Resmed S9 AUTO vs Respironics REMStar Series 60 AUTO

[Uncle_Bob]

I've been using the Resmed S9 APAP for 2 years and recently changed to a PR System One REMStar 60 Series Auto, which I have used the past 5 nights.
I thought I’d post some of my observations of the differences between the two machines.

Build quality

The REMStar 60 seems very solid; I immediately noticed the difference with the more solid feel of the dial and the button with the REMStar 60.
The humidifier tank is also constructed of thicker plastic with a more solid feel to the hinged lid.

Setup

The REMStar comes with the humidifier attached so all I had to do was plug in, clip on the hose and fill her up. Much easier than connecting a humidifier and fumbling around with rubber tether and aligning and twisting on the climateline hose. However the filter on the REMStar 60 is a two piece filter consisting of a grey block of foam and a white thin filter with a tab. I could not find any instructions on how they should be inserted. So i put the white in first with the tab folded out and then set the grey one in over it assuming the tab is for pulling the whole lot out.
The manuals that come with the REMStar 60 are nowhere near as good as the Resmed manuals. I have the clinical type manuals for both machines and found the REMStar awkward, menu items are not listed in order etc.

Noise

The REMStar makes a louder whezing sound than the S9 when you exhale. i notice it when i first hose up with the REMStar but it slowly goes away as my breathing slows down.

Features

Both machines are now very similar but ..

a few things that i liked about the S9 that i didn't get on the REMStar 60

-Climate line pre heat
-Large enough humidifier water tank
-I could fill the H5i water tank without removing it
-LCD showed daily AHI & leak
-Climate control on auto, never gave me rainout.
-Climateline is longer in length
-ResScan preferred over Encore Basic 2.0
-Sleephead support
-Simple mask settings (nasal, pillow full face)

Things i liked on the REMStar over the S9

-Top hose swivel mount (although it’s not a 360 degree swivel, more of a 270 degree one due to the wiring to the hose)
-Easier to read water level on side of the tank
-Back lit LCD turns on/off immediately on pressing the button (button sounds and button/humidifer LEDs can be turned on/off)
-Don't have to sleep with the SD card in the machine to get detailed data or turn on options to get detailed data (sleep quality on the S9)
-4GB SD card versus 1GB for the S9 (Not sure what this is going to mean exactly yet)
-Supplied humidifier tank comes apart for cleaning
-Heated hose seem more durable
-No smiley face

Climate Control/Humidification

This is where i notice the biggest difference between the two machines so far. i use both machines in the auto mode and not the manual humidification settings.
To start with the REMStar 60 holds approximately half the amount of water than the H5i tank
I have the dishwasher safe version of the H5i tank and if I fill the REMStar tank and empty it into the H5i tank the water level is at the top of the stainless steel tank bottom section. That’s the middle marker on the H5i yellow level indicator. I woke once with no water and woke at 2am one night to check it and found it at only 25% so i felt i had to refill it (and woke the wife).

I think the climate control settings are more intuitive on the S9 than the REMStar 60. On the S9 you set the climate control to auto and a preferred temperature setting. Or for manual is a simple 1-6 level and a preferred temperature setting.

i find the REMStar options confusing, Here are the options described in the manual

HEATED TUBE HUMIDIFICATION Heated tube enabled or disable
SYSTEM ONE HUMIDIFICATION constant mask humidity by monitoring and adjusting for changes in room temperature and humidity. Enabled or disabled, if disabled the classic style of basic control will be used
HUMIDIFIER - Desired humidity 0-5 (not shown if SYSTEM ONE humification is enabled)
HUMIDITY LEVEL - Only for heated tube. Choose desired humidity level for the humidifier 1-3
TUBE TEMPERATURE - 0-5, zero will turn off humidifier and tube.

Maybe this allows for more flexible settings but the fact that when you set SYSTEM ONE to enabled for an auto mode you can still change a HUMIDITY LEVEL (1-3) and a TUBE TEMPERATURE (0-5) is confusing. I've been running with SYSTEM ONE enabled I got rainout on my first night with HUMIDITY LEVEL of 3 and TUBE TEMP 5. I since backed the settings down to 1 and 4 and have not had rainout since. I’ve a feeling I’m going to have to use manual mode during certain parts of the year on the lowest setting to prevent the tank from running dry. If it’s going to be a problem then this may be a backup machine.

Mask settings

On the S9 setting a mask type of nasal, FFM or pillows is simple. On the REMStar its a SYSTEM ONE resistence specifically for respironic masks, the numerical value should be set to the one on the mask box. Simple also if you have a respironics mask, but what to use for a non-respironics mask?

Thanks all I can think of for now

Resmed free, for half the price, for now

~UB

[Pugsy]

The mask Resistance thing...for non Respironics masks set to 0....or find a similar Respironics mask.
It is not a critical issue. It has nothing to do with the leak reporting feature and will not affect the leak numbers at all unlike the ResMed mask choice thing.
Personally...from what I have read and my own experiments (at all settings) more hype than anything else. Set it at 0 if you wish.

Filters.....white goes in first with fuzzy side out. The tab is a leftover from the M series filters (same filters)...there are PR S1 filters without the tab. The tab actually sort of makes things easy to pop out accidentally...hence Respironics came up with the same filter without a tab.
I just cut the tab off...you can buy the filters with the tab on Ebay very reasonably in bulk.
The ones without the tab..not so reasonable.

Gray foam filter goes on the outside...It is washable and will last a really long time.
The white fine disposable filters....depends on how dusty the air is in your home but I get about a month out of mine before they start looking gray..you will be able to tell the change when it gets rather dirty.

Not long ago I found the gray foam filters on Ebay for $11.99 for 12 of them and that included shipping.

Odd that the humidifier tank is so much smaller. I have the regular PR S1 BiPap and I thought I measured the volume and they came out really close. Perhaps they changed the size with the 60 series.

Minor pros and cons with each machine. I am now using the S9 VPAP auto...same deal with me...some things I like about the BiPap better and some things I like about the VPAP better. If the BiPap would give me the fixed pressure support in auto mode that I prefer...I wouldn't have even wanted the VPAP.
Therapy wise....I do quite well with either.

There's a good chance that when they come out with the Bipap auto 60 series...I will probably be itching to get one. Gotta do something to help with the boredom.

[RandyJ]

Thanks, UB - that is a lot of useful info!

[Guest]

Ditto: lack of ability to read nightly data on the 60. No Sleepyhead for the 60. Solid feel for the 60. Rotating hose on the 60. 12V for the 60.
Both really good. Tough to pick.
Thanks
Ed M.

[pratzert]

Uncle_Bob,

Thank you very much for the review.

I am contemplating the purchase of a new machine and was set on the S9 until I read some users complain of the "Whoooooo" noise frmo the S9 on exhale.

You mentioned the PR S1 was kinda noisy (wheezy) until your breathing calmed down and the machine settled.

Did you have that dreaded "Whoooooo" sound with your S9 ?

And which one wins for being the most quiet machine overall ? Tied ?

Other than the "Whoooo" noise from the S9, it seems to be a toss up still between these two machines.

Thanks, Tim

[Uncle_Bob]

Uncle_Bob,
Did you have that dreaded "Whoooooo" sound with your S9 ?

only very slightly but not as much as the series 60 before i settle down, it sounds like its a motor spinning round. I try to use the sound to help lull me into sleep

And which one wins for being the most quiet machine overall ? Tied ?

Other than the "Whoooo" noise from the S9, it seems to be a toss up still between these two machines.

Thanks, Tim

Yes tied.

[mindy]

I don't get that sound with the S9....but for me the difference is in the algorithms. I previously had the M series auto and the algorithm didn't work well for me. If I ran it in APAP mode, my ahi would climb along with the pressure. Cpap mode was ok. Then I went to Sandman auto and that worked really well for me. Now I'm on s9 which is amazingly quiet and I don't seem to get the increasing events as the pressure goes up (at leat so far). So my vote is for the machine that gives me, personally, the best therapy (and is available). We're all different!

Mindy

[pratzert]

I don't get that sound with the S9....but for me the difference is in the algorithms. I previously had the M series auto and the algorithm didn't work well for me. If I ran it in APAP mode, my ahi would climb along with the pressure. Cpap mode was ok. Then I went to Sandman auto and that worked really well for me. Now I'm on s9 which is amazingly quiet and I don't seem to get the increasing events as the pressure goes up (at leat so far). So my vote is for the machine that gives me, personally, the best therapy (and is available). We're all different!

Mindy

Thanks for the input Mindy.

I have a Respironics Remsta Auto at this time and the Algorithm seems to do the job. But it would be good to see how the algorithm of the Resmed machines does for me too.

Problem is.... the DME (Crapria) gives me SUCH a hard time with the machines..... and they do everything in their power to avoid letting me try different machines or masks that I have found it impossible to see how anything else would perform for me.

My dealings with Crapria have been dismal and disgusting and I have not come across one single employee who seemed compatent, much less cooperative. The experience with Crapria has been so horrible that I purchased my CPAP machine out of pocket just to avoid dealing with them, even though my Insurance provides 100% coverage for DME supplies & CPAP machines.

Whatever machine I get, I'll be stuck with for the next 5 years.

That's why am doing as much research as I can before I commit to a new machine.

My sleep Doc's office just informed me that they believe that I "may" have a possibility of using a different DME supplier besides Apria. It looks as though CIGNA/CareCentrix has contracted with other Suppliers beside Crapria. That is something else I have to investigate. Maybe I will be able to switch and use one that actually cares about patient care who will work with me to get the best machine for my treatment.

Thanks again for the ideas.

[pratzert]

Well I've done some research and it looks like I AM stuck with Crapria.

So I called the local office today to see if they stock the Resmed S9 Autoset or if they had to order it.

They informed me that they carry ONLY Phillips Respironics machines.... NO OTHER BRANDS.

WTH !!!!!! I have never heard of such a thing.....

Looks like I'll be buying my own machine AGAIN..... at least I'll try to submit it to the insurance company as an "Out of Network" purchase and hopefully get a 60% reimbursement.

CRAPRIA....CRAPRIA.... CRAPRIA...... you SUCK !!!!!