New CPAP prescription: ResMed or Respironics Dream Machine

I am allowed to get a new machine next month.

I've only experienced the ResMed machine. Should I also consider the Dream Machine? Why or why not? My physician says he doesn't prefer one over the other, but I'm wondering if actual USERS of the machines have a preference?

Unless a person has used both it's unlikely you will get a good comparison. There are a couple in that group

I would suggest that you stay with the ResMed brand.
You know its algorithm is working well for you.
Respironics DreamStation is a nice machine but their algorithm works just a little differently and while most people could probably do okay with either...some do better with one over the other.

I have owned both brands and in fact right now have a Respironics bilevel machine (not the DreamStation but the one model older) and 2 ResMed (one S9 and one AirCurve) bilevel machines. I actually do a little better with the ResMed algorithm...not hugely better but a little better.
I also think that the ResMed is a tiny bit more quiet...and if you happen to be using exhale relief that the ResMed offering a little more reduction during exhale is a plus.

Both brands now have integrated heated hoses for greater customization of humidity and hose air temp.
The ResMed water chamber is slightly larger if you happen to use lots of humidity...less chance of running out of water.

Pugsy wrote:\
I have owned both brands and in fact right now have a Respironics bilevel machine (not the DreamStation but the one model older) and 2 ResMed (one S9 and one AirCurve) bilevel machines. I actually do a little better with the ResMed algorithm...not hugely better but a little better.
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Do you actually feel and sleep better or is it the numbers that look better?
I have noticed my numbers are slightly better on the Resmed than the PR at the same settings.
I'm happy the the numbers are better but I don't actually think i sleep or feel any better.
I was thinking PR might be a little more aggressive on flagging events.

IrishAyes wrote:I am allowed to get a new machine next month.

I've only experienced the ResMed machine. Should I also consider the Dream Machine? Why or why not? My physician says he doesn't prefer one over the other, but I'm wondering if actual USERS of the machines have a preference?

Which specific one? (generation and model)
And, what settings have you been using?


Den

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jtravel wrote: Do you actually feel and sleep better or is it the numbers that look better?
I have noticed my numbers are slightly better on the Resmed than the PR at the same settings.
I'm happy the the numbers are better but I don't actually think i sleep or feel any better.
I was thinking PR might be a little more aggressive on flagging events.

Respironics isn't necessarily more aggressive on flagging...they use the same criteria as ResMed for earning a flag except one uses a 40% minimum reduction for a hyponea flag and the other uses 50% minimum of the hyponea flag.
They both use 80% or more for OA flag.
Instead Respironics has bit of a "gentler" algorithm when in auto adjusting mode. Doesn't move up as fast or down as fast as ResMed. We are talking small differences in response time here...it's not that ResMed is super fast..it isn't at all. None of the apap mode machines when in apap change pressures in the blink of an eye. Any changes are all very gradual despite what the pressure graph may look like...if you zoom way in the changes are slow.
My personal opinion about why there seems to be a difference in the numbers (OAs and hyponeas only because central or CAs we don't fix with cpap/apap machines) is that the slightly slower response time allows for the airway to maybe collapse a little more when the pressures are the same between the 2 machines. I have found that I need just a little more pressure with a Respironics machine to get the same numbers as I get on a ResMed machine. Maybe 1 or 2 cm more minimum or baseline pressure.

As to your question about "is it the number look better or do I feel like I sleep better".
Now I know some people can tell a difference in how they feel with a change in numbers. I have never found that to be the case. I can't really tell that much difference unless unless I just have a terrible night with a lot of tossing and turning from the pain issues and I have a lot of SWJ centrals getting flagged and messing with the AHI.
One of my best days in terms of how I felt during the day was after a night with the AHI 10.2...go figure that one. Goes against every bit of logic I can muster up but it happened about 3 months into therapy. Back then I only checked the data in the evening because I didn't want my "feelings" clouded by what the data said. I was feeling great that day and I just knew I must have had an AHI of 0.0 to feel that good. I was totally surprised to see that it was 10.2.

Respironics and ResMed...very close in terms of how I feel I sleep. ResMed is a little better because at my pressures the ResMed is a tiny bit less noisy. Not that the Respironics is loud but the conducted noise is less with the ResMed so that potential annoyance when I first go to bed is lessened.

My "numbers" are essentially the same with either brand but the settings to get those numbers aren't the same. I have to use a little more pressure with the Respironics machine...not a huge amount but a little more and while I don't have a problem using the higher...I prefer less while awake. Purely a comfort thing. Once I go to sleep it doesn't matter and I never notice any pressure changes.

With the slightly more aggressive response time of the ResMed algorithm I can get by with a little less pressure while awake as a base line and still get the airway held open very well. For this reason I tend to prefer ResMed but I still own a PR S1 760 machine. It's my travel machine. When I travel and use it...I feel just as good during the day as I do with the ResMed. Sleep quality is still good. In all honesty except for the slight difference in noise and baseline pressure ...if I didn't know which machine I was using I wouldn't be able to tell any difference in terms of sleep quality or how I feel during the day.

I don't numbers watch because for me it's a waste of time. I can feel like total crap with an AHI of 0.5 and feel great with an AHI of 3.0 or more...all depends on sleep quality unrelated to sleep apnea.
I glance at the numbers...AHI and leak and that's about it and certainly not every day unless I am experimenting on something. I might go months without using the software and I never bother with the LCD screen.

LSAT wrote:Unless a person has used both it's unlikely you will get a good comparison. There are a couple in that group

I don't think that anybody has used the current models of both!

The newest ResMed Airsense 10 Autos now have the option of Soft or Standard Auto algorithms.
Previously you had to purchase the ResMed Airsense 10 for Her Model to get the Soft Algorithm option.
From ResMed the For Her Algorithm was described as follows:
One of the most innovative features of the AirSense™ 10 AutoSet for Her is the algorithm developed for women and the manner in which OSA affects them. A standard algorithm responds after 3 flow limited breaths and will move up by as much as 3 cmwp. The For Her algorithm responds after just 1 flow limited breath and will move up by as much as 2.5 cmwp. If needed the algorithm setting can be changed to the standard AutoSetAutoSet™ algorithm version.

I think this would be a Plus to select the Resmed 10 Auto over the Dreamstation auto.

jtravel wrote:The newest ResMed Airsense 10 Autos now have the option of Soft or Standard Auto algorithms.

Do the older Airsense 10's update to the latest firmware over the cell connections? If not, can they be manually updated?

trslp1 wrote:

jtravel wrote:The newest ResMed Airsense 10 Autos now have the option of Soft or Standard Auto algorithms.

Do the older Airsense 10's update to the latest firmware over the cell connections? If not, can they be manually updated?

I have not heard of any of the older Airsense 10's being updated.
In theory Resmed could do it if the Memory chip in the older units have the Capacity for the extra Algorithm.

jtravel wrote: I have not heard of any of the older Airsense 10's being updated.
In theory Resmed could do it if the Memory chip in the older units have the Capacity for the extra Algorithm.

Mine is the AutoSet (37028) which is the same unit that has the later firmware. It doesn't appear that the same flashing new firmware process we take so for granted on our Android, iOS and other computer devices is supported by the cpap manufacturers.

Maybe some brave soul somewhere has done it and can tell us how to update our cpap's. When I called ResMet, they told me to take it to my DME and have them update it. My DME is Craigslist, so I am not expecting much help....