Need Resmed education

[carbonman]

In my quest for the full cpap Monty and I am going to get a third machine,
I am considering the purchase of a Resmed machine.
I am looking at the S8 Autoset II/w HH.

I have always used the Mseries auto, because that is what the DME gave
me when I started cpap, and it has provided excellent therapy.
Time to expand my horizons.

I live at 12.5-17cm and use C-flex at 2.

How can you tell how old a Resmed machine is???
W/Mseries I always ask what the software ver. # is and
which style HH tank it uses.

What do I need to look for/look out for, in purchase of system from the auction.

Thoughts/comments/suggestions

OK, Resmed lovers.....educate me, please.

[Velbor]

Two aspects to the "age" of a ResMed machine: the first four digits of the serial number will give the year of manufacture, but probably more important is the number of hours on the blower. That can be found in the Clinical Menu, under Servicing information (not to be confused with the re-settable hours of use found in Results).

You may or may not want to distinguish between the "original" S8 series and the S8-II series. A principal difference in the AutoPAPs is that the original S8's have EPR (expiratory pressusre relief) only in the constant-pressure CPAP mode, but not in Auto. The S8-II series Autos have an EPR function in the Auto mode as well. Since you mention using C-Flex in auto, you may not want to consider the older "original" S8's. The S8-II series may also be quieter; I'm not certain.

Another consideration is the integrated humifier. Until this year all the S8's have come with the Humidaire 3i unit. Adequate for most users. Recently (February) ResMed came out with the 4i unit, which is supposedly a bit better. The 4i is physically a bit different in shape, but electronically compatible, and is usable on any of the S8's.

Another issue is that several years ago (2004 - 2006, involving original S8 but not S8-II) there was a recall for a possible power-system defect. The serial numbers affected can be found on the ResMed site. Getting one of the units involved in the recall may not be a bad thing: in the past ResMed (through its contractor SteriCycle) would replace involved units with brand new ones, virtually no questions asked about where you got it. Not sure what the current status of that program is; had to search on the ResMed site for "recall" to find the information.

You might perhaps also consider an older S7 AutoSet Spirit. No EPR, and a larger footprint, and a key inconvenience is that it does not come with a smartcard to transfer data as the S8 series does; you need a null-modem serial cable (and there is a variety of opinions whether the cable itself is generic or proprietary). Functionally it's pretty much the same machine as the S8 Vantage, though with no EPR function. The S7 uses the Humidaire 2i HH, not interchangeable with the 3i and 4i.

Both the S7 and the S8 original are supported by ResMed AutoSet software. Those, plus the S8-II, are supported by the current ResScan software. Any way you go, you will presumably want the software, and for the S8's, the smartcard and the proprietary card reader (though there are posts about retrofitting selected generic card readers).

Good luck!

[Raj]

Carbonman, I have only one thing to add to Velbor's excellent and exhaustive response: I'd recommend the Autoset II over the older models. The new dual-action motors are noticeably quieter and seems to operate much smoother.

[cpapqueen1]

Resmed's are far more reliable than the M-series. Stericycle is no longer handling the recalls, contact Resmed directly. The auto-set II is much quieter.

[carbonman]

Thanks! Velbor, great information.

The search begins.

[Goofproof]

Resmed would be my third choice in treatment if I couldn't get the other two brands. Jim

[carbonman]

Resmed would be my third choice in treatment if I couldn't get the other two brands. Jim

Man.....there's always got to be a fly in the ointment.

What is your second choice??

Maybe that will be my third machine or maybe the fourth.

Is OCD a side effect of CPAP due to OSA???

[Raj]

Respironics and ResMed have different basic approaches to their breathing algorithms (setting aside c-flex, a-flex, and EPR). With Respironic machines, pressure begins to build up toward the end of each exhalation and the result, for me, is that I never feel that I've fully exhaled before it's time to inhale again. For this reason, ResMed machines fit my breathing style much better.

[Goofproof]

Resmed would be my third choice in treatment if I couldn't get the other two brands. Jim

Man.....there's always got to be a fly in the ointment.

What is your second choice??

Maybe that will be my third machine or maybe the fourth.

Is OCD a side effect of CPAP due to OSA???

Glad to be there for you! https://www.cpap.com/productpage-bundle ... undle.html, I don't have one but I think with their software they would be my next try. Resmed would come in DEAD last. (Buzz, Buzz)

I have seen too many switch, or start out with Resmed, and they seem to have more treatment problems with it. But the Diehards will defend anything, we all think we have the best, but we are always ready to get the newest in hopes of better. That's what keeps the manufactures and junk yards in bussiness. Jim

[rested gal]

What do I need to look for/look out for, in purchase of system from the auction.

I'd look for " II " at the end of the name. ResMed Autoset II.

I'd want the new H4i humidifier, not the older H3i.

[-SWS]

I live at 12.5-17cm and use C-flex at 2.

I'd also take a close look across plenty of data to see what kinds of events your REMstar happens to be elevating pressure in direct response to---above that 12.5 cm min pressure. REMstar will let all single-occurrence A or H events sit there unchallenged. But REMstar will directly respond to densely packed clusters of 2 or more A/H occurrences. Of course, Resmed A10 would not directly respond to any of those A or H occurrences above 10 cm by statistical design.

But do you remember when I recently commented that one of your old REMstar Encore reports showed almost exclusively candidate FL and VS sitting above 10 cm? Resmed would have responded to those events just fine.

So before buying your Resmed AutoSet, I'd see what kinds of residual events happen to be living between 12.5 and 17 cm. Statistically, for most people, it happens to be snore and FL. As long as your REMstar is not incredibly busy hiking pressure in direct response to A and/or H above that 12.5 cm setting, then you are probably a statistical match for the A10 algorithm as are most people.

[dsm]

CarbonMan

Re the II models vs the pre II models. The II models have a newer quieter blower (I think but can't say for certain, that the new blower is their award winning dual impeller design based on the unit pioneered in the Vpap Adapt SV). Resmed imply this is so.

Also they adopted the shark fin wave form also pioneered in the Vpap Adapt SV. The EPR is an improved version & definitely worth getting in pref to a pre II model. Re the H/H. The new 4i really only adds extra water capacity & little else (you can buy the new chamber as an upgrade kit for a 3i). The shape at the front of the H/H was drawn out more so a bit more water could be added. Some people were commenting that they could empty their 3i H/H units before a full night had passed.

Re the S7 models. The blower noise with them compared to the new S8 II models is such that I wouldn't bother going down that path (The S7 Elite tended to be a bit quieter than the Spirit (Auto) version - this was to do with a whine that the Auto could emit that tended not to show in the Elite even though they are mechanically identical to each other, the software was the difference).

Happy hunting.

DSM

[dsm]

<snip>

REMstar will let all single-occurrence A or H events sit there unchallenged. But REMstar will directly respond to densely packed clusters of 2 or more A/H occurrences. Of course, Resmed A10 would not directly respond to any of those A or H occurrences above 10 cm by statistical design.

<snip>

SWS,

Can you clarify this aspect of your post. "not directly respond to any of those A or H occurrences" - Reason I ask is that I always understood that the A10 algorithm looks for pre-cursor signs (Snore, FL, flattening) & uses these to determine if what looks like a looming A or H is actually OSA based. If these occur then A10 raises pressure. It seems to me your comment implies (once again) that A10 misses A & H events when in fact it has pre-empted them by sensing the Snore, FL & Flattening signs.

Tks

DSM

[-SWS]

It seems to me your comment implies (once again) that A10 misses A & H events when in fact it has pre-empted them by sensing the Snore, FL & Flattening signs.

Your above "in fact" statement is very happily the "usual" case, Doug. But it's not at all a good universalism for patients like Mar, who present inadequate snore and FL signals above 10 cm. Despite running a max pressure of 17 cm, and a min pressure of either 10 cm or 11 cm, A10 just sat at her min pressure all night long. Unfortunately she very often didn't present adequate snore or FL signal above 10 cm; consequently the A10 algorithm often didn't even budge from her min pressure, despite tons of A and H occurring. That's a scenario worth openly discussing.

And that often gave Mar a residual AI of around 7 and residual HI around 17 (for a combined residual AHI commonly around 24)----with A10 just sitting at that min pressure of 10 cm or 11cm all night long for lack of A10-crucial snore and FL signals.

That situation is undoubtedly why Resmed is forthright, to this day, in describing to clinicians exactly which signals do and do not receive direct pressure responses:
Below 10cm- FL, snore, and A
Above 10cm- FL and snore only

In cases where FL and snore signals are either inadequate or missing above 10 cm, the Resmed A10 algorithm will either under-respond or fail to respond. Carbonman has the advantage of looking at his historical data to see exactly which residual signals sit above 12.5 cm in his case: A, H, FL, snore. Note that Respironics directly works with all four signal types above 10 cm---while Resmed works with two of those signal types above 10 cm (FL and snore) and three of those signal types below 10 cm (FL, snore, and A).

[dsm]

SWS

Thanks for that, makes sense, but, you didn't mention flattening & that is where I understand A10 will raise pressure if flattening is showing a repeated restriction that doesn't score as Hyp or Apnea. Resmed makes a big issue of monitoring the flattening & indexing it.

DSM