PR vs ResMed, any observations?

[Captain_Midnight]

Hi all!

Occasional visitor Capt Midnight here, with a question that some of the experienced xpappian veterans might be able to answer.

Do you have any comparisons and contrasts between the PR-1 and Airsense 10 APAP machines?

For some background, I've been a happy Respironics, then PR-1 papper since 2005, w most recent machine a PR-1 apap. Now, a patient ready for a new machine, and now a Medicare patient (some positive and some...ugh to say about Medicare), I'm told that my latest replacement machine will be an Airsense 10. I was not provided with a choice!

I would love to hear from apneic patients who have used both PR1 and ResMed10, as those comparisons and contrasts could be quite useful to me.

Thanks in advance! - - Capt Midnight

[Pugsy]

I have owned both brands in various models and just recently acquired the AirSense 10 AutoSet for Her.
Started cpap therapy in 2009 with the M Series Respironics APAP and when the PR S1 models came out I had to have one.
Spent some time with various bilevels in both brands and now have come back to the AirSense 10 AutoSet for Her.

What do you want to know about them?

The algorithm in apap mode is different (and I am not talking about the for her special apap mode but the regular mode..which I have tried along with the special for Her mode).
ResMed's algorithm is a bit more aggressive meaning that it will increase and decrease the pressure a little faster than the Respironics apap algorithm. Pros and cons to either I suppose but most people would do well with either way of doing things. They both have the same goals but just take a slightly different path getting there.

I think the ResMed is maybe slightly less noisy but ever so slightly because my S1 machines were all fairly silent...at least to me and my husband.

I like EPR better the Flex exhale relief but that is just me. Again they both offer relief but go about it a little differently.

I actually prefer the ResMed over the Respironics but it is an ever so slightly preference over the Respironics. I used Respironics for years and still own a PR S1 BiPAP Auto.

[Captain_Midnight]

I have owned both brands in various models and just recently acquired the AirSense 10 AutoSet for Her.
Started cpap therapy in 2009 with the M Series Respironics APAP and when the PR S1 models came out I had to have one.
Spent some time with various bilevels in both brands and now have come back to the AirSense 10 AutoSet for Her.

What do you want to know about them?

The algorithm in apap mode is different (and I am not talking about the for her special apap mode but the regular mode..which I have tried along with the special for Her mode).
ResMed's algorithm is a bit more aggressive meaning that it will increase and decrease the pressure a little faster than the Respironics apap algorithm. Pros and cons to either I suppose but most people would do well with either way of doing things. They both have the same goals but just take a slightly different path getting there.

I think the ResMed is maybe slightly less noisy but ever so slightly because my S1 machines were all fairly silent...at least to me and my husband.

I like EPR better the Flex exhale relief but that is just me. Again they both offer relief but go about it a little differently.

I actually prefer the ResMed over the Respironics but it is an ever so slightly preference over the Respironics. I used Respironics for years and still own a PR S1 BiPAP Auto.

Thanks, muchly, Pugsy for the informed and comprehensive response. I'm looking forward to the -10.


.

[Granddaddy]

now a Medicare patient (some positive and some...ugh to say about Medicare), I'm told that my latest replacement machine will be an Airsense 10. I was not provided with a choice!

You need to take your business to another provider now or you will have more trouble later.

When I went on Medicare I called a couple DME's to ask if they would provide the equipment I wanted, they said they could. When they got the order and all they needed from the doc & sleep center suddenly they said the order didn't specify Respironics but hey it didn't specify Resmed either. So we went back n forth trying to get the order to what they would accept when they (AHP) called (4 weeks later) to say it was a go and they would now order a Respironics for me by this time a month had already passed.

During the very first call to AHP I had told them to put it in my record that under no circumstances would I accept anything but a Respironics since all the supplies and the DC power cord I have are for a Respironics I will not accept anything else. So why it changed is beyond me (they obviously lied) but why all the extra work for all involved which was not needed.

They all try to wear you down to where you will accept anything but I did tell them I am not new to this, I already have equipment and this is what I want.

So after AHP called I took all my paperwork to another provider who I didnt want to do business with but told them the problem and delay I was having and told them if they could get me what I wanted before the other came in I would buy from them. It took another week as they just do not accept the paperwork you hand deliver to them and want (or need) to get it directly from the sleep center and/or doctor but they got it and I took delivery, tho they made me come pick it up and I now understand that for Medicare they are supposed to deliver it to the home.

Then FFWD another month when I get a call from AHP to tell me my equipment is in and they want me to come pick it up. Oh well, I told them I already have my equipment so didn't need it any longer. They asked where I got it from to which I said it doesn't matter. But I did ask if they would provide the supplies. She put me on hold and came back with a yes that is OK (well since they already had ALL of the needed paperwork, right) <smile>.

So AHP provided the Medicare supplies for equipment I got from another DME until I found out on this forum that there was a mail-order Medicare supplier available. So now AHP calls everytime my supplies are due to be ordered - don't think they are sposed to do that either.

So in summary, think about all of the supplies you have on hand, what will happen with those not to mention the outrageous price Resmed charges for the DC power cord and the troubles you are certain to have with a DME who likes to boss you around - your call.

Believe me - there are plenty of Medicare providers out there.

HTH

[palerider]

I have owned both brands in various models and just recently acquired the AirSense 10 AutoSet for Her.
Started cpap therapy in 2009 with the M Series Respironics APAP and when the PR S1 models came out I had to have one.
Spent some time with various bilevels in both brands and now have come back to the AirSense 10 AutoSet for Her.

What do you want to know about them?

The algorithm in apap mode is different (and I am not talking about the for her special apap mode but the regular mode..which I have tried along with the special for Her mode).
ResMed's algorithm is a bit more aggressive meaning that it will increase and decrease the pressure a little faster than the Respironics apap algorithm. Pros and cons to either I suppose but most people would do well with either way of doing things. They both have the same goals but just take a slightly different path getting there.

I think the ResMed is maybe slightly less noisy but ever so slightly because my S1 machines were all fairly silent...at least to me and my husband.

I like EPR better the Flex exhale relief but that is just me. Again they both offer relief but go about it a little differently.

I actually prefer the ResMed over the Respironics but it is an ever so slightly preference over the Respironics. I used Respironics for years and still own a PR S1 BiPAP Auto.

Thanks, muchly, Pugsy for the informed and comprehensive response. I'm looking forward to the -10..

To add to what Pugsy said about the Resmed being faster, it's also more responsive to needs, if you look at a lot of the sleepyhead posts from both kinds of machines, you'll see that there's often long periods of time where the respironics doesn't change pressure, even if there are some apneas and hypopneas.... and the pressure jumps by half cm steps most (if not all) of the time... whereas resmed adjusts much more often, and in finer increments. It's more responsive to your needs

[Gerald?]

Hi I moved from the PR S1 to the Airsense 10 Autoset for Her about 2 months ago. Happily used my PR S1 for 7 years. There is nothing wrong with my PR S1, I just wanted to get a new machine in case something went wrong and so I could have a back-up. I did look at the Dreamstation (new Respironics) but at the time I was buying, Resmed offered a $250 rebate that made it too hard to pass up.

I find it very comfortable and did not notice any difference in the way it deals with exhale relief. However, I do find that the Resmed moves up to higher pressures more quickly.
I went from a normal hose to the heated hose just using the auto settings. I have not noticed any real difference but it is very temperate and humid where I live.

My daily AHI is a little better with the Resmed. With the PR S1 it would average around 2-3 per night. With the Resmed it is averaging around 0.5 per night. I'm male but I have been using the "for her" algorithm and it seems to work well.
I can't really tell if that means I am getting better therapy or if Resmed just measures differently. It might be as Pugsy and palerider said, I am getting the benefits of it responding more quickly. I don't feel any better or worse.

A few differences:
1. I miss the dry box technology of the PR S1 in the humidifier. The Resmed tends to leak on my nightstand when you open it. It is not from the bottom, I think it is from water on the lid when you lift it to 90 degrees.

2. When you hit the off button in the morning, the PR S1 used to expel a last amount of air winding down comfortably. The Resmed stops instantly before you can get the mask out, almost to the point that it feels like it is sucking the air back. Not a big deal, just different. I might try taking it off and let the auto shut off do its job.

3. I have my machine about a foot off the ground just in case of rain out (although I've never had a problem). I find that the screen on the Resmed is much harder to read in this position (it is almost vertical) than the Respironics which was on top of the device. I have to get out of bed and on my knees to read it (my wife was worried something was wrong because I had started "praying" every morning).

4. For a similar reason I find it harder to take out and put back the humidifier. With the PR S1 I could open the lid put the chamber in and close it pretty much with one hand. Because of the Resmed design where you have to push in the clips and then pull out, it definitely takes two hands. Same for putting it back. Also at this point I don't get the same satisfied feeling of it being locked into place like you do with the PR S1. I probably will with time.

5. The PR S1 has a much smaller and I think better designed travel bag than the Resmed. The Resmed one is very bulky presumably because it has more padding. The PR S1 case will fit inside my carry on suitcase comfortably so it is going to be my travel machine now.

6. I like that the Resmed can remotely download new software now, although again has not happened yet.

These are all very minor differences. Very happy with machine.

[Pugsy]

To add a little more information to what PR said about the responsiveness.
I am using less pressure with the ResMed APAP than I would be needing to use with the Respironics APAP to attain pretty much the same results in terms of AHI numbers.

With the Respironics I would have to use a minimum of 10 cm or I would get some pretty nasty clustering of OAs in what was probably REM sleep since that is where my OSA is worse and where I seem to need the higher pressures sometimes.
When using Respironics APAP I used minimum of 10 with AFlex at 2.

While I had no problems with the 10 minimum and the flex drop of about 1.5 (flex won't ever drop more than 2 cm even with the setting of 3)...it's pretty sweet to be able to use 7 inhale and 4 exhale and get the job done.
I think in the past few weeks I have had maybe one or two nights where I saw a potentially small ugly REM cluster and I am not going to worry about them when/if they happen. Yeah, I could increase the minimum and kill them off early but they show up so rarely and they are nothing like what I had in terms of ugliness and density of OAs with the Respironics at 8 cm minimum (which is where I started my titration when I got my machine) that I have elected to just ignore them at this stage of things. They don't affect my sleep quality or how I feel.

This is why I will suggest ResMed APAP for DIYers if at all possible. We don't know what pressures might be needed and let's face it...lower is more comfortable.

[Pugsy]

Respironics pressure probes are far from "blasts of air" and they certainly aren't nearly as rapid as the graphs make it look like they are.
They are a 1.5 cm (when using apap and 2.5 when using bilevel) increases over several minutes and decreases over several minutes and 1.5 or 2.5 cm doesn't qualify as a "blast of air" in any normal person's book.

[Pugsy]

my resmed seems to send random blasts at 25

Yes of course it does. You are using an ASV machine and it is a totally different machine from what the OP in this thread has been using and will be getting.
You can't compare your ASV and how it does things to an apap/cpap machine and how it does things.

[Captain_Midnight]

color=#FF40FF]Thanks so much to Pugsy, Granddaddy, PR, and G?.
I do have a couple of additional questions for you experts.

1. For the PR-1, I’m able to use encore basic; and it gives me quite a bit of excellent feedback info.
Does something similar exist for the Airsense 10? (Yes, I do know about “sleepyhead” and I respect that it gets some stellar reviews hereabouts. My issue is that it does not seem to work well with my pc.)

2. And, while I’m asking questions, might there be a link for a “professionals’ handbook”, or whatever it might be called, so I might make a few prudent adjustments to my therapeutic pressures, over time?
Again, my thanks to y’all!

[Pugsy]

Here's the provider/clinical manual
https://sleep.tnet.com/home/files/resme ... -guide.pdf

ResScan is ResMed's official software like Encore is from Respironics.
If you go over to the apneaboard forum
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
and register and log in you can find the instructions for requesting ResScan via email.
Here's a video tutorial. A bit old but the basics are the same no matter which version of ResScan.
http://montfordhouse.com/cpap/resscan_tutorial/

[Captain_Midnight]

Thanks again Pugsy!

You da chick!

.

[Pugsy]

i said they all had their own methods of determining central vs obstructive apnea

Your "blasts" to 25 have nothing to do with determining central vs obstructive. The "blast" is simply the machine breathing for you ..that's what ASV machines do.

For determining central vs obstructive the ResMed machines use the FOT technology and it certainly isn't a "blast" to 25.
Respironics machines use what they call pressure pulses and they aren't anywhere near 25 either. In fact they don't even show up as a pressure increase on the pressure line graph.

Determining event status isn't the same thing as treating the event.
Your "blasts" have nothing to do with determining central vs obstructive and everything to do with treating your central apnea issues.