S9 Reviews

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
jnk
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Re: S9 Reviews

Post by jnk » Tue Mar 09, 2010 9:39 am

-SWS wrote:
jnk wrote: So, what do you think, -SWS--is the S9 THE machine to buy, or is the jury still out? Seriously. Just on what you've read so far.
So far I'm personally impressed by the preliminaries. I'm seriously considering an S9 Auto for my next machine.

I happen to love the new case style and really would like to have something like that sitting on my nightstand. And I don't normally fall prey to consumer psychology exploits. The hose interface in the back is a non-issue for my nightstand arrangement: plenty of hose length and I never read LCD data during the night. The low sound level sure sounds sleep-conducive as well!

Physical build quality and treatment efficacy achieved by the new algorithm (population based efficacy) fall under this category IMHO:
jnk wrote: withholding judgment until more information becomes available
I like the case style too, and the hose in back doesn't bother me. I don't even mind the power brick. It doesn't look like it solves any problems for me the S8 hasn't solved, but, who knows.

I guess my only real "concerns" at this point, after reading the reviews so far, are "Hey, where did all the hypopneas go?" and "How sure is it those are truly centrals?" Perhaps the high-resolution flow data DreamDiver is showing makes up for those concerns of mine, all things considered, though.

It seems silly, and a step backward, for patients to have to get into the clinician's menu to see AI and HI, but that's no deal-breaker for me, either.

I hope more info DOES become available.

Thanks for the great reviews, DreamDiver. They are a real help to me.

jeff (notH )

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ozij
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Re: S9 Reviews

Post by ozij » Tue Mar 09, 2010 9:51 am

I haven't voiced my thanks, DreamDiver - and I should. Your reviews are an excellent help to me too.

O.

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Last edited by ozij on Tue Mar 09, 2010 11:07 am, edited 1 time in total.
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jmelby
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Re: S9 Reviews

Post by jmelby » Tue Mar 09, 2010 10:49 am

jnk wrote:It seems silly, and a step backward, for patients to have to get into the clinician's menu to see AI and HI, but that's no deal-breaker for me, either
Not quite true... you can get the AHI from the patient info screen if "Sleep Quality" is set to "On" and not "Usage" in the clinical menu setup. To get the finer grained detail on the OAI, CAI, HI breakout, it is not the clinical menu you need to get into, it is the advanced Info menu... different keys to hold down together (Info and Setup--hold 3 seconds) as opposed to the clinical menu (Setup and Push Button).

I'm not sure how this is any different than the S8... I was never able to get any AHI data from the patient menus on my S8--always have had to go into the clinical menu. I tried different settings (smart data, etc) but never got it to work. The setup options on the S9 make much more sense as opposed to the funny names they gave things on the S8. It is also nice that they give you a smaller list of selections of generic mask types (Nasal, Pillow, Full Face) as opposed the large list of ResMed masks that you had to match to other mask manufacturers.

I've only used the S9 one night, but I have a similar experience of finding all of my hypopneas have disappeared, replaced by centrals... still a low AHI though (1.7--lower than I ever saw on my S8). It makes me wonder if ResMed felt they were mis-scoring centrals as hypopneas before? Or is the S9 mis-scoring in the other direction? I find it hard to believe that the therapy itself changed a whole lot except in the case of an obstructive apnea over 10 pressure... I had one of these and see that the pressure went up right after the obstructive apnea was over--something that would not have happened on the S8.

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ozij
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Re: S9 Reviews

Post by ozij » Tue Mar 09, 2010 11:06 am

jmelby wrote:
jnk wrote:It seems silly, and a step backward, for patients to have to get into the clinician's menu to see AI and HI, but that's no deal-breaker for me, either
Not quite true... you can get the AHI from the patient info screen if "Sleep Quality" is set to "On" and not "Usage" in the clinical menu setup. To get the finer grained detail on the OAI, CAI, HI breakout, it is not the clinical menu you need to get into, it is the advanced Info menu... different keys to hold down together (Info and Setup--hold 3 seconds) as opposed to the clinical menu (Setup and Push Button).

I'm not sure how this is any different than the S8...
It's not. S8 has a "Review Menu" -- hold down right and left buttons for 3 seconds to get into it.
I've only used the S9 one night, but I have a similar experience of finding all of my hypopneas have disappeared, replaced by centrals... still a low AHI though (1.7--lower than I ever saw on my S8). It makes me wonder if ResMed felt they were mis-scoring centrals as hypopneas before?
Resmedica April 2002
An interview with Dr. Michael Berthon-Jones a physician and one of the inventors of the ResMed auto's algorithm
Why doesn’t ResMed's AutoSet respond to
hypopnoea?
When you are lying quietly awake, or when you
first go to sleep, or when you are dreaming, you
can have hypopneas (reductions in the depth of
breathing) which are nothing to do with the state of
the airway. For example if you sigh, which you do
every few minutes, you usually have a hypopnea
immediately afterwards. This can also happen if
you have just rolled over and are getting settled, or
if you are dreaming. And the annoying thing is that
when you are on CPAP, this tendency to have what
are called central hypopneas - hypopneas that are
nothing to do with the state of the airway - is
increased. If you make an automatic CPAP device
that responds to hypopneas, you will put the
pressure up to the maximum while the patient is
awake
.
Underlines mine.

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And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
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Good advice is compromised by missing data
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jnk
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Re: S9 Reviews

Post by jnk » Tue Mar 09, 2010 11:37 am

jmelby wrote:
jnk wrote:It seems silly, and a step backward, for patients to have to get into the clinician's menu to see AI and HI, but that's no deal-breaker for me, either
. . . To get the finer grained detail on the OAI, CAI, HI breakout, it is not the clinical menu you need to get into, it is the advanced Info menu... different keys to hold down together (Info and Setup--hold 3 seconds) as opposed to the clinical menu (Setup and Push Button) . . .
ozij wrote: . . . S8 has a "Review Menu" -- hold down right and left buttons for 3 seconds to get into it. . . .
Ah. Thanks. I totally misunderstood that! That helps.

So you get AHI without any combination button pushes, then, if the clinical menu is set up to allow it? Then I guess that would be a step forward.

My VPAP Auto works a little differently menu-wise from the true S8 II machines, at least in how they are named.

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carbonman
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Re: S9 Reviews

Post by carbonman » Tue Mar 09, 2010 11:49 am

Random view......from the periphery of the UT........
may just be my reflection in the glass.....

I wonder if the S9 algorithm has been changed
just so better numbers are achieved....
so the "average" user "feels" better about their therapy.
No one liked the high hypopnea numbers...
so change it so you get "good" numbers.

Much like the cosmetic effect of changing the appearance
so small children won't be afraid of your machine
and you won't have to be embarrassed when your family sees your machine.....
and you can pretend it's really an MP3 machine.

Cosmetically fix the numbers, too.
WOW.....look at my AHI.

Win, win.


"As I see your AHI....darling,
yoouu look MAhvelous!"
"If your therapy is improving your health but you're not doing anything
to see or feel those changes, you'll never know what you're capable of."
I said that.

jnk
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Re: S9 Reviews

Post by jnk » Tue Mar 09, 2010 12:03 pm

ozij wrote:
Resmedica April 2002
An interview with Dr. Michael Berthon-Jones a physician and one of the inventors of the ResMed auto's algorithm
Why doesn’t ResMed's AutoSet respond to
hypopnoea?
When you are lying quietly awake, or when you
first go to sleep, or when you are dreaming, you
can have hypopneas (reductions in the depth of
breathing) which are nothing to do with the state of
the airway. For example if you sigh, which you do
every few minutes, you usually have a hypopnea
immediately afterwards. This can also happen if
you have just rolled over and are getting settled, or
if you are dreaming. And the annoying thing is that
when you are on CPAP, this tendency to have what
are called central hypopneas - hypopneas that are
nothing to do with the state of the airway - is
increased. If you make an automatic CPAP device
that responds to hypopneas, you will put the
pressure up to the maximum while the patient is
awake
.
Underlines mine.
Good stuff. That approach makes sense to me: responding to the inspiratory flow limitations, the flattening of the flow curve that represents the status of the airway, instead of simply responding to less flow. Status of the airway is the thing when treating OSA and should be what indicates the need for more pressure, as I understand it. But I may not understand it very well.

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jmelby
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Re: S9 Reviews

Post by jmelby » Tue Mar 09, 2010 12:08 pm

jnk wrote:So you get AHI without any combination button pushes, then, if the clinical menu is set up to allow it? Then I guess that would be a step forward.
Yes... the clinical menu needs to have "Sleep Quality" set to "On". Otherwise, you just get usage.

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dsm
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Re: S9 Reviews

Post by dsm » Tue Mar 09, 2010 3:35 pm

carbonman wrote:Random view......from the periphery of the UT........
may just be my reflection in the glass.....

I wonder if the S9 algorithm has been changed
just so better numbers are achieved....
so the "average" user "feels" better about their therapy.
No one liked the high hypopnea numbers...
so change it so you get "good" numbers.

Much like the cosmetic effect of changing the appearance
so small children won't be afraid of your machine
and you won't have to be embarrassed when your family sees your machine.....
and you can pretend it's really an MP3 machine.

Cosmetically fix the numbers, too.
WOW.....look at my AHI.

Win, win.


"As I see your AHI....darling,
yoouu look MAhvelous!"

But C'Man,

While we are in theory mode - There is also the distinct possibility that Resmed leveled the playing field by reporting the same events as other brands in a way that is closer to how they do it. Hive off the other unwanted scores into other buckets that no one pays attention to

But, all in all you have hit on a reality of perceptions that has plagued comments about the main brands for many years now. It has been (at times painfully) obvious that cpappers who track their numbers typically have an obsession with a 0 AHI score. Any debate on how meaningless AHI is as a real world indicator of airway patency gets lost very quickly. Even Prof Sullivan has commented about the lack of meaning in AHI scores BUT the reality is that for us plebs on xPAP machines out in our little boxes out in the 'burbs, we have little else to go by or to use to set goals by.

The fact that so many of us look at our AHI numbers and want to see them as close to 0 as possible is a good motive. It is just a bit of a pity that the AI & HI data is questionable. But short of maintaining a sleep clinic at home. The machines we have are all we can go by. It also does seem that the reporting of data from the machines has gone forward in an astonishing way lately and can be seen as a great & positive indicator that these newer machines are most likely becoming more accurate (rather than any imputation that they are being 'trained to fib' ).

Cheers

DSM
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torontoCPAPguy
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Re: S9 Reviews

Post by torontoCPAPguy » Tue Mar 09, 2010 4:39 pm

Funny thing is that without evidence to the contrary or more to the point evidence to support the numbers that a blower is displaying for you, you have to take the manufacturer's word for it. And how much effort does it take to make your product produce the numbers that you want the public to see?

I want to see empirical data backing up the numbers that the S9 is putting out. Irrefutible numbers that either support or cut down the numbers in one fell swoop. An algorithm to calculate a displayed number is exactly that... it is an algorithm composed of forumulas that are provided and implemented by the guy that's selling the machine!

The proof is in the pudding as they say. We are just going to have to wait and see, after considerable experience, exactly what we are getting for our money.

And if it turns out to be a fib? What then? Would a company risk its entire reputation on such a thing? Hmmmm. Lets see. Oh yes. A one word answer. Exxon. Worked for them for how many years?

I want to see results before I dump what I have and run out to spend a pile of dough on a pie in the sky.

In the meantime I am giving careful thought to sending off some top notch masks to have them reverse engineered, improved perhaps and made offshore in order to give me something to do since I took early retirement. That might be a good start. While they are reverse engineering the blowers. And for the cost of the electronics? I would come out with one model only.... the one with ALL of the bells and whistles software. Sure the interfaces are going to cost a few bucks, but what's the point of saving a buck or a buck and a half by scrimping on the software? I thought for sure with the S9 series there would be only one model.

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dsm
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Re: S9 Reviews

Post by dsm » Tue Mar 09, 2010 4:44 pm

torontoCPAPguy wrote:Funny thing is that without evidence to the contrary or more to the point evidence to support the numbers that a blower is displaying for you, you have to take the manufacturer's word for it. And how much effort does it take to make your product produce the numbers that you want the public to see?

I want to see empirical data backing up the numbers that the S9 is putting out. Irrefutible numbers that either support or cut down the numbers in one fell swoop. An algorithm to calculate a displayed number is exactly that... it is an algorithm composed of forumulas that are provided and implemented by the guy that's selling the machine!

The proof is in the pudding as they say. We are just going to have to wait and see, after considerable experience, exactly what we are getting for our money.

And if it turns out to be a fib? What then? Would a company risk its entire reputation on such a thing? Hmmmm. Lets see. Oh yes. A one word answer. Exxon. Worked for them for how many years?

I want to see results before I dump what I have and run out to spend a pile of dough on a pie in the sky.

In the meantime I am giving careful thought to sending off some top notch masks to have them reverse engineered, improved perhaps and made offshore in order to give me something to do since I took early retirement. That might be a good start. While they are reverse engineering the blowers. And for the cost of the electronics? I would come out with one model only.... the one with ALL of the bells and whistles software. Sure the interfaces are going to cost a few bucks, but what's the point of saving a buck or a buck and a half by scrimping on the software? I thought for sure with the S9 series there would be only one model.
TorontoCpapGuy

That is a good point & one that researchers have made an issue of for years now. Show us the algorithms used in Autos so we can make accurate evaluations of the effectiveness of the machines. But the vendors (due to the capitalistic nature of this business) won't budge & have thus far declined to divulge their algorithmic approaches in Autos as well as in the newer machines.

Smart researchers can guess at what & how the vendors go about what their machines do. But without the official info we users plus most researchers just have to go along with what we have.

DSM
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Re: S9 Reviews

Post by WillSucceed » Tue Mar 09, 2010 7:41 pm

JNK wrote:
Cool. So if we're being blunt, I'll just say that I have no idea what you are talking about or how it relates even remotely to my post.
Now there is a nail smacked square on the head. A very limited few folk on this site blather just to see their words in print and, take pretty much every opportunity to indulge their own pompous sense-of-self. When others respond with something that challenges the grandiose self-fluffing, it generally invites a flurry of complaint and woe-is-me, holier-than-thou crying. How dare someone have a different opinion?

I've been following posts on this site for over 5 years now have much to thank this site, and the people on it, for. However, over the 5 years, I've read the same blathering self-indulgence again and again. Just wait until you see the crap-storm coming!

For what it is worth JNK, I, and others I suspect, are very interested to read a variety of posts with a variety of thoughts/opinions. This difference makes for interesting and informative reading.
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dsm
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Re: S9 Reviews

Post by dsm » Tue Mar 09, 2010 8:11 pm

WillSucceed wrote:JNK wrote:
Cool. So if we're being blunt, I'll just say that I have no idea what you are talking about or how it relates even remotely to my post.
Now there is a nail smacked square on the head. A very limited few folk on this site blather just to see their words in print and, take pretty much every opportunity to indulge their own pompous sense-of-self. When others respond with something that challenges the grandiose self-fluffing, it generally invites a flurry of complaint and woe-is-me, holier-than-thou crying. How dare someone have a different opinion?

I've been following posts on this site for over 5 years now have much to thank this site, and the people on it, for. However, over the 5 years, I've read the same blathering self-indulgence again and again. Just wait until you see the crap-storm coming!

For what it is worth JNK, I, and others I suspect, are very interested to read a variety of posts with a variety of thoughts/opinions. This difference makes for interesting and informative reading.
Will

I am sorry that the posts distressed you so much.

DSM
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Nord
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Re: S9 Reviews

Post by Nord » Tue Mar 09, 2010 8:41 pm

ozij wrote:I haven't voiced my thanks, DreamDiver - and I should. Your reviews are an excellent help to me too.

O.
Your intelligent and unbiased commentary has certainly helped me DreamDiver

Nord

WillSucceed wrote:JNK wrote:
Cool. So if we're being blunt, I'll just say that I have no idea what you are talking about or how it relates even remotely to my post.
Now there is a nail smacked square on the head. A very limited few folk on this site blather just to see their words in print and, take pretty much every opportunity to indulge their own pompous sense-of-self. When others respond with something that challenges the grandiose self-fluffing, it generally invites a flurry of complaint and woe-is-me, holier-than-thou crying. How dare someone have a different opinion?

I've been following posts on this site for over 5 years now have much to thank this site, and the people on it, for. However, over the 5 years, I've read the same blathering self-indulgence again and again. Just wait until you see the crap-storm coming!

For what it is worth JNK, I, and others I suspect, are very interested to read a variety of posts with a variety of thoughts/opinions. This difference makes for interesting and informative reading.
I find the variety of opinions and comments in the posts can be somewhat self-indulgent... they are nontheless very helpful in getting a fuller picture of "our" complex and different problems. I have read this thread and many others making my best impression of a sponge I have only recently been prescribed for CPAP and have yet to obtain a mask and blower. But through the many postings, it has helped me to choose an S9 Elite. I was supposed to pick it up tomorrow but as a result of either popularity or a ResMed induced shortage... its on backorder for 7 - 10 days. As anxious as I am to start therapy... I am willingly waiting for the S9 because with my limited exposure to machines... I believe it to be the best machine available right now

Nord

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WillSucceed
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Re: S9 Reviews

Post by WillSucceed » Tue Mar 09, 2010 9:38 pm

DSM wrote:
Will

I am sorry that the posts distressed you so much.

DSM
Jeez-Louise... I'm not aware of having said that I'm in any way distressed. In fact, I'm not distressed at all. I'm just mindful of a recurring theme and, decided to comment on it by acknowledging JNK's comment.

Can't imagine what would make you think you need to apologize for anything. You certainly don't owe anything to me.
Buy a new hat, drink a good wine, treat yourself, and someone you love, to a new bauble, live while you are alive... you never know when the mid-town bus is going to have your name written across its front bumper!