Why does the Respironics show more events?

[Ronberta]

HI there

I am currently coming to the end of a one month trial using a Phillips Respironics System one (60 series) and also a Resmed Airsense 10 Autoset machine. I noticed that in Sleepyhead the Respironics shows a lot more events than the Resmed machine. I will need to purchase one of these machines in the next couple of weeks and I really want to know why the Phillips is showing more events during the night. Does this mean that the Resmed is working better and I am having less events or is the Respironics better at picking up on events? I have attached a sleepyhead screen shot of both machines so you can see what I am talking about.

I would appreciate and advice as I am very new to the world of CPAP and I don't want to purchase the wrong machine.

https://www.dropbox.com/s/9ep6nk986zscr ... 7.png?dl=0
https://www.dropbox.com/s/gpdy6kustr72c ... 1.png?dl=0

Thanks for your help!

Robbie

[palerider]

HI there

I am currently coming to the end of a one month trial using a Phillips Respironics System one (60 series) and also a Resmed Airsense 10 Autoset machine. I noticed that in Sleepyhead the Respironics shows a lot more events than the Resmed machine. I will need to purchase one of these machines in the next couple of weeks and I really want to know why the Phillips is showing more events during the night. Does this mean that the Resmed is working better and I am having less events or is the Respironics better at picking up on events? I have attached a sleepyhead screen shot of both machines so you can see what I am talking about.

they're both good machines, the resmeds are more aggressive at raising pressures after fewer events so they may result in a lower AHI, also, your min pressure is lower on the respironics than on the resmed, and the resmed stays at that base pressure less, so you're getting more treatment. also see the difference in 95% pressure.

basically, it looks like the resmed is giving you more pressure and that's preventing more hypos, so you're looking at a lower AHI.

either one of them, however, is giving you acceptable treatment.

I do prefer resmed for a long list of nitpicky reasons, that I've posted before under "nitpick"

[JustinD9]

palerider, currently I am preferring my respironics 560 over my A10. Probably will go back to the A10 but I am finding the 560's softer, less aggressive algorithm easier to cope with so I don't get the leaks or aerophagia I was getting with the A10. Yes, my AHI is now 1-3 rather than 0.2-1.5 but I currently have a seemingly more "restful" sleep. I agree that the A10 has many better attributes and I am sure to be switching back and forth.

[palerider]

palerider, currently I am preferring my respironics 560 over my A10. Probably will go back to the A10 but I am finding the 560's softer, less aggressive algorithm easier to cope with so I don't get the leaks or aerophagia I was getting with the A10. Yes, my AHI is now 1-3 rather than 0.2-1.5 but I currently have a seemingly more "restful" sleep. I agree that the A10 has many better attributes and I am sure to be switching back and forth.

it's good that there's options, and while I prefer the resmed way of doing things, I do recognize that there are folks that prefer the respironics way.

they're both giving the OP, and you, good enough treatment, and that's the important bit.

[robysue]

palerider, currently I am preferring my respironics 560 over my A10. Probably will go back to the A10 but I am finding the 560's softer, less aggressive algorithm easier to cope with so I don't get the leaks or aerophagia I was getting with the A10. Yes, my AHI is now 1-3 rather than 0.2-1.5 but I currently have a seemingly more "restful" sleep. I agree that the A10 has many better attributes and I am sure to be switching back and forth.

Things to keep in mind:

The scoring algorithms for each machine are proprietary and they're not necessarily the same. One historical note to illustrate what I mean: The old Resmed S8 Autoset was notorious around here for overscoring hypopneas---as in people around here would routinely say the S8's HI should be "cut in half" before comparing to the Respirionics machine of the same generation. When the Resmed S9 Autoset came out, a lot of S8 users were shocked at how much their machine reported AHI dropped when they switched from the S8 to the S9. They didn't report feeling any better, and the rest of their data looked remarkably the same. And many people around here were very suspicious about why their AHI's were so much lower on the S9; in fact, at the time some of them were quite worried that the S9 was intentionally under scoring H's. (But, in fairness, the old S8 did not record flow rate data).

I mention this because it's quite possible that some of the difference between your AHI's on the Resmed A10 Autoset and the PR System One APAP may be due to scoring routines rather than what's actually happening.

Next, the clinical differences between a treated AHI running 1-3 and a treated AHI running < 1 are not statistically important. In other words, even if the both machines are accurately recording all events, that difference in AHI is not really significant enough to matter in terms of OSA-related health issues. Once the AHI is consistently below 3 or 4, the major criteria for judging the effectiveness of the therapy is How are you feeling in the daytime?.

Finally, I want to point out that you write:

I am finding the 560's softer, less aggressive algorithm easier to cope with so I don't get the leaks or aerophagia I was getting with the A10

This IS clinically significant: If you find it easier to cope with the 560's less aggressive algorithm, you are more likely to get high quality sleep with the PR S1 560. There's more to high quality sleep than a near-0 AHI: The more you fight leaks at night, the more fragmented your sleep is. The more you wake up with aerophagia, the more miserable you are. And aerophagia has a tendency to set up a nasty positive feedback loop:

• ... more aerophagia leads to more arousals leads to more aerophagia leads to more arousals leads to ....

And that feedback loop is a recipe for a really bad night's sleep even if the AHI is close to 0. (I speak from experience here; I've had more than my fair share of serious problems with aerophagia through the years.)

In the end, I would offer this advice: Since both machines reduce your AHI to well less than 5.0, go with the machine that you personally find it easier to sleep with. In other words, if you prefer the PR S1's less aggressive APAP algorithm, the go with the PR S1. You'll sleep better in in the long run if you have a machine that minimizes your problems with leaks and aerophagia.