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Permalink Reply by Judy on August 26, 2009 at 10:45pm

I can't answer your question about the difference in pressure settings but I can tell you that there is starting to become an awareness that titration on a Respironics system and then being provided w/a Resmed system or vice versa there IS a difference and the settings from one do NOT compute well w/the other, especially w/the more sophisticated PAPs. Both manufacturers provide conversion charts from one to the other but according to a Respironics Rep I recently talked to neither conversion chart is particularly accurate or useful.

I've had two bi-level titrations done, both times on Respironics systems despite I have a Resmed VPAP Auto. I can NOT comfortably use my Resmed VPAP Auto in Spontaneous (bi-level) mode BUT it is wonderful in Auto mode with the Pressure Support set at the diffference in IPAP vs EPAP range, i.e. IPAP 12, EPAP 7, Pressure Support 5.

AND my first bi-level titration came up w/an IPAP 13, EPAP 8, PS 5, but the second bi-level titration came up w/IPAP 10, EPAP 5, PS 5. Why the difference??? LEAKS. The second titration they added a chin strap to reduce mouth leaks.

The next time I am due for an in-lab titration my titration will be done on Resmed equipment. Or I will refuse the titration. I've already talked to my sleep lab AND our local Remsed Rep and both are willing that the Rep will supply the Resmed equipment for the sleep lab to use and since the Rep is also an RRT/RPSGT he will stay the night w/the sleep tech doing the titration to be available w/suggestions and assisitance during my titration.

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Permalink Reply by RockRpsgt on August 29, 2009 at 11:07am

Judy, you do know that the in lab titration protocol may be different from what the rep. suggest.

Judy said:

I can't answer your question about the difference in pressure settings but I can tell you that there is starting to become an awareness that titration on a Respironics system and then being provided w/a Resmed system or vice versa there IS a difference and the settings from one do NOT compute well w/the other, especially w/the more sophisticated PAPs. Both manufacturers provide conversion charts from one to the other but according to a Respironics Rep I recently talked to neither conversion chart is particularly accurate or useful.

I've had two bi-level titrations done, both times on Respironics systems despite I have a Resmed VPAP Auto. I can NOT comfortably use my Resmed VPAP Auto in Spontaneous (bi-level) mode BUT it is wonderful in Auto mode with the Pressure Support set at the diffference in IPAP vs EPAP range, i.e. IPAP 12, EPAP 7, Pressure Support 5.

AND my first bi-level titration came up w/an IPAP 13, EPAP 8, PS 5, but the second bi-level titration came up w/IPAP 10, EPAP 5, PS 5. Why the difference??? LEAKS. The second titration they added a chin strap to reduce mouth leaks.

The next time I am due for an in-lab titration my titration will be done on Resmed equipment. Or I will refuse the titration. I've already talked to my sleep lab AND our local Remsed Rep and both are willing that the Rep will supply the Resmed equipment for the sleep lab to use and since the Rep is also an RRT/RPSGT he will stay the night w/the sleep tech doing the titration to be available w/suggestions and assisitance during my titration.

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Permalink Reply by Judy on August 29, 2009 at 12:02pm

To be truthful, Rock Hinkle, I don't know what I do and don't know anymore - except that I do well in Auto mode w/my VPAP Auto and don't do phershtunga in Spontaneous mode - and that means that either Resmed has a problem - or the RRTs, Respironics and Resmed Reps don't have the slightest idea of what the VPAP Auto's Spontaneous mode's problme is - OR I am just one of "those" who don't do was well w/the usual Resmed algorhythm as w/the Respironics algorhythm - or - is there some other reason I may have missed?? *weak smile*

Thank goodness I do well w/the VPAP Auto in Auto mode! And I should just let sleeping dogs lie. But at the price of these bi-levels IF it is a Resmed problem better they should know about it and correct it. I PREFER the Resmeds for their easy access to more data via the LCD screen so I am disappointed if it is a Resmed problem and I want very much for it to be corrected if it is a Resmed problem. There are things I do NOT like about the Respironics devices that have absolutely NOTHING to do w/the excellent therapy they provide. But I gotta tell you - that new SystemOne of theirs .... I AM going to be interested in the SystemOne bi-level when IT is released!!!!

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Permalink Reply by Judy on August 29, 2009 at 12:27pm

At least I will be IF I can get my hands on their EncorePro 2.1 software. No software, no data, no sale!

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Permalink Reply by RockRpsgt on August 31, 2009 at 5:03am

12cmwp is 12cmwp regardless of what machine you use. The problem is in the algorithm. the Resmed version is not as aggressive as the Respironics. This can be seen in the way that Resmed suggest you treat hypopneas. This is especially noticed when using a machine in auto mode or an ASV/VPAP. Typically if a person uses a Respironics auto machine and they switch to a Resmed auto they will need to raise there pressure to adjust for the differences in algorithms. A person that starts out on a Resmed and switches to a Respironics will be able to lower their pressure. We have experimented with thesae machines until we were blue in the face. The Respironics algorithm is just more sophisticated. Sorry jnk, judy

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Permalink Reply by Judy on August 31, 2009 at 12:26pm

Bless you, and thank you for the information, Rock Hinkle. Even if I don't like your answer. *wicked grin*. I'd ask you, didn't your momma teach you if you can't say something nice, don't say anything at all? But - in this case, it NEEDED to be said. It doesn't mean I have to like it tho!!!! So there! And, yeah, a long time ago I read one, maybe two, abstracts that said it amounted to about a 1 cm difference and THEY considered that 1 cm difference negligible. *sigh*.

For some odd reason for the first time I am encountering what I am assuming is some form of seasonal allergy, tho darned if I have even the slightest clue as to what. My sinsuses are dripping, dripping, dripping, sneezing, blowing and emptying only to fill up again and drip and sneeze some more. Grrrrrrr!!! Fortunately, whilst using my VPAP and humidifier I having no problems breathing and sleeping at night! But this daytime dripping, sneezing, blowing is NOT doing my usual sweet, sunny dispostion any good at all! (Tongue in check on that one!)..

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Permalink Reply by susan mccord on August 31, 2009 at 1:40pm

Judy, I had that nose-running, heavy sneezing, etc. alternating with extreme, nearly unbearable stuffiness two different times, one lasted 8 days, the next about five days. It was totally miserable and nearly took me off CPAP treatment. Knowing, finally, that it was a humidification problem issue, I just got pissed one night and turned my humidifier all the way to 5, and wonder of wonders, it all cleared up and hasn't come back. I keep it on 4 or on 5 again if I even feel the LEAST bit weird. Some people say that's too high, but for me it's kept me functioning and not sick all the time.

I wonder if it has something to do with all the heart meds I take, some of which are extremely drying. Maybe my sinuses and naval cavity just can't tolerate all that air blowing in so hard. But high-level humidification was and, so far, is the magic bullet for me.

Susan McCord

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Permalink Reply by Judy on August 31, 2009 at 3:19pm

What the hay, nothing ventured, nothing gained, Susan. Thank you. I'll try that! Tho, I will say, thank goodness! I've NOT been stuffed up. Its all loose and running!!! Boy! Is it loose and running! And running. And running. And .....

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