Resmed's S8 AutoSet II CPAP Machine vs. Respironics M Series

Newbie here. Read the collective wisdom materials - wow! Thanks for making it easier to understand how cpap works.

I finished two session sleep center study and cpap visits and getting ready for delivery. My supplier - after some prodding agreed to provide auto cpap with humdifier and masks (will get to this later). My brother used them with good success and his cpap is older respironics unit. Now they are recommending the S8 AutoSet II CPAP Machine. I've read about C-flex vs EPR, etc. My sleep center doc said I have severe apnea, index 51, oxygen down to 79% - but after sleeping with mask/cpap for 5 hrs, no episodes and oxygen up to 98%....good news.

It appears the new Resmed machine now has EPR function working in auto mode - my doc said i don't need any of this and a pressure of 8-9 is sufficient for me. And supplier doesn't recommend respironics anymore? How do you all feel about S8 AutoSet II CPAP Machine?

Re mask - sleep center gave me the respironics comfortgel nasal mask - it was the same i used for my test and i don't have any 'major' problems. Also asked supplier to provide smaller nasal mask and nasal pillow to try and see which one works better since I tend to sleep on side and also have dry eyes.

Newbie-becoming-cadet here. Welcome!

I have the Autoset II and I love it. From what I see, a lot of people on here have the Respironics which is a fine machine as well. Occasionally I see someone with a Sandman, GoodKnight, etc.

As far as I know, and I could be wrong, EPR on ResMed is the equivalent of C-Flex (A-Flex) on Respironics machines. Basically, it is an exhale relief system that drops the pressure on exhale to make it easier to breathe. From what I can tell, it has little to no bearing on the effectiveness of the therapy itself. It's simply for comfort.

Your pressure is on the lower side, but some people with lower pressures need it, some don't, etc. If you find that you are having trouble exhaling, you may want to ask to see if you can turn it on. It's really no biggie to do.

Veterans, correct me at will!

Buy American! Keep your dollars in this country!

tattooyu wrote:Newbie-becoming-cadet here. Welcome!

I have the Autoset II and I love it. From what I see, a lot of people on here have the Respironics which is a fine machine as well. Occasionally I see someone with a Sandman, GoodKnight, etc.

As far as I know, and I could be wrong, EPR on ResMed is the equivalent of C-Flex (A-Flex) on Respironics machines. Basically, it is an exhale relief system that drops the pressure on exhale to make it easier to breathe. From what I can tell, it has little to no bearing on the effectiveness of the therapy itself. It's simply for comfort.

Your pressure is on the lower side, but some people with lower pressures need it, some don't, etc. If you find that you are having trouble exhaling, you may want to ask to see if you can turn it on. It's really no biggie to do.

Veterans, correct me at will!

Comparing CFlex with EPR isn't an equal comparison. The EPR feature adds a mini bilevel to the CPAP. It allows for an inhale pressure (the pressure the machine is set to) and an exhale pressure that can be 1 2 or 3 CMs below the main set pressure (Inhale). This relief lasts for the full exhale cycle, similar to the way a bilevel works. If the machine detects OSA events or a 'no-flow' situation (like a central) it suspends EPR & reverts back to the main inhale pressure.

CFlex provides an undetermined (in that the docs don't spell out how much CMs it drops by ) dip in pressure, momentarily, at the start of the exhale cycle. CFlex was one of the 1st exhale relief add-ons for cpaps EPR is a recent add-on. CFlex was very popular - more recently Respironics has added AFlex which is a bit more like EPR.

DSM

Hey! Guest! Where you been? Resmed is now headquartered in Poway, California! Adn w/all the "outsourcing" who the devil knows what is "really" American made thru and thru, ALL American made?? (Besides Philips just bought Respironics and Philips is an Dutch company).

dtsm wrote:My sleep center doc said I have severe apnea, index 51, oxygen down to 79% - but after sleeping with mask/cpap for 5 hrs, no episodes and oxygen up to 98%....good news.

This is my situation exactly. I start next week with an Elite II. I hope I have results similar to yours. Seeing all these newbie people post these good numbers is making me feel somewhat optimistic about what lies ahead.

I like that.

ThomasMcKean wrote:

dtsm wrote:My sleep center doc said I have severe apnea, index 51, oxygen down to 79% - but after sleeping with mask/cpap for 5 hrs, no episodes and oxygen up to 98%....good news.

This is my situation exactly. I start next week with an Elite II. I hope I have results similar to yours. Seeing all these newbie people post these good numbers is making me feel somewhat optimistic about what lies ahead.

I like that.

They can't deliver until Friday so I might take half day off and go over on Mon or Tues to start earlier....right now I find myself waking myself up with the snoring!

New here also.

See my sig.

Not really familiar with the S8 AutoSet II, as I had a much older Resmed machine, but when it came time to replace it, I tested it and the Respironics M series.

I'll not knock anyone's choices...just understand, all CPAP machines do basically the same job...if you have a choice make sure you choose the best one for you, and even then, after a few months or years of use you may change your mind about "best".

After 8+ years on this therapy I'm still not sure about "best"...I just know what is acceptable.

EPR
http://www.resmed.com/en-us/products/fl ... =products2
When a Resmed suspends EPR, it will suply the same pressure for inhale and exhale - that is - according to Resmed, it will revert to set pressure CPAP. That will never happen on a Bi-Level.

Comfort without compromise
To ensure comfort without compromising therapy, EPR has an automatic time-out feature. After determining the baseline breathing average for each patient, the device suspends EPR if the patient’s breathing drops 75% below the baseline for 10 seconds or more. EPR restarts when the event is over and breathing is again within range.

Resmed's series II machine have EPR with EasyBreathe: http://www.resmed.com/en-us/assets/docu ... sa-eng.pdf

I remember Rested Gal reporting that EPR felt very abrupt to her. I believe the EasyBreathe technology solves that problem.

C-Flex and A-Flex cflex.respironics.com and aflex.respironics.com

C-Flex Pressure Relief Technology

C-Flex pressure relief technology makes sleep therapy more comfortable by reducing pressure at the beginning of exhalation and returning to therapeutic pressure just before inhalation. The level of pressure relief varies based on the patient’s expiratory flow and which of the three C-Flex settings has been selected.

A-Flex Pressure Relief Technology
As you can see, A-Flex starts supplying pressure relief at the end of the inhale, before you start ehxhaling.

dtsm wrote: It appears the new Resmed machine now has EPR function working in auto mode - my doc said i don't need any of this and a pressure of 8-9 is sufficient for me. And supplier doesn't recommend respironics anymore? How do you all feel about S8 AutoSet II CPAP Machine?

The answer which is better: Resmeds AutoSet II vs Respironics M Series APAP with A-Flex? The answer usually is "Which one do I own?".

They're both great machines. They both have loyal followers. The Resmeds looks A LOT cooler. I think the Respironics, all stuff included, for me was cheaper. I liked the reports better, but the main thing was price. If I wasn't a computer geek that knew that whatever I owned I would be getting the software for it, I might have spent a bit more for Resmeds so I could see my nightly data every morning on the LCD...

dsm wrote: Comparing CFlex with EPR isn't an equal comparison. The EPR feature adds a mini bilevel to the CPAP. It allows for an inhale pressure (the pressure the machine is set to) and an exhale pressure that can be 1 2 or 3 CMs below the main set pressure (Inhale). This relief lasts for the full exhale cycle, similar to the way a bilevel works. If the machine detects OSA events or a 'no-flow' situation (like a central) it suspends EPR & reverts back to the main inhale pressure.

CFlex provides an undetermined (in that the docs don't spell out how much CMs it drops by ) dip in pressure, momentarily, at the start of the exhale cycle. CFlex was one of the 1st exhale relief add-ons for cpaps EPR is a recent add-on. CFlex was very popular - more recently Respironics has added AFlex which is a bit more like EPR.

DSM

I guess I would have to try EPR, but I assumed they are the same. I just know with C-Flex exhaling is like not being hooked to a CPAP. C-Flex has a 1,2,3 setting which I assumed was 1 2 or 3 CMs, but when I set mine to 1 I feel like I'm getting a whole lot more than 1 CM relief so I guess you're right.

I used A-Flex at first and they both seemed to act the same. I think I'll try it again now that I'm more acclimated to the whole experience...

dsm wrote:

tattooyu wrote:Newbie-becoming-cadet here. Welcome!

I have the Autoset II and I love it. From what I see, a lot of people on here have the Respironics which is a fine machine as well. Occasionally I see someone with a Sandman, GoodKnight, etc.

As far as I know, and I could be wrong, EPR on ResMed is the equivalent of C-Flex (A-Flex) on Respironics machines. Basically, it is an exhale relief system that drops the pressure on exhale to make it easier to breathe. From what I can tell, it has little to no bearing on the effectiveness of the therapy itself. It's simply for comfort.

Your pressure is on the lower side, but some people with lower pressures need it, some don't, etc. If you find that you are having trouble exhaling, you may want to ask to see if you can turn it on. It's really no biggie to do.

Veterans, correct me at will!

Comparing CFlex with EPR isn't an equal comparison. The EPR feature adds a mini bilevel to the CPAP. It allows for an inhale pressure (the pressure the machine is set to) and an exhale pressure that can be 1 2 or 3 CMs below the main set pressure (Inhale). This relief lasts for the full exhale cycle, similar to the way a bilevel works. If the machine detects OSA events or a 'no-flow' situation (like a central) it suspends EPR & reverts back to the main inhale pressure.

DSM

Can you clarify - are you saying EPR works 'better' than C-flex? I thought the prevailing wisdom (from the wisdom section) was that EPR followed Respironic's C-flex but still not as good?

I've only used the Resmed, but from reading the boards, the one that is better is the one that is better for YOU. If you look at the details, the Resmed EPR may reduce the pressure for a longer period of the exhale than A-flex or C-flex. If you really need that pressure relief, that would be good. If you don't and it allows your airway to partially close down, it would be bad. If EPR feels too abrupt, it would be bad, if it feels like a relief, it would be good. It is really going to depend on what you need, and many people may not feel any difference at all.

With my Autoset II, I can feel a distinct reduction of pressure with EPR set at 2. It seems to follow my breath easily, and my breath on it feels very natural, much easier than the CPAP at the sleep center, even though it has been running at higher than my titrated pressure. My AI is running consistently below 1, and the HI keeps going down as I creep my bottom pressure up. It runs so quietly I can't hear the machine run at all. So, it works. For me.

I also find C-Flex to be more comfortable than CPAP, to the point that the air pressure sensation is not really an issue for compliance.

Something else to consider, aside from comfort: my Respironics C-Flex was damaged by a humidifier water spill, probably due to one of my children getting tangled in the tube and jerking it. The CPAP device electronics appear to be well exposed to a water spill: there is a gap for wires at the bottom of the water contained receiving chamber. There are warnings about this but the design seems flawed to me if damage is so easily caused. I looks like my health insurance won't pay for a damaged machine, so I'll probably have to pay. (I'm going to see about home owner's insurance.) In any case, for this reason, I'm going to try ResMed Autoset. It was a ResMed device of some kind that was given to me for a home sleep study to diagnose sleep apnea, and I remember it was quite comfortable. The machine appears to be better isolated from a water spill in that the only entry point for water appears to be the air tube.

Look at the issue of comfort in this way. If several hundred persons were rotated between devices for a few days trial on each with no knowledge of which machine they were using, and were asked to rate comfort, most likely one device would come out ahead. But I doubt either device would be a clear winner, such that, say, 90% of people preferred one over the other. Even if it were 75% vs 25%, which seems unlikely, you wouldn't know for yourself unless you tried them both. Unfortunately, this is too expensive to do for everyone.

Actually, what I said was the EPR felt resistant to me, not abrupt. The resistance was at the beginning of each exhalation. At the beginning is where I want exhalation relief to give its most drop, to make it feel easy to get my exhalation started.

C-Flex gives its most drop at the beginning of exhalation -- feels easier to me at the start of each exhalation.
EPR gives its most drop as the exhalation continues -- feels like no exhalation relief to me since there was no noticeable "give" at the very start of each exhalation.

At high pressures C-Flex's design (which is to always let the regular pressure back in before the exhalation is finished) feels abrupt to me. Tthankfully, moderate pressures do fine for me.
At high pressures, despite the feeling of resistance at the beginning of exhaling, EPR feels better to me since EPR's greatest lowering of the pressure happens after the start and doesn't raise the pressure until a person begins to inhale again (or until after about 15 seconds have gone by if the person hasn't already started to inhale again.)

Everyone's experience and impression of the comfort (or lack thereof) of either of those features can be different.

As riverdreamer said:
"the one that is better is the one that is better for YOU."