Comparison Resmed S8 AutoSet II vs Remstar M Series

[bangy104]

Hi Friends

I am getting a new APAP. I was advised by by DME that Resmed S8 Auotset II is the best out there. As per him it is better than Respironics M series. Please give your opinions on these 2 machines to me to enable me to decide which one is better. My titrated pressure is 14 cm. I have not seen my charts for a long time but I have the software and card reader with me. If anybody can let know what information would be useful for the decision and I can post that information in this thread for more inputs.


Also I sleep on my back most of the night any opionions on which mask would be better for me SWIFT LT or Swift 2 please let me know.

At present I am using Remstar Auto CPAP with CFLEX which has stood me in good stead over last couple of years.

Added 06 April

Thankyou Everybody it is really interesting to read the whole thread and all of a sudden I am now feeling the need to download the data of my machine and look it my charts once again. Regarding Leaks at 14 pressure I would say that my swift mask gives me a very good fit and there are no leaks infact the sleep tech who conducted my sleep study a few months back also mentioned this fact after the study as she was suprised I had very few leaks even at such a high pressure. I am using Remstar Tank APAP with pressure set between 8 - 20 under the assumption that it would set my pressure according to the needs and when I used to monitor my charts I also found that pressure reduced when my weight went down and again up when my weight went up. I do not feel 14 is a very high pressure for me and I am used to it and can handle the pressure very well.I am very comfortable with APAP although now I do not feel as refreshed as I used to feel when I started APAP. My doctor suggested a day studt (MSLT) which is scheduled on April 25. My old tank is still going strong and only reason I want to get a new machine is because it is free for me and it starts the 5 year period after which I will be eligible for next machine. I would also say I am a laid back user of APAP who after initial enthusiasm would now just like to lay back and enjoy positive effects of CPAP/APAP without monitoring it daily or weekly or monthly if possible. However as Georgio said eventually I need a recommendation but I do have a couple of days to make up my mind so any inputs are really appreciated and also if any info regarding my sleep study or current numbers can be helpful in arriving at a recommendation please let me know and I can post them. Once again thankyou everybody for your help

Here are my numbers that i found in one of my previous posts

Here are the numbers from 8/16 - 8/29

Avg 90% Pressure 13.0
Avg Pressure 11.1
Avg Non Responsive AHI 0.0
Average OAI 0.7
Avg HI 1.3
Avg AHI 2.0
Avg FLI 1.1
Avg VSI 15.1
Avg Max Leak 79.1
Avg 90% Leak 40.0
Avg Leak 32.3
Avg Large Leak 0 mins


Thanks in Advance

[Fredman]

First, I must say you are lucky to be getting another machine after a couple of years. My insurance won't pay for another unit until my first one becomes 5 years old. Of course, I can pay for one on my own.

I have a Respironics Auto, I have been looking that the Resmed units as well as the Intellipap.

I think for the most part it is a subjective decision in part, for the most part, you will have to decide what features are most important to you.

Mark

[bangy104]

I thought both of these machines had same features APAP with cflex / aflex for remstar and resmed apap with epr. What are the other differences. I have the old remstar tank and softwares and I do not use software much just whenever i go to a doc i get the charts. So I would say I am looking for basic stuff just apap with exhalation pressure releif which both of these can provide. I was going to go for remstar but the DME's recommendation and also first review for resmed apap has caused me to research this a little more before i take a final decision

[Fredman]

My undederstanding is that AFLEX and CFLEX are Respironics patented treatment modes and exhale relief is tied to one them, I am can't remember so I wont try to begin to pretend I know.

Our Wisdom, the yellow lightbulb located in the top banner of this page, is often helpful with information that the community has saved as what is often called stickys in some forums - these may help:

Whats the differences in BIPAP, XPAP, APAP, CFLEX
viewtopic.php?p=56836

Suggested Specific CPAP Equipment Scripts (Slinky) (Diagnosis and Prescription)
our-collective-cpap-wisdom/CPAP-machine ... ption.html

[Georgio]

Those two machines were my short list before purchasing my M-Series w/ A-flex. Both top quality machines. One consideration is your pressure setting. I understand that the ResMed machines do not respond to apneas over 10, because they are considered centrals. I'm not an authority on ResMeds, however this may be a consideration if your pressure runs above 10. If you post your titrated pressure, as well as findings from your sleep study, you can get better guidance on your machine selection.

Good luck with your new machine.

Georgio

[Wulfman]

I thought both of these machines had same features APAP with cflex / aflex for remstar and resmed apap with epr. What are the other differences. I have the old remstar tank and softwares and I do not use software much just whenever i go to a doc i get the charts. So I would say I am looking for basic stuff just apap with exhalation pressure releif which both of these can provide. I was going to go for remstar but the DME's recommendation and also first review for resmed apap has caused me to research this a little more before i take a final decision

It depends on a number of things. One of them being what your prescribed pressure is. If your pressure is higher then 10 cm., the ResMed Auto may not be for you. ResMed Autos will only respond to apnea events above 10 cm. if they're preceded by snores or flow limitations. The reason is their A10 algorithm (program). ResMed would rather not pursue apneas above that pressure for fear of inducing Central Apneas in the patient. If your pressure is higher than 10 cm., and you're not susceptible to Centrals, you may be better off with a ResMed CPAP or running the Auto in CPAP mode or with the minimum pressure set at where it eliminates almost all of your events.

Respironics takes a different approach to potential Centrals in that they'll attempt 3 pressure increases.....and if the increased pressure does not clear the event, they'll back off and lower the pressure.

The two machines are only the same in that they are APAPs/Autos and the decision to choose one or the other becomes a little more complicated. EPR actually drops the exhale pressure by the setting number....1 - 1 cm., 2 - 2 cm., 3 - 3 cm. The Flex technology of the Respironics machines momentarily drops the pressure relative to the exhale force.

Both company websites have links to their various technologies and you can read more there.

Den

[Slinky]

MOST people will get as good therapy w/one brand or the other of the two you are considering. Both manufacturers' devices provide EXCELLENT therapy. There are a FEW apneans who do better w/the algorhythm of one manufacturer over another, that varies w/the individual.

The differences between the two devices under consideration are mostly "conveniences". In this respect I've found the Resmeds to be more my preference.

1] Three basic parts to the Resmeds: xPAP, integrated humidifier, water tank. Four basic parts to the M Series: xPAP, integrated humidifer, water tank and that *$%& "plate" (power brick, whatever you want to call it).
2] The M Series is 1 lb heavier when packed for travel.
3] The Resmeds excel and can't be beat for ease of access to and amount of data available via the easy to read LCD screen.
4] Maybe because I used it first I find the Resmed software data to be easier to understand and it was much easier for me to install as I'm not very 'puter literate. I had to have my 'puter guru install the Respironics software because I couldn't get it to install correctly and work for me and I still do not find the way it presents the data as easy to understand. HOWEVER, Respironics' software has the WONDERFUL Daily Events Per Hour table chart that I wish Resmed would emulate!
5] Resmeds do not have the aggravating blue lights you can't turn off.
6] My Resmeds have not dropped data whereas the M Series tends to drop data one to two nights a month.
7] There is the possibility that the local DME supplier may still have the notoriously poorly designed M Series integrated humidifier on their shelves instead of the current version.
8] The early M Series had TWO cords instead of just one like the Resmeds. I "think" I've read that that has been corrected and only one cord may be needed w/the newer versions of the M Series - but again the local DME supplier MAY still have the old version on their shelves.

As you will notice, all I listed above have NOTHING to do w/the QUALITY of therapy they provide. You really can't go wrong w/either one unless you have strong likes and dislikes about the features I've listed.

[bangy104]

Hi Wulfman

My titrated pressure is 14 cm. I have not seen my charts for a long time but I have the software and card reader with me. Can you let me know what information would be useful for the decision and I can post that information in this threadfor more inputs.

I thought both of these machines had same features APAP with cflex / aflex for remstar and resmed apap with epr. What are the other differences. I have the old remstar tank and softwares and I do not use software much just whenever i go to a doc i get the charts. So I would say I am looking for basic stuff just apap with exhalation pressure releif which both of these can provide. I was going to go for remstar but the DME's recommendation and also first review for resmed apap has caused me to research this a little more before i take a final decision

It depends on a number of things. One of them being what your prescribed pressure is. If your pressure is higher then 10 cm., the ResMed Auto may not be for you. ResMed Autos will only respond to apnea events above 10 cm. if they're preceded by snores or flow limitations. The reason is their A10 algorithm (program). ResMed would rather not pursue apneas above that pressure for fear of inducing Central Apneas in the patient. If your pressure is higher than 10 cm., and you're not susceptible to Centrals, you may be better off with a ResMed CPAP or running the Auto in CPAP mode or with the minimum pressure set at where it eliminates almost all of your events.

Respironics takes a different approach to potential Centrals in that they'll attempt 3 pressure increases.....and if the increased pressure does not clear the event, they'll back off and lower the pressure.

The two machines are only the same in that they are APAPs/Autos and the decision to choose one or the other becomes a little more complicated. EPR actually drops the exhale pressure by the setting number....1 - 1 cm., 2 - 2 cm., 3 - 3 cm. The Flex technology of the Respironics machines momentarily drops the pressure relative to the exhale force.

Both company websites have links to their various technologies and you can read more there.

Den

[Wulfman]

Hi Wulfman
My titrated pressure is 14 cm. I have not seen my charts for a long time but I have the software and card reader with me. Can you let me know what information would be useful for the decision and I can post that information in this threadfor more inputs.

I thought I must have missed something when I just now re-read your first post......and then I noticed you had edited it to insert your pressure.

OK. With that information, I wouldn't "waste" my money on a ResMed Auto.

At present I am using Remstar Auto CPAP with CFLEX which has stood me in good stead over last couple of years.

Actually, you currently have the best machine made......IMHO. I have....um...."several" of them, myself.
Have you always used yours in CPAP mode or do you use a range of pressures? I started out using a Pro 2 CPAP and after over a year of that, bought my first Auto and found the range of pressures disturbed my sleep and went back to CPAP mode and straight pressure.

You may be able to find another lightly used Legacy model (like the one you have) on CPAPAuction.com.
or......
If I were you, I'd also contact the guy who started this thread. It's a heck of a good deal on an Auto M Series w/A-Flex.

viewtopic/t40257/Respironics-MSeries-wi ... -SALE.html


Den

[dsm]

Those two machines were my short list before purchasing my M-Series w/ A-flex. Both top quality machines. One consideration is your pressure setting. I understand that the ResMed machines do not respond to apneas over 10, because they are considered centrals. I'm not an authority on ResMeds, however this may be a consideration if your pressure runs above 10. If you post your titrated pressure, as well as findings from your sleep study, you can get better guidance on your machine selection.

Good luck with your new machine.

Georgio

Sadly this is an oft repeated falsehood (I know many folk don't realize they are propagating it as such but it is just not true!).

The A10 algorith *does* respond to OSA events over 10 CMs pressure. What the algorithm doesn't do (very sensibly) is to respond to an event that has NO PRECURSOR events and is a no-flow event. The algorithm applies the best common sense by deciding if there was no flattening (which means Flow Limitations & hypopneas) prior to the no-flow event then it is more probably a central apnea.

Also, no brand of Auto machine I know (incl Resmed or Respironics) will try to adjust pressure during a no flow event. They always wait for it to end naturally then decide what to do. The Resmed will raise pressure if there was flattening prior to the event. NOTE!!! Flattening shows that an obstruction is looming. It is near Impossible for someone to have an OSA no-flow event without signs of flattening unless the event really a central. Resmed machines do detailed analysis of the respiration curve shape. Other brands take slightly different approaches. All though, tend to achieve the goal of providing effective therapy.

People can continue to propagate the untrue statement that 'A10 doesn't respond to apnea over 10 cm' (which is plainly deceptive) - or can tell the true story which is A10 algorithm will not raise pressure if a no-flow apnea occurs without being preceded by flattening of the inspiration curve once pressure has reached 10 cms.

DSM

[dsm]

Hi Friends

I am getting a new APAP. I was advised by by DME that Resmed S8 Auotset II is the best out there. As per him it is better than Respironics M series. Please give your opinions on these 2 machines to me to enable me to decide which one is better. My titrated pressure is 14 cm. I have not seen my charts for a long time but I have the software and card reader with me. If anybody can let know what information would be useful for the decision and I can post that information in this thread for more inputs.


Also I sleep on my back most of the night any opionions on which mask would be better for me SWIFT LT or Swift 2 please let me know.

At present I am using Remstar Auto CPAP with CFLEX which has stood me in good stead over last couple of years.

Thanks in Advance

Re the Remstar Auto 'tank' - that along with the RBipap Auto 'tank' is amongst Respironics classic all time great machines. I'd be inclined to hang on to it unless that is something quite wrong with it.

Of the newer M series, try to do a comparison for noise level with an S8 II as well as your existing 'tank' Remstar.

Good luck

DSM

[-SWS]

I understand that the ResMed machines do not respond to apneas over 10...

Sadly this is an oft repeated falsehood (I know many folk don't realize they are propagating it as such but it is just not true!).

The A10 algorith *does* respond to OSA events over 10 CMs pressure....

People can continue to propagate the untrue statement that 'A10 doesn't respond to apnea over 10 cm' (which is plainly deceptive) - or can tell the true story which is A10 algorithm will not raise pressure if a no-flow apnea occurs without being preceded by flattening of the inspiration curve once pressure has reached 10 cms.

DSM

Doug, that's a change compared to the way Resmed claimed to have originally designed A10. If you are aware that Resmed announced a change over the years to A10's pressure-response to apneas above 10cm, please cite a reference. Thanks!

http://www.resmed.com/en-en/assets/docu ... 0906r1.pdf

Why doesn't ResMed's AutoSet respond to apnea above 10 cmH2O in pressure?

I mentioned before that the higher the pressure, the more central hypopneas you will have. At a pressure somewhere around 10 cmH2O, the central hypopneas become central apneas. On the other hand, the vast majority of obstructive apneas are already well controlled by 10 cmH2O, and we are only fine tuning using snore and flattening...

My comment about that last statement: fine tuning by using only snore and flattening above 10 cmH2O refers to A10 pressure-responding only to snore and FL above 10 cm H2O (and not apneas). Interview continued below:

...So it is a pretty good bet that if the pressure is already above 10 cmH2O, any apneas are most likely central, and you should leave them alone

Doug, I'm very amenable to the idea that Resmed might have changed A10 in recent years by responding to apneas above 10 cm H2O. I just haven't read that anywhere yet.

[dsm]

SWS

The claim that A10 doesn't respond to apnea over 10 is misleading. It doesn't qualify what is meant by apnea. The machine's A10 algorithm referenced in your 1st quote is I believe from the Autoset-T machine released in approx 1999. The sampling of flattening is far more sophisticated in 2009 than it was then. I am sure you will agree with that.

The machine looks at snoring and flattening & flattening covers a wide range of shape analysis.

For those of us who have have the Reslink, we can gather that data using ResScan see what the machine sees & it does monitor the level of flattening over several breaths to determine if events are looming.

I am sure you know that the S8 & S8 II machines do respond to 'OSA events' over 10 CMs if you don't believe this can you explain where & why ? I may have got it wrong but just can't see so at this time

Cheers DSM

[-SWS]

Well, a Resmed marketing representative flat out said during an interview that A10 does not respond to apneas above 10 cm H2O:
http://www.talkaboutsleep.com/sleep-dis ... chat.htm#6

Why does AutoSet Spirit (and AutoSet T™) have the A10 algorithm?

The A10 algorithm increases pressure in response to Flow Limitation, Snore, and Apnea up to 10cm H2O. Above 10cm H2O, pressure response to Flow Limitation and Snore continues, but there is no response to Apnea.

So based on what A10's inventor said and what the Resmed marketing representative above very explicitly said (see my underlined text) ...I am under the impression that Resmed was not kidding us when they told us: "but there is no response to Apnea"..

I don't think anybody was originally propagating flat-out lies or falsehoods earlier in this thread. It seems to me they were accurately repeating what Resmed tells the world during interviews. Unless Resmed announced a recent change to A10's former "essence" of not responding to apneas above 10 cm...

Seems like they would no longer call the algorithm "A10" if it was now responding to apneas above 10 cm. But where is that Resmed information describing that apneas (not FL or snore) are now receiving a pressure response above 10 cm? I think that's a plausible change, but I have yet to see it mentioned by Resmed. Thanks.

[dsm]

SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM