Weinmann SomnoBalance vs. ResMed Autoset S9

[Apappy]

I'm a newbie here and to CPAP -- APAP now because my first doctor prescribed a 14.6 CPAP with full-face mask, and I did not have full confidence in this person so I went to another sleep lab with a much better reputation (deservedly so, as I have concluded), where I was prescribed for a 6-15 APAP machine (Weinmann SomnoBalance) with nose mask. I'm about 2 weeks into it now, and have been trying to get answers to several questions. I have tried calling the companies, but that doesn't help much because you don't get to talk to the experts, and you can't rely on their objectivity, either. Of course I will ask my doctor (the second one!), but I want to inform myself first. I hope someone can help.

I have read through a number of forum threads, and may have missed the ones discussing my question, but maybe someone can link me directly.

Does either one of these machines react to nasal blockage (as with a cold)? The Weinmann person I talked to said theirs does not, the ResMed people said theirs does. It seems to make sense that more pressure would help with nasal blockage, but does it? Or does the pressure actually make it worse? With the Weinmann, the last couple of nights I have woken up with my mouth open and my nose more stuffy than it was when I went to sleep. Opening the window and cool air often helps to clear the nose, otherwise the only alternative I guess is nose sprays and, if that doesn't work, a full-face mask so I can breathe through my mouth. I want to avoid that if possible, and with the nose mask it seems to be impossible to breathe in through the mouth, although you can exhale more quickly through the mouth (losing the benefit of the pressure, I guess, although it continues to blow), and I suspect that is why the mouth pops open, in an effort to get more air. I have tried lying awake with the mask and machine on and breathing through a stuffy nose, but the pressure doesn't go up with the Weinmann. I am wondering if the ResMed AutoSet does, and if that helps to clear the nose. Nasal blockage would be included in the measurements of "air flow," wouldn't it (though apparently not with Weinmann)?

2. I also read something about ResMed not reacting to hypopneas, i.e. not breathing at all, with pressure over 10. Is this still true of the S9? I don't understand this. I have tried holding my breath with the mask on, after inhaling and after exhaling, for more than 10 seconds in each case (hoping the pressure would increase and help clear my nose), but the Weinmann does seem to react to this. This function -- forcing you to take a breath -- is more a central apnea problem and requires a different machine altogether, doesn't it? I believe both ResMed and Weinmann say that their machines do distinguish between obstructive and central apnea, but exactly how they react is not clear to me. I believe I have only chronic obstructive apnea, and as I understand it everyone has some "central apnea," (i.e., breath pauses) and overreacting to them can be harmful and actually cause more problems (more breath pauses).

By the way, I live in Germany.

[James @ Intus]

Hi and welcome.

I'd say that neither reacts to nasal blockages. The machine has no way of knowing whether your nose is blocked. All a machine CAN know, is degrees airflow resistance.

So if you rephrase your question, then I'd say both can indeed, indirectly, pick up on nasal blockages. For that matter, any Auto-CPAP can. If for whatever reason (sinus, apnoea, hypopnoea, leak) the machine notices it's not delivering the best pressure, according to it algorithm, it will try and change its output to ensure it does deliver the best pressure.

More pressure help with apnoea, not with sinus blockages. Most sinus problems stem from inflammation in the nose/sinusses. More air rushing through a narrowed passage often means even more inflammation. So you could argue that an APAP's response to a narrowed upper airway passage may actually make things worse, even though it was well-intended.

What does hepl with sinus problems is a humidifier. Fisher & Paykel has put this to the test many times. You may also want to read threads about our SinuPulse Elite. It's a hit on Amazon DE too. Based on your intro, you probably can't rely on my objectivity but other members here can vouch for its great benefits to CPAP therapy.

A full face mask may also help. If during the night you get blocked up, at least the air has a chance of going in through your mouth. As you describe yourself, you naturally start opening your mouth, which goes dry. A full face mask plus humidifier may solve that.

Some members here also use Olbas or Pur Sleep Vapour Clear oils to hepl kepe their nose open. It's another tactic you can epxlore.

For question 2, holding your breath and judging the machine's reaction is far from useful. Most machine are more clever than that, though it's hard to explain. I have no direct experience with the S9, but the SleepCubes for example, wouldn't be folled by such a simple test. Speaking of the hypopnoeas (partial breathing restriction by the way), the SLeepCubes for example have clinican settings to define what a hypopnoea is (by default 90% drop in airflow for X seconds). Perhaps the S9 has something similar you can tweak (with the help of the clinicians).

Your sleep study will probably show how many hypopnoeas and possibly central apnoeas you had in comparison with obstructive apnoea events.

Nobody knows the exact APAP algorithms, that is intellectual, proprietary knowledge of the various manufacturers. They're all slightly different, that's all I know!

[symmit]

Hi and welcome!

I'd not worry too much about the algorithms behind the APAP. I've got a german machine too (a Hoffrichter) and in three months and a couple of colds I've not had any problems with needing to adjust it.

I will say it's handy to have a full face mask to hand for those nights where your nose isn't right, and I'll echo James's recommendation that if you don't have a humidifier on your machine you really should get one - I forgot to switch mine on the other night and had a terrible night of dry mouth and stuffy nose.

[Apappy]

Thanks. Yes, a full-face mask on hand does seem almost essential, since everyone gets colds, and the humidifier makes sense, too.

[Apappy]

Thanks, James, makes sense. But I've heard from others that the CPAP does help keep the nose free, and as I said the ResMed people explicitly say their machine does react to nasal blockage, which makes sense too because that reduces the air flow, doesn't it? Looks like a humidifier and a second full-face mask are the way to go, though.

[James @ Intus]

Thanks, James, makes sense. But I've heard from others that the CPAP does help keep the nose free

That's another indirect thing in my opinion/experience. Untreated OSA = immune system under stress = more problems like sinus inflammation. Treat OSA with CPAP = increase immune system function = lesser prone to infection.

So CPAP fixes health, better health means avoiding other problems.

To say CPAP directly fixes sinus problems would be a tough claim I think.

and as I said the ResMed people explicitly say their machine does react to nasal blockage, which makes sense too because that reduces the air flow, doesn't it?

Yes, that's what I meant with indirectly responding to airflow-based changes. Whether it's a sinus blockage or you pinching your nose, the machine won't know, and doesn't care. It just cares about maintaining a good output to help avoid and respond to breathing events.

Looks like a humidifier and a second full-face mask are the way to go, though.

Yes, many people enjoy the flexibility that gives them.

[Grumpy]

Put a SinuPulse elite on your wish list too.

Best thing I ever bought; having suffered with severe sinus problems for many years.

[Apappy]

Best thing I ever bought; having suffered with severe sinus problems for many years.

Great if this works for you Grumpy, but I asked in an ayurveda store about this just the other day -- not that they know any more than anybody else -- and the guy said to be careful because the pressure, as opposed to the simple flow of a nasal wash, might be harmful to the delicate mucous membranes of the nose. He said most people don't bend far enough forward when they do the nasal rinse to get the water into their sinuses (head should be almost parallel with ground, said he, rather than just tilted). I tried this yesterday but didn't notice any difference from the way I have been doing it (head tilted).

Experience is the best teacher, though, so it's good to know that it works for you, and apparently without complications. In my case, I'm not sure whether I have a sinus problem, throat, or bronchial problem because it seems to wander up and down. I suspect it is related to the apnea, and I am hoping the APAP that I have only been on a few weeks will clear it up. In the meantime I am doing nasal rinses (neti pot), inhalation (hot water + a drop of Japanese mint oil and (recommended by the ayurveda guy) sage oil, and after inhaling about 20 times I gargle. Whether this will help I don't know, haven't been doing it long enough. In any case the more important thing for me to get used to sleeping with the mask. I am having trouble falling asleep without the help of Ximovan (zopiclone), which I have to get off of.

[shuckie]

Hi Apappy!

I don't have sinus problems myself (fingers crossed, touchwood!), but I vaugely recall reading/hearing somewhere about a technique for clearing sinuses which involves using a face flannel in a warm shower. I can't remember the details but it involved holding the flannel over the face whilst in the shower, and this somehow helped to clear the sinuses.

I tried Googling this but received mixed search results. Assuming that someone on here has the foggiest idea what I'm talking about, hopefully they can update this thread with more specific information, and maybe even comment on whether or not this technique seems to work.

I hope this contribution helps!


Cheers

shuckie

[Tigers Fan]

Hot shower, breath the steam through your nose.