Still using an older APAP, but should I get a new one?

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Justin Case
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Still using an older APAP, but should I get a new one?

Post by Justin Case » Sun Jul 27, 2014 11:48 pm

My Remstar Respironics Pro Auto was replaced just before the 2 year warranty was up. I got the APAP back in 2004.

It doesn't seem that much has changed in CPAP technology or has it? For me, the hose and mask noise is one of the most problematic issues with CPAP therapy. My Pro isn't bad in these areas as long as I hide the machine under the bed, wear earplugs and have the air filter on for white noise. I use the Mirage Activa Nasal Mask and I have replaced it a few times over the years, I haven't tried any new masks since.

Over the years, the DMEs had me try the M series from Respironics. It was a major disaster when it came out. It was loud as heck. They also had me try the Autoset Spirit and it was a bit more noisy than the Respironics Pro. The DME looked at the results and said I did better with Respironics so I am leaning a bit more toward them.

I am not sure how secretive the industry is in terms of what's coming down the road with models and features replacing the older ones. I don't know what Resmed and Respironic's model lifecycle is. I am in no hurry, I can wait, unless my machine decides to crap out all of a sudden. Besides, I am in Canada and the CDN dollar has taken a big hit over the last few weeks so everything bought in the US is now 10% more expensive. If I bought Apple stock a month ago like I was told to, I wouldn't be concerned.

The three models I am currently leaning toward are Resmed PR 60 Series Auto, PR Auto CPAP and Respironics S9 AutoSet. I would like to go to my DME and rent each model but I fear they will hound me to buy from them but of course, I won't.
JC

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Re: Still using an older APAP, but should I get a new one?

Post by SandysSpot » Mon Jul 28, 2014 5:05 am

I've only got experience with the new machine I was given - ResMed S9 AutoSet and you don't hear it on at all. I showed it to my kids, sisters, etc - they're shocked they can't hear it run. I find it (in my *very* limited experience) very easy to care for, and to travel with even as mine came with a travel bag. Just got back last weekend from visiting family so I even got to experience that aspect.

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Re: Still using an older APAP, but should I get a new one?

Post by robysue » Mon Jul 28, 2014 6:39 am

Justin Case wrote:t
The three models I am currently leaning toward are Resmed PR 60 Series Auto, PR Auto CPAP and Respironics S9 AutoSet. I would like to go to my DME and rent each model but I fear they will hound me to buy from them but of course, I won't.
You are listing machines that where the maker and model do not match up.

Resmed PR 60 Series Auto?? Do you mean the PR System One REMStar 60 Series Auto CPAP Machine?

PR Auto PAP?? Do you mean the PR System One REMStar 60 Series Auto CPAP Machine?

Respironics S9 AutoSet??? Do you mean the S9 AutoSet CPAP Machine??


Both the PR System One Auto CPAP and the Resmed S9 AutoSet are top notch machines. Both are very quiet and both come with a full set of patient comfort features that may or may not be important to you.

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Re: Still using an older APAP, but should I get a new one?

Post by ChicagoGranny » Mon Jul 28, 2014 6:42 am

Certainly the three machines you are considering have improvements over the model you are currently using.

should I get a new one?
You failed to report some critical information.

- How effective is the therapy with the current machine and how good is your sleep in your judgment?

- How much of a problem would it be for you if you had a machine failure at an inopportune time? (The older the machine gets, the higher the probability of failure.)

- What is the cost to you of a new machine and how do you feel about spending that money?

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Re: Still using an older APAP, but should I get a new one?

Post by BlackSpinner » Mon Jul 28, 2014 8:34 am

2004? that makes it 10 years old for a machine that has an average life span of 5. Any night now it could roll over and die - probably on a friday night of a holiday weekend.

Get either the resmed S9 autoset or the Pr 60 auto - both are good and covered by Sleepyhead. That old clunker can become your back up/travel machine.


To buy them online check out clinicalsleep.com in Canada - when factoring in shipping from the usa (and you can NOT get the resmed shipped to canada form our host) the prices are about the same.

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Last edited by BlackSpinner on Mon Jul 28, 2014 3:33 pm, edited 1 time in total.
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Re: Still using an older APAP, but should I get a new one?

Post by archangle » Mon Jul 28, 2014 3:05 pm

Yes, get a new machine. If for no other reason than that the new ones record data you can use to check your therapy. The hardware and software in the machine has gotten much better, too.

The old one is old enough for reliability to be a concern.

Get the ResMed S9 AutoSet or PRS1 60 series Auto.

Be careful, that the DME doesn't try to fool you with one of the lesser models such as the S9 Escape Auto.

Read the links in my signature line for further info on pitfalls to avoid.

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Justin Case
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Re: Still using an older APAP, but should I get a new one?

Post by Justin Case » Mon Jul 28, 2014 9:43 pm

Thank you everyone for your replies, it is most appreciated!
robysue wrote: You are listing machines that where the maker and model do not match up.

Resmed PR 60 Series Auto?? Do you mean the PR System One REMStar 60 Series Auto CPAP Machine?

PR Auto PAP?? Do you mean the PR System One REMStar 60 Series Auto CPAP Machine?

Respironics S9 AutoSet??? Do you mean the S9 AutoSet CPAP Machine??

Both the PR System One Auto CPAP and the Resmed S9 AutoSet are top notch machines. Both are very quiet and both come with a full set of patient comfort features that may or may not be important to you.
My bad. I copied and pasted in the wrong spot. Nonetheless, the manufacturer really isn't important to me as long as the apparatus is reliable and there is a decent warranty with after warranty support. I also would like to continue to buy generic hoses too.
ChicagoGranny wrote: You failed to report some critical information.

- How effective is the therapy with the current machine and how good is your sleep in your judgment?

- How much of a problem would it be for you if you had a machine failure at an inopportune time? (The older the machine gets, the higher the probability of failure.)

- What is the cost to you of a new machine and how do you feel about spending that money?
How effective is my therapy? About as effective as it can be I suppose. Aside from mask noise when the pressure is at it's highest, I still have considerable sleep fragmentation; however, I don't believe it has anything to do with my cpap therapy. If anything, APAP helps reduce them. My Encore data consistently shows the most events during REM.

If the machine fails suddenly, I will be ok without it until I get a rental which is a few days at most.
BlackSpinner wrote:2004? that makes it 10 years old for a machine that has an average life span of 5. Any night now it could roll over and die - probably on a friday night of a holiday weekend.

Get either the resmed S9 autoset or the Pr 60 auto - both are good and covered by Sleepyhead. That old clunker can become your back up/travel machine.

To buy them online check out clinicalsleep.com in Canada - when factoring in shipping from the usa (and you can NOT get the resmed shipped to canada form our host) the prices are about the same.
My my machine was replaced once and at the three year mark, so it's 7 years old now.

Clinical Sleep Solutions (above link) is the DME I deal with; however, they do not sell online and they sell at full bloated DME prices. I don't plan to buy my APAP in Canada, rather in the USA so shipping to Canada won't be an issue. I wiill get the the APAP shipped via a mail redirect service from Cpap.com (or anyone else you kind folks might recommend).

I guess though that nobody knows then the lifecycle of the machines? I mean with a car, depending on the brand and model, it typicaly changes every 4 to 5 years. Additionally, the first generation, maybe second too, Respironics M series was plagued with noise issues until they fixed the problem; however, if memory serves me correctly, it was discontinued a year or two later.

Since the general consensus is to go with either PR System One Auto CPAP or the Resmed S9 AutoSet. What are the key benefits over one vs the other that you like over the other (assuming you tried both)?

I do like to go to the Clinician's menu and with Respironics, in the past it was easy. Not sure about Resmed. I also use the ramp feature quite a bit. One of my pet peeves with my Respironics is the clock is wrong and I don't know if it can be changed at all.

I do see in the specs the S9 is rated much lower than the PR. I might lead toward them. But I do like the availability of Encore software that I can use with the PR. I recall with Resmed, it was a PIA in as much you had to have tricky fingers to get into the Clinician's menu. It had more features available on the screen, but not as much detail as with with Encore pro viewer.

The thought crossed my mind to consider a bi-level machine too help with the leaks during peak pressure. Maybe renting each machine for a week or even a weekend to check things out; however, I know I will be pressured by my DME to buy one. I don't like that awkward feeling, if you know what I mean.

And finally does any one know how old are each of the above models?
JC

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Re: Still using an older APAP, but should I get a new one?

Post by hyperlexis » Tue Jul 29, 2014 12:05 am

Wait. The new ones are smaller, have better auto humidification and are quieter. Plus some have heated hoses. However is this worth the expense and other negatives?

The current two Cadillac machines (S9 and PR60) while slightly better, each have significant, nagging omissions, many of which have been discussed at length on this site -- i.e., the S9 doesn't have an audible leak alert, and the one on the PR60 is almost inaudible and not adjustable. The PR60 doesn't have a filter frame so filters pop out easily, and the S9 vents out the rear, with a fixed hose connection. The display on the S60 is small, black and white, doesn't show a backlight to see pressures while operating, and neither machine can easily, practically be given firmware updates or improvements to improve functionality. Neither machine has wifi or Bluetooth connectivity.

If you are doing well on the existing machine, can deal with the possible risk of needing a new machine (fed ex works great...) then I would wait. The next generation machines are long overdue and will likely add features and improvements worth waiting for.

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Re: Still using an older APAP, but should I get a new one?

Post by archangle » Tue Jul 29, 2014 2:32 am

hyperlexis wrote:If you are doing well on the existing machine, can deal with the possible risk of needing a new machine (fed ex works great...) then I would wait. The next generation machines are long overdue and will likely add features and improvements worth waiting for.
The next generation machines will probably "copy protect" the data and make it impossible for us users to read our data or change pressure settings. In order to protect us, of course. Coincidentally, that will probably generate extra revenue by making doctors and DME's sign up for "cloud based" services to allow them to control the machines.

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Re: Still using an older APAP, but should I get a new one?

Post by BlackSpinner » Tue Jul 29, 2014 8:32 am

http://www.clinicalsleep.com/

Join and login on the website. Nothing available unless you login. Lots of people buy from them.

Manuals are available online for every machine out there. If a brain dead techie can figure it out so can you. The latest PR system is not difficult - turn the knob, push the button, turn the knob......

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Re: Still using an older APAP, but should I get a new one?

Post by Hose_Head » Tue Jul 29, 2014 4:19 pm

BlackSpinner wrote:http://www.clinicalsleep.com/

Join and login on the website. Nothing available unless you login. Lots of people buy from them.

Manuals are available online for every machine out there. If a brain dead techie can figure it out so can you. The latest PR system is not difficult - turn the knob, push the button, turn the knob......
The OP is correct about Clinicalsleep's prices for xpap machines. You can almost buy two PR System One autos from cpap.com for what you would pay at clinical sleep.com. You just need to find a way to get them to deliver it.

Clinicalsleep's prices for supplies is competitive with US online suppliers. I've ordered masks from them numerous times. However, I see no reason to buy an xpap from them when machines are much cheaper from cpap.com.

Canada still needs one or more volume mail order houses for cpaps and supplies. Competition would do the market a lot of good.


To get back to the topic of the thread: it's time for a new xpap my friend. These things don't last forever. It's anybody's guess as to when new lines will be introduced by these manufacturers. And what is introduced could be a step backwards in some respect. Also, remember that like new car models, you probably want to avoid a first-year model. (example: early PR System One models had problems). Unless you really really really want to hold out for some new bell or whistle, you can't go wrong with what's available now.
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Re: Still using an older APAP, but should I get a new one?

Post by Justin Case » Tue Jul 29, 2014 11:39 pm

Very good additional points everyone. Thank you!

Clinical Sleep solutions was great in having me try loaner machines. The people there especially one of the owners, Cox is highly recommend for first time apnea sufferers.

The "new" advancement scares me somewhat in terms of tech. I was looking for "smarter" technology that would help lower my AHI which has always been in the low teens to high single digits. Too much pressure created centrals so it took a long time to find the "sweet spot". My new sleep doc at the time said just stay with the pressure I had 'tweaked". It wasn't perfect but it was a balance.

The last thing I want to be though is an early adopter with sleep therapy or for anything for that matter. I wanted a smarter, smaller and quieter machine. At the time, it was the M Series which appealed to me. Sadly, the experience was a disaster.

It is indeed quite plausible with new features (like software updates on other electronics such as phones) they fix old issues but also create new annoyances, and omissions. The definite killer for many would be if one can't monitor their own sleep data. Basic" user data is available on the screen menu of the newer xPAP machines which seems to be the norm now. However, my previous sleep doc wrote on my file that I micromanaged my sleep data when I told him about the software I had. He of course assumed incorrectly.

Finally, what is also holding me back on when to buy is in part the cost. If a new model is introduced in the near future (it does seem overdue) then the older models would [ideally) be reduced in price until completely discontinued. Nonetheless, my insurance company probably likes the fact I didn't jump on a new machine at the 5 year mark since that is when they will allow me to buy a new machine/cpap supplies.
JC

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Re: Still using an older APAP, but should I get a new one?

Post by Christine L » Wed Jul 30, 2014 7:41 am

y AHI which has always been in the low teens to high single digits. Too much pressure created centrals so it took a long time to find the "sweet spot".
Sounds like you are getting poor therapy. Does your doctor know what an ASV machine is?

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Re: Still using an older APAP, but should I get a new one?

Post by Drowsy Dancer » Wed Jul 30, 2014 7:47 am

archangle wrote:
hyperlexis wrote:If you are doing well on the existing machine, can deal with the possible risk of needing a new machine (fed ex works great...) then I would wait. The next generation machines are long overdue and will likely add features and improvements worth waiting for.
The next generation machines will probably "copy protect" the data and make it impossible for us users to read our data or change pressure settings. In order to protect us, of course. Coincidentally, that will probably generate extra revenue by making doctors and DME's sign up for "cloud based" services to allow them to control the machines.
Wait, what? Why are you saying this? Surely jedimark will be able to find a workaround?

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Re: Still using an older APAP, but should I get a new one?

Post by robysue » Wed Jul 30, 2014 8:20 am

Justin Case wrote:Since the general consensus is to go with either PR System One Auto CPAP or the Resmed S9 AutoSet. What are the key benefits over one vs the other that you like over the other (assuming you tried both)?
I wrote a very detailed comparison of the two machines a while back. You can find it at What's the Best APAP?
The last thing I want to be though is an early adopter with sleep therapy or for anything for that matter. I wanted a smarter, smaller and quieter machine. At the time, it was the M Series which appealed to me. Sadly, the experience was a disaster.
and
And finally does any one know how old are each of the above models?
The Resmed S9 has been on the market for four years. The PR System One Series 60 has been on the market for 2 or 2.5 years, and is really a "refreshed" and "updated" version of the PR System One Series 50 machines that came on the market around 2009. So you won't be an early adopter with either of these machines.
Additionally, the first generation, maybe second too, Respironics M series was plagued with noise issues until they fixed the problem; however, if memory serves me correctly, it was discontinued a year or two later.
Both the S9 and the System One are rated as "very quiet" machines. Both machines generate less than 30 dB of noise. (The S9 is technically quieter at 24 dB; the System One is rated at 29 as I recall) Most "noise" complaints these days are actually noises generated by the mask or the hose rather than the blower unit itself. Mask noises (mainly due to serious leaks) and hose noises (mainly due to rainout and/or magnifying the sound of your own breathing) can be issues with some people. But it is extremely important to understand that these noises are NOT coming from the blower unit. And that they can be addressed if they are a concern.
I guess though that nobody knows then the lifecycle of the machines? I mean with a car, depending on the brand and model, it typicaly changes every 4 to 5 years.
Expected life cycle of CPAPs is about 5 years. But many (like yours) continue working well past the 5 year mark.
I do see in the specs the S9 is rated much lower than the PR. I might lead toward them. But I do like the availability of Encore software that I can use with the PR. I recall with Resmed, it was a PIA in as much you had to have tricky fingers to get into the Clinician's menu. It had more features available on the screen, but not as much detail as with with Encore pro viewer.
Don't know what you mean by "the S9 is rated much lower than the PR"

If you are using an old version of Encore, it probably won't work with a brand new PR System One Series 60 machine. But links to the newest version of EncoreBasic can be communicated to you through a PM if you want to stick with Encore. Likewise, links to the newest version of ResScan (the official Resmed software) can be communicated to you through a PM. But both machines work well with SleepyHead, which is still in beta-testing, but is an impressive program written by our very own Jedimark.

I find Encore easier to use than ResScan. But SleepyHead is much easier than both Encore and ResScan.

And yes, the S9 has more info available on the machine's LCD. But that info is not as detailed as what you get in Encore, ResScan, or SleepyHead. The S9 also writes the detailed data directly to the SD card, so if you forget to reinsert the card, you loose the detailed data for the night. Also, the S9 overwrites some of the detailed data every seven days and all the detailed data every 30 days. So you must download data at least once a week if you want all your data preserved. The System One stores all the detailed data except for the Flow Rate data on-board and writes that detailed data back to the card when you re-insert it after using the machine without the SD card in place. And it doesn't periodically overwrite the data on the SD card.
The thought crossed my mind to consider a bi-level machine too help with the leaks during peak pressure. Maybe renting each machine for a week or even a weekend to check things out; however, I know I will be pressured by my DME to buy one. I don't like that awkward feeling, if you know what I mean.
Bi-level machines require a different prescription, at least here in the US. In other words, if your script says CPAP or APAP, you can't legally buy a bilevel from a DME here in the US.
I do like to go to the Clinician's menu and with Respironics, in the past it was easy. Not sure about Resmed. I also use the ramp feature quite a bit. One of my pet peeves with my Respironics is the clock is wrong and I don't know if it can be changed at all.
Clinician's menu on the PR System One is trivial to get into. The clinician's menu on the Resmed is also not hard to get into.

The Ramp is easier to use on the PR in my opinion: You hit the ramp button whenever you want the ramp to come on. And if you don't need the ramp, you just don't hit the button. On the Resmed, the ramp only comes on if you restart the machine. And there is no way to start the machine and bypass the ramp without going into a set up menu to turn the ramp off altogether.

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