep certified physician in their area, and to have them re-interpret the study and the cpap data. So this is why I am making sure that my education on these machines is above par. I know I have said it before but COMPLIANCE STARTS WITH ME!

Judy said:

Rock Hinkle, I know not all, in fact probably most, "apneans" aren't "into" knowing much about their CPAP therapy except that the doctor told them they have OSA and they need to use the CPAP. But I would think since these truckers' jobs depend on adequate xPAP therapy to "keep on truckin'", I would guess that the extra encouragement of good data, or the feeling of having some control in seeing their results and getting help sooner when they need it, would be of great importance and encouragement to them. Sometimes keeping their job provides more incentive than "you'll die if you don't use your xPAP".

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Permalink Reply by Rock Conner RRT on April 20, 2009 at 6:02pm

The S8 platform is our default unit & I like it. We don't have many warranty issues w/ them, but when we do ResMed is a dream to work with. The H3i humidifiers had serious issues but we're getting much better results w/ the H4i unit. We're now using the Escape II as our base unit, & the AutoSet II when called for.

I think there's a tricky issue about using the humidifier in a truck. ResMed folks told me it just won't work with their technology because of the electrical draw, but I did not pursue a workaround. Let me know what you find out about that.

I agree that on the AutoSet II 45 min. is too long for settling, of which I'm not a big fan. Why delay proper pressure responses if the user starts having events early on?

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Permalink Reply by RockRpsgt on April 20, 2009 at 8:40pm

I have been told the same thing about the humidifier. My understanding is that with the inverter they can purchase from their company it will work. I am still waiting for comformation. I am not sure what inverter it is but as soon as I here I'll get back to you. We are also giving them the H4i.

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Permalink Reply by Judy on April 20, 2009 at 10:02pm

Why on earth the Escape II??? Yech. That is really the pits! Start them out on a good device like the AutoSet II and then toss them an Escape II. Start them out on a bite or two of filet mignon and then toss them a slab of Spam. Replace those Escapte IIs w/the Elite!!!

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Permalink Reply by RockRpsgt on April 20, 2009 at 11:23pm

I do believe that you can completely turn the heater off on the H4i. Still waiting to find out what the inverter is. I do know that it cost them $180 to have it installed. I would imagine it to be the better one. Although we all know what happens when we assume. Thanks for all of the input everyone. I think I have the best research team there is.

j n k said:

I'm not a fan of the Escape II, since I am an advocate of patients' seeing data. I like the Elite II.

The problem with the humidifier is that it needs a pure sine wave, which would require a big-power-drawing inverter:

http://www.cpap.com/productpage/DC-to-AC-pure-sine-wave-power-Conve...

Whereas the machine without the humidifier can run with an $80 ResMed converter that plugs into the cig lighter:

http://www.cpap.com/productpage/DC-12-Inverter.html

Here is ResMed's, uh, explanation of the complication of powering humidification--quite an education. It is somewhere in all that mess . . .
:-) :

http://www.resmed.com/us/assets/documents/service_support/battery_g...

Technically, I guess you could run the humidifier as a passover (no heat) with the $80 converter, but you would have to be sure to go into the blower's menu to deselect the humidifier if you did that in order to keep from frying the humidifier by accidentally turning it on when the sine wasn't pure. So I wouldn't recommend that setup. Too risky. Just thought I'd mention it to be confusing.

I understand from other boards that some find it hard to breathe in with a pressure of 4 or 5 cm starting out, so I would at least raise that up to 6, maybe even 8. And if someone really needed ramp, he could always run the thing in CPAP mode (at the 95 centile pressure found by auto mode), couldn't he? And wouldn't that give him use of the EPR? I'd rather self-titrate than auto-titrate, anyway. Safer. (May I point to this discussion whenever Duane complains about the dangers of self-titrating, by the way? :-))

Sorry. Thinking outside the box again. Bad habit of mine. I'm not sure I'd know a box even if I tripped over one! :-)

Rock Conner RRT said:

The S8 platform is our default unit & I like it. We don't have many warranty issues w/ them, but when we do ResMed is a dream to work with. The H3i humidifiers had serious issues but we're getting much better results w/ the H4i unit. We're now using the Escape II as our base unit, & the AutoSet II when called for.

I think there's a tricky issue about using the humidifier in a truck. ResMed folks told me it just won't work with their technology because of the electrical draw, but I did not pursue a workaround. Let me know what you find out about that.

I agree that on the AutoSet II 45 min. is too long for settling, of which I'm not a big fan. Why delay proper pressure responses if the user starts having events early on?

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Permalink Reply by TOM GIBBS on April 21, 2009 at 6:27am

Hi Rock,
I have been using different machines now for about 1 year. First the Government supplied basic one then experimented with the more sophisticed machines.
I also experimented with different masks. Found that the 'full face' ones tend to leak pressure around the edges more than the other smaller ones. The mask i finished uo with was the 'mirage' as it leaked the least. It appears the the face shape has alot to do with leakages. I have a long thin face which is harder to fit than a rounder fuller face.

MY experience with machines is that the Govt. one is a constant pressure which is absolutely a no help machine for me as i could not exhale against the air being pumped into the mask. ( and i have only a low pressure of 8)

I found after experimenting with hired machine that the top of the range "S8 11" was the best and well worth the money of around $2000. When you exhale it stops pumping the air into the mask and you can exhale normally, when you inhale it resumes pumping at thte predetermined pressure.
Considering that the machine has to last the rest of your life, the investment is well worth it. Before i was constantly tired day in day out, after a few months of settling in with RESMED i am now enjoying my days actively and less tired, less sleepy, more energy.

If you can find the right combination of machine and mask, the rewards are worth the cost I can imagine truckies getting a bit impatient considering their environment but tell them to persevere. i know many's the night i threw 'the thing' off in frustration but when i found the right combination i was telling a different story. Also sinusitus or blocked airways can also be a problem
.
Hope this helps................tom

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Permalink Reply by Daniel on April 21, 2009 at 1:20pm

OK, let me clear up the convertor/invertor misinformation. By using the $80 Resmed model and plugging it into the little receptacle above the AC receptacle, the device will automatically disable the heat from the humidifier. It doesn't matter what level the heat is set at, and the patient does not have to remember to turn it off. While running the device with DC power, patients should still be encouraged to put water in the humidifier. No matter how it is set, it will simply work in "passover" mode.

I don't know anything about a $180 model, but my guess is that it is a pure sine wave inverter that takes the DC power from a battery and turns it into AC. You would then plug the AC power cord from the S8 into the convertor. Since you are using the AC receptacle, the device has no clue that there is a battery source, and you can set the humidifier to whatever heat level you like. The problem with this setup is twofold: 1) The convertor itself uses some of the battery power; and 2) using heat on the humidifier is going to drain the battery VERY quickly.

I recommend that you use the $80 Resmed solution, and you won't have to worry about a thing.

Daniel

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Permalink Reply by RockRpsgt on April 21, 2009 at 4:02pm

Thanks to everyone for all the great info. betweem this and the manuals I have learned alot about this particular machine. Like I said before you guys are the best research team a simple sleep tech could have.

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Permalink Reply by RockRpsgt on April 22, 2009 at 1:51pm

For reasons that I can not discuss in an open forum I will no longer be participating in these studies. I would like to thank everyone for the time you put into helping me research this information.

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Permalink Reply by RockRpsgt on April 22, 2009 at 11:35pm

Thanks J N K. At least I am familiar with this machine now.

j n k said:

You are a good man, Rock Hinkle.

'Nuff said.

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