Consenus On Best Setup

[paradise]

I'm sure it differs for everyone...

But I need a new machine and guess I want an apap and software to anaylize what is going on..

What do you suggest?

[rested gal]

I'm sure it differs for everyone...

Yes.

But I need a new machine and guess I want an apap and software to anaylize what is going on..

I think that's a very wise decision.

What do you suggest?

I've gotten good treatment from all the three major manufacturers' autopaps. Bearing in mind your first comment: "I'm sure it differs for everyone..." my own personal preference in autopaps is for the Respironics REMstar Auto with C-flex -- either the regular size one or the new slightly smaller "M series". Respironics machines use Encore Pro software.

If you think you might like a combo bipap/autopap machine, Respironics also makes that. It's the machine I've been using the past several months.

I don't think you'd go wrong using one of the other manufacturers' autopaps either. Just check out the features on all of them in case there is something you'd like that one has and another doesn't.

[Offerocker]

I hesitated responding, but it's already been stated that "...everyone is different, needs and personal wants are different..."
I can just relay what I have, and that I have been completely happy with it.
I have the Remstar Auto w/C-flex.
I did NOT get the integrated heated humidifier because:
The humidifier needs to be lower than your head, and I want the cpap itself on headboard shelf. This actually makes 'hooking up' easier, since the HH is more accessible, as I need to attach the oxygen input AFTER the cpap machine is on. Hard to do with the machine behind me, but easy with it nearer the floor. So, it depends on your needs, and what you find easiest for you to live (with).
In addition, I liked the features of the HC150 heated humidifier (ambient tracking), AND no worried of leakage, since it doesn't have to fit properly into the cpap. That's all the justification I can give: personal preferences.
I will admit that I didn't investigate EVERY mfgr and every model. I got my positive impressions from posts on the forum and used that criteria, plus what I thought would suit me best.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): cpap machine, resmed, humidifier, CPAP, auto

[gulfpearl]

Offrocker

I think you meant to say a Respironics Auto With cflex & not Resmed Your profile shows a Respironics Auto with CFlex.

[oldgearhead]

Here's a brief synopsis:

1. Some here believe and/or have directly experienced that REMstars may be prone to "runaway" pressure titrations up to the full 20 cmh20, for reasons as yet undetermined. I have NOT experienced this with my REMstar Auto w/C-flex. Two users, Niighthawkeye and DSM are the most learned about this and you ought to correspond with them for further information regarding this;

2. Many here have complained about experiencing considerable difficulty in installing and using Respironic's VERY useful and comprehensive suite of software (EncorePro) for tracking and analyzing your response to treatment (useful only on REMstar Pro2 and Auto, and M series Pro and Auto. This software is intended for use by sleep clinics, sleep docs and DMEs and therefore, neither Resprionics nor CPAP.COM provide ANY support or assistance to end-users who purchase the software. I have NOT experienced any difficulty in either installation or use of EncorePro v1.5.77;

3. Some believe or have directly experienced the phenomenon that Respironic's auto-titration algorithm is slow to respond to sleep-disordered breathing events and therefore, does not provide effective treatment for them, in comparison to ResMed AutoSet machines which have an algorithm that responds VERY aggressively with a very sharp attack (rapid increase in pressure). I (and many others here), on the other hand, experienced that ResMed's sharp attack leads to arousals and awakenings that tend to fracture sleep and therefore, make treatment less effective than what I've experienced when I switchedfrom a ResMed S8 AutoSet VAntage to a REMstar Auto with its more temperate algoithm;

4. Virtually all here agree that monitoring efficacy data reported by machines capable of collecting it is an ESSENTIAL part of our ensuring the success of our treatment. REMstars require the purchase of the EncorePro software and a SmartCard reader, and the use of a Windows computer in order to do so. ResMed data capable machines (S8 Elite and S8 Vantage) report efficacy data directly on the unit's LCD display with just a few, simple keystrokes with NO need for software, card reader or even computer. However, ResMed's software suite (AutoScan v5.7) does not provide nearly as useful nor as comprehensive data as does Resprionic's EncorePro, in my opinion, and I've used both. It should be noted that the new Respironics M series Pro or Auto DOES report AHI and leak data on its LCD, but only in the form of 7 and 30 day averages, while the ResMeds report Pressure, leak, AHI, AI, and HI on their LCDs in nightly, weekly, monthly, six-monthly and yearly averages, at the touch of a few keys.;

5. The human factors design on Respironics machines, particularly prior to the new M series, is, IN MY OPINION, abyssmally primitive. They are BIG and ugly with hard to read, non-backlit, confusing LCD screens and reservoirs for the humidifier that are somewhat inconvenient to fill (ALL MY OPINIONS only). The human factors design on ResMeds is light-years ahead (again, my opinion) with a cute form factor and colors, and reservoir that opens to fill with the flip of a lid, a timed-backlight to a very easy to read dot-matrix display, all in a very compact, travel friendly package (all my opinions). The M series is somehat more user friendly than the older REMstars, but only very slightly (though I have NO direct experience with the M series). The older Respironics is VERY sturdily built, though some have reported relaibility problems, and is generally thought to be whisper quiet. The ResMeds are VERY slightly more noisy with a slightly higher pitched whine; and finally,

6. Respironics autos offer MOMENTARY exhalation pressure relief (C-flex) in both auto and constant (CPAP) modes. ResMed Autos offer Expiratory Pressure Relief (EPR) at exact pressure decrements of 1, 2 or 3cm (user selectable) that lasts for the ENTIRETY of the exhalation, but ONLY IN CONSTANT (CPAP) MODE. The actions of EPR however, is almost identical to the comfort afforded by a bi-level PAP, at a savings of nearly one half the cost of a bi-level, and many refer to the S8 Elite or S8 Vantage as "mini-biPaPs". I have NOT used EPR however, and I do find C-flex to be remarkably effective.

Hope this helps.

Chuck

As you can see, even some good information can be gleaned from a
horrible thread.

[DreamStalker]

I'm sure it differs for everyone...

But I need a new machine and guess I want an apap and software to anaylize what is going on..

What do you suggest?

If you post some of your background, some may be able to provide you more details for making your decision.

What pressure have you been prescribed?

Generally, C-flex and EPR which do basically the same thing in reducing pressure to facilitate exhalation are useful only for folks with higher pressures ... while those using lower pressures do not get as much benefit from this type of feature. The main difference between the two is that ResMed's EPR continues throughout the exhalation period while RemStars C-flex only reduces pressure during the initial period of an exhalation. Also, EPR is only available in an APAP machine while used in straight CPAP mode whereas C-flex is available in an APAP machine when used in either APAP or straight CPAP modes. If you were prescribed a high pressure, you may want/need a Bi-PAP as opposed to an APAP.

What was you AHI number for the diagnostic part of your sleep study? ... Which were more prevalent -- apneas of hypopneas? ... Were your apneas mostly obstructive, central, or mixed? ... Are you easily aroused (awakened) by changes in pressure of the APAP?

I think ResMed tends to raise pressure more rapidly in response to an obstructive event and may cause arousals if your are sensitive to such things ... on the other hand, I believe RemStar is slower to react to an obstuctive event ... and the obstruction itself may arouse you.

[Those of you more experienced and knowledgeable feel free to correct me if I'm wrong about this]

As you are aware and others have mentioned, it is indeed a very subjective choice and all three major brands provide effective treatment. I know absolutely nothing about PB products so I will not comment on this machine at all.

Ideally if at all possible you would want to try out each of the machines for a couple of weeks and collect data to determine which one is best for you ... much easier to said than done however.

Good luck,

- roberto

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, C-FLEX, CPAP, AHI, APAP

[Bob...]

I would suggest that you read this again:

Here's a brief synopsis:

1. Some here believe and/or have directly experienced that REMstars may be prone to "runaway" pressure titrations up to the full 20 cmh20, for reasons as yet undetermined. I have NOT experienced this with my REMstar Auto w/C-flex. Two users, Niighthawkeye and DSM are the most learned about this and you ought to correspond with them for further information regarding this;

2. Many here have complained about experiencing considerable difficulty in installing and using Respironic's VERY useful and comprehensive suite of software (EncorePro) for tracking and analyzing your response to treatment (useful only on REMstar Pro2 and Auto, and M series Pro and Auto. This software is intended for use by sleep clinics, sleep docs and DMEs and therefore, neither Resprionics nor CPAP.COM provide ANY support or assistance to end-users who purchase the software. I have NOT experienced any difficulty in either installation or use of EncorePro v1.5.77;

3. Some believe or have directly experienced the phenomenon that Respironic's auto-titration algorithm is slow to respond to sleep-disordered breathing events and therefore, does not provide effective treatment for them, in comparison to ResMed AutoSet machines which have an algorithm that responds VERY aggressively with a very sharp attack (rapid increase in pressure). I (and many others here), on the other hand, experienced that ResMed's sharp attack leads to arousals and awakenings that tend to fracture sleep and therefore, make treatment less effective than what I've experienced when I switchedfrom a ResMed S8 AutoSet VAntage to a REMstar Auto with its more temperate algoithm;

4. Virtually all here agree that monitoring efficacy data reported by machines capable of collecting it is an ESSENTIAL part of our ensuring the success of our treatment. REMstars require the purchase of the EncorePro software and a SmartCard reader, and the use of a Windows computer in order to do so. ResMed data capable machines (S8 Elite and S8 Vantage) report efficacy data directly on the unit's LCD display with just a few, simple keystrokes with NO need for software, card reader or even computer. However, ResMed's software suite (AutoScan v5.7) does not provide nearly as useful nor as comprehensive data as does Resprionic's EncorePro, in my opinion, and I've used both. It should be noted that the new Respironics M series Pro or Auto DOES report AHI and leak data on its LCD, but only in the form of 7 and 30 day averages, while the ResMeds report Pressure, leak, AHI, AI, and HI on their LCDs in nightly, weekly, monthly, six-monthly and yearly averages, at the touch of a few keys.;

5. The human factors design on Respironics machines, particularly prior to the new M series, is, IN MY OPINION, abyssmally primitive. They are BIG and ugly with hard to read, non-backlit, confusing LCD screens and reservoirs for the humidifier that are somewhat inconvenient to fill (ALL MY OPINIONS only). The human factors design on ResMeds is light-years ahead (again, my opinion) with a cute form factor and colors, and reservoir that opens to fill with the flip of a lid, a timed-backlight to a very easy to read dot-matrix display, all in a very compact, travel friendly package (all my opinions). The M series is somehat more user friendly than the older REMstars, but only very slightly (though I have NO direct experience with the M series). The older Respironics is VERY sturdily built, though some have reported relaibility problems, and is generally thought to be whisper quiet. The ResMeds are VERY slightly more noisy with a slightly higher pitched whine; and finally,

6. Respironics autos offer MOMENTARY exhalation pressure relief (C-flex) in both auto and constant (CPAP) modes. ResMed Autos offer Expiratory Pressure Relief (EPR) at exact pressure decrements of 1, 2 or 3cm (user selectable) that lasts for the ENTIRETY of the exhalation, but ONLY IN CONSTANT (CPAP) MODE. The actions of EPR however, is almost identical to the comfort afforded by a bi-level PAP, at a savings of nearly one half the cost of a bi-level, and many refer to the S8 Elite or S8 Vantage as "mini-biPaPs". I have NOT used EPR however, and I do find C-flex to be remarkably effective.

Hope this helps.

Chuck

As you can see, even some good information can be gleaned from a
horrible thread.

I would add this:

1. I found early on that I did not respond to treatment with an APAP and switched my REMstar Auto with C-flex to CPAP mode. After 3 months use I had to return the REMstar to Respironics for some warranty work and while it was being repaired I used a ResMed S8 Elite (about 3 months). The S8 suited my therapy and I found the data available with the LCD more that sufficient for my needs. When the REMstar was returned I sold it and bought a ResMed S8 Elite and have been happy with it since (about 2 months).

2. I was unable to tolerate Respironics C-flex, however ResMeds EPR is quite comfortable and the reduced pressure has helped me keep mouth leaks under control.

3. I had no problems with Respironics EncorePro (V1.5i) or MyEncore (V1.5b7) either on install or during daily use, however it seems that newer versions of the software may not be so easily configured. A search of recent topics may be in order to make a final conclusion. I have not used ResMed's software because as I have stated the data available on the LCD is adequate for my use.

It is a shame that we all cannot use multiple machines to find out which is best suited to our therapy as I for one have found there are indeed distinct differences between them.

Good Luck,

Bob

[Fletch]

I'm still intereted in opinions on this. I finally returned the insurance rental Remstar today and used the S8 as primary for the first time. While I like the small footprint I'm still undecided on the vantage/auto question, especially as the costs are comparable.

[DreamStalker]

I'm still intereted in opinions on this. I finally returned the insurance rental Remstar today and used the S8 as primary for the first time. While I like the small footprint I'm still undecided on the vantage/auto question, especially as the costs are comparable.

I don't think the size of the footprint should rank high on the list of decision priorities.

Read the previous posts on this thread ... they pretty much sum up all of the pros and cons.

- roberto