DME ordering Respironics PR One - is this a good machine?

Zzzer wrote: Now ... ResMed S9 or Respironics 460 ??? I

Which S9? Remember the model names.
Elite is like the PR S1 460.
Any S9 with Escape in the name is either a total brick or has such limited data available as it is pretty much a brick.

There are 4 S9 ResMed machine models in the cpap/apap line.
S9 Escape...hours of use only...a brick
S9 Escape Auto...hours of use and gross AHI only...not much better than a brick

S9 Elite..straight CPAP and full efficacy data
S9 AutoSet ...cpap and apap modes available so like 2 machines in one.

Before the 60 series with their heated hose option I would tell you the S9 machine with their heated hose was probably the better choice but now it's really a toss up. Minor pros and cons with either.
At least with the 460 machine there is limited APAP mode availability...I think it is limited to 30 days and can be reset to give an additional 30 days 5 times...so 150 days available in apap trial mode.
So between the S9 Elite and the PR S1 460 machine....I would go with the 460.

just a word--you may want to call the first DME back and make sure they cancel the order and billing with your insurance company. i read a post here about someone who switched DME's and their CPAP got hung up in cyberspace because both companies were trying to bill for it..............

Zzer,

Resmed S9 is a family of machines, so the specific model name is important.

The "elite" is a data capable CPAP machine, it cannot be used in APAP mode to autotitrate in the future when your needs change.
The "Autoset" is tghe resmed APAP and can be used in Auto adjusting CPAP mode or fixed pressure CPAP mode.

Dont accept the "escape". The name of the machine is located next to the power button.

Zzzer wrote:I just got off the line with Apria and they told me that they would provide either the ResMed S9 OR the Respironics 460.

If you go with the ResMed S9 make double sure that the machine model does NOT have the word "Escape" in it.

The Resmed S9 Escape is a basic brick that records nothing but compliance data.

The Resmed S9 Auto Escape is a dumbed down Auto that does not record leak data and it only records the most basic of the AHI data---it does not break the AHI down into separate types for example.

just a question: due to ability to change pressure if needed in future to low and high range, and get full data, why wouldnt OP ask for ResMed S9 Autoset or PR System One 560??
hopefully OP isnt getting overwhelmed with all of this model stuff. if you do, just come back to it later and reread IMHO: it gets pretty technical

Wow ... This is harder than shopping for a new car.

I was told they offer the S9 Elite

As far as "auto" I think my Rx is for a specific number (7) since this is what came out of my 2nd sleep study using CPAP. So, do I need an "auto"? The lady at the (2nd) DME said the Rx would probably just specify CPAP set at 7.

remember the sleep study is just a window in time. you or your doctor may find you need a different pressure or a range of pressure to "kill" the apneas or hypopneas. or, your needs may change. the machines that do auto as well as straight CPAP setting just give you more options for the future. BTW, loved your comment about buying a new car!!! gotta keep a sense of humor through all this

Zzer,

I've got the Philips Respironics System One "Pro" model 460. It is a great machine, and I'm someone who likes straight CPAP and only using a few days of the limited "Auto-Trial" for when I'm trying a new mask, then letting the machine set a good CPAP level and check it every 4 or 5 nights ("CPAP-Check" mode). Nobody else has a CPAP with that feature. Most people on this forum want the 550 or 560 since it allows unlimited time in "Auto" mode, and they can be set to CPAP too. Is your 460 coming with the humidifier that accepts the heated hose, and is it coming with the heated hose? In other words, is Apria offering that "full option loaded" model, or your other DME which said you could get a "Pro," was that with the heated hose humidifier and the actual heated hose too? I ask because model 460 can also come with a humidifier which does not work with the heated hose (it can be later converted if you buy the $75 special lid, and then you can by the $50 heated hose -- you can see why it is good to ask, as the amounts add up).

If you prefer S9, then as mentioned by others, above: finding out which S9 will be important, as you should get at least the Elite to be able to show data. As they say above, the S9 Elite can't give you anything but straight CPAP pressure. Would they be giving you heated hose with that? I don't know if there are ways to sell the S9 machines without heated hose, but if there is then assume the provider will find a way to maximize profit.

I think the Elite shows more data on the display screen, but if you intend to use software that isn't a deal breaker with the Philips Respironics 460 (which won't give real leak numbers, and won't show decimal places below 1.0 AHI on its display screen, but will give you everything in detail if you use computer software).


--SleepyCPAP

Thanks everyone.

The way I understand it, my doc would have to prescribe an Auto, otherwise I'm going to get a straight CPAP. This from speaking with the (DME) associate, who was very helpful and made clear this was just her opinion, not for certain.

Based on all the feedback above, the Auto seems to make sense, but if I can only get my insurer to pay for what's on the Rx, I may have to take the straight CPAP.

If you get a straight CPAP, i would make SURE to at least get one that is data capable per the posts above. You wont be sorry. Remember, Apria is in it for profit just like your other DME. Some also keep the patient in mind; some dont.

The System One 60-SeriesSE is the newest brick introduced by Philips Respironics.

It has four buttons and a 3-digit LED display instead of the knob, ramp button
and large LCD display that the other S1s have. It works with the Same 60-series
humidifier as the other 60-Series machines.

Curiously, it is listed as having "Flex Technology" without specifically calling it
"C-Flex". Not quite sure why.

Here's a link to PR's site:
http://www.healthcare.philips.com/us_en ... efault.wpd

Well actually a DME can supply an APAP machine with a cpap fixed pressure if they would just be willing to do it.
An APAP mode machine is a cpap machine with auto adjusting pressure capabilities but it also has a fixed pressure cpap mode available and the DME simply has to set it to cpap mode at the prescribed pressure and the RX requirements have been met.
Insurance companies typically pay by HCPCS billing code and the HCPCS billing code is exactly the same for either the S9 Elite or the S9 Autoset or the PR S1 460 or 560.
DMEs use the old "RX" excuse to again offer a machine that costs just a little less (the APAP mode capable machines do cost a little more) so that their bottom line profit margin is a little better.

There are some DMEs who routine offer APAP machines as standard procedure. Wulfman just mentioned one he talked to the other day in Cody, Wyoming.
So it can be done with a fixed pressure on the RX...all they need to do is set the machine to cpap mode.

There are some situations where some people might do better with auto adjusting pressures than with fixed pressures but that doesn't mean that someone who only has a cpap mode fixed pressure machine can't get good therapy even if they do happen to have situations where pressure needs vary during the night.
The 2 most common situations where sometimes variable pressures are of benefit...sometimes pressure needs increase when supine sleeping and sometimes pressure needs increase during REM stage sleep. I happen to be one of those people who sometimes needs higher pressures in REM stage sleep...not all the time but 2 or 3 times a week I see my machine increase pressures significantly for short periods of time during the night. Just last week I topped out at 20 cm which is about 8 cm more than I usually might see.
I could still use a fixed pressure machine but I would have to make some compromises...either use higher pressures all night long or use lower pressures and just let those few times that I might have needed more pressure just slide and accept a few extra apnea events during those times.

Finally...apap mode isn't for everyone anyway. Some people find that the variable pressures actually are a disturbing factor to their sleep or maybe the higher pressure causes aerophagia so maybe they don't want to use apap mode.

It is nice to have apap mode available though...just in case because a person can always use the APAP machine in cpap mode if they won't to...the cpap fixed pressure machine can't be used in a mode that it doesn't have.

Zzzer wrote:Thanks everyone.

The way I understand it, my doc would have to prescribe an Auto, otherwise I'm going to get a straight CPAP. This from speaking with the (DME) associate, who was very helpful and made clear this was just her opinion, not for certain.

Based on all the feedback above, the Auto seems to make sense, but if I can only get my insurer to pay for what's on the Rx, I may have to take the straight CPAP.

There's NOTHING wrong with a straight CPAP machine, as long as it's fully data-capable.
These forum pages have numerous experiences from people who got Auto/APAP machines and couldn't get decent sleep with them because they ran them in ranges of pressure. The pressure changes can bump the users out of their needed sleep stages and further disrupt their sleep, consequently leaving them feeling unrested. Another problem with APAPs (and varying pressures) is they can create more mask leakage.......which can lead to more sleep disruption.

I have no problem with people buying APAPs (I own four of them), but they need to realize that they have limitations along with their advantages.


Den

.

Wulfman... wrote: There's NOTHING wrong with a straight CPAP machine, as long as it's fully data-capable.
These forum pages have numerous experiences from people who got Auto/APAP machines and couldn't get decent sleep with them because they ran them in ranges of pressure. The pressure changes can bump the users out of their needed sleep stages and further disrupt their sleep, consequently leaving them feeling unrested. Another problem with APAPs (and varying pressures) is they can create more mask leakage.......which can lead to more sleep disruption.

I have no problem with people buying APAPs (I own four of them), but they need to realize that they have limitations along with their advantages.


Den

.

That's really, REALLY, bad advice. If the Auto APAP machine pressure changes make you uncomfortable, you can reduce the pressure range. You can even set the APAP machine to run in manual CPAP mode and it will work exactly the same as a manual CPAP machine.


Zzzer,

Getting the data capable CPAP vs. the PRS1 SE model is a very big improvement. S9 Elite vs. PRS1 460/Pro is sort of a tossup, but people tend to like their S9s and find them more comfortable.

Be sure you really get the machine you've been promised. The S9 will say "Elite" near the power button. Be sure it's not "Escape," you wouldn't be the first victim of the old switcheroo.

The PRS1 will say REMStar PRO blahblah near the display. Make sure it doesn't say "REMstar Plus." Or take out the water tank first, and check the bottom of the blower for 460 somewhere on the bottom label.

archangle wrote:

Wulfman... wrote: There's NOTHING wrong with a straight CPAP machine, as long as it's fully data-capable.
These forum pages have numerous experiences from people who got Auto/APAP machines and couldn't get decent sleep with them because they ran them in ranges of pressure. The pressure changes can bump the users out of their needed sleep stages and further disrupt their sleep, consequently leaving them feeling unrested. Another problem with APAPs (and varying pressures) is they can create more mask leakage.......which can lead to more sleep disruption.

I have no problem with people buying APAPs (I own four of them), but they need to realize that they have limitations along with their advantages.


Den

.

That's really, REALLY, bad advice. If the Auto APAP machine pressure changes make you uncomfortable, you can reduce the pressure range. You can even set the APAP machine to run in manual CPAP mode and it will work exactly the same as a manual CPAP machine.


Zzzer,

Getting the data capable CPAP vs. the PRS1 SE model is a very big improvement. S9 Elite vs. PRS1 460/Pro is sort of a tossup, but people tend to like their S9s and find them more comfortable.

Be sure you really get the machine you've been promised. The S9 will say "Elite" near the power button. Be sure it's not "Escape," you wouldn't be the first victim of the old switcheroo.

The PRS1 will say REMStar PRO blahblah near the display. Make sure it doesn't say "REMstar Plus." Or take out the water tank first, and check the bottom of the blower for 460 somewhere on the bottom label.

Not if her options are a data-capable straight CPAP or a "brick" (non-data-capable) machine.


Den

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