Choosing between two Cpap machines

[btesterman]

FINALLY my titration is over, I saw my doctor (actually one of his nurse practitioners), went to a DME and I think I'm down to choosing between two machines. This whole experience has taken FOREVER, I didn't like the guy who handles the CPAP scripts etc. at my doctor's but I won't go into all that now. Basically, my experience this morning at the DME was one of the few good experiences - the DME was helpful, understood my desire to track my own results etc. (unlike the guy at my doctor's office) and she showed me two machines: Respironics Remstar Pro (not the M series) and the Resmed Elite II. Unfortunately you can't get the best of both features but I probably wouldn't be UNHAPPY with either. What the DME was not sure of was just how available the software is and how detailed each is. The guy at my doctor's office who writes the scripts (different than the nurse practitioner who was very nice) said he prefers Respironics because of the information THEY got. The DME said both machines will give them the same info, I think it's just formatted differently?????
My AHI is 14.3 and I just need a pressure of 6 so some of the features aren't critical for me but I do believe in being in charge of your own health care so being able to see the info is. I was hoping the LCD screen would give more info than they do - they only give averages, not nightly info. At this point I think I know only enough to get me into trouble. Any advice on choosing between the two, esp. considering the software availability and info on those. My script is for a Respironics unit but I have the hard copy and would not hesitate to trot back to my doctor's and ask them to redo the script. I have United Healthcare insurance which I understand is not the greatest on CPAP but I am willing to pay what I need to be satisfied - using something nightly for the rest of my life is important enough to get what I want.

[KatieW]

You will likely get opinions from both sides--Respironics and Resmed. I know many love their Respironics Remstar Pro. I can only speak to the Resmed line, which is what I have (though I have the S8 AutoSet II, which can be used an an auto or straight cpap). When I was choosing (3 months ago), I based my decision on these things:

--daily info on LCD screen--leaks, AHI, AI, HI available before noon; and weekly and monthly averages also available
--size of humidifier tank--Resmed is 390 ml
--quietness of ResMed--24 decibels
--software availability--both are available. I find the Resmed reports easier to read, but that's because I'm not familiar with Respironics. Resmed does give the duration of apneas, which Respironics does not. See this thread:

viewtopic/t48184/ResScan-owner-jealous- ... ports.html

Another consideration is how each machine "breathes" but that is an individual thing, and you won't know unless you try it out. If you are doing a "rent-to-own", perhaps you could try both.

Oh, and the Remstar Pro, though very popular, is an older machine.

[ycartf]

Just make sure you get one that records full data (beyond simple compliance data). I am unsure of whether the Respironics unit you are speaking of has full data capabilities or not. If it is the older-style Legacy (BIG, tank-looking) type unit, the only one of those that records full data is the Pro 2 IIRC. But you may be speaking of the "System One Remstar Pro" which would record full data. Restedgal has a great thread about which machines are data-capable -

viewtopic/t35685/viewtopic.php?p=307168#p307168

That said, I do not know what insurance/copays/deductibles you have, but I have pretty good insurance (BCBS of Alabama). And my "portion" of the original machine I got was more than I would have paid for the same machine/equipment/mask combination if I had bought them outright on cpap.com. Not to mention how much less you can pay if you're willing to get a slightly-used CPAP on cpapauction (which I have had very good experiences with). Personally, I prefer the Respironics machine (I own both brands) because the software (Encore Pro) gives you a lot of data that "Encore Pro Analyzer" by James Skinner can make into some easy-to-understand reports, trends, etc. Here's to your health, therapy, and willingness to steer your own ship. This is a great place to get help/answers/advice. Take care.

[Komodo]

I have the Resmed S8 Elite 2, and am very happy with it. It is a very quiet machine, which is fairly important, and the LED screen gives you most of the info you need. (It's easy enough to get the software to get all the info)

The only thing I would do differently, is to get the S8 Autoset 2. It's the same as the Elite except that it's an apap machine, but, can be set for straight cpap. You may not need the apap now, but who knows what will happen in a couple of years??? The cost to YOU is the same, apap or cpap, so why not get the better machine to start with?

[flylow]

I have had both. Respironics and Resmed. I am now using the resmed S8 autoset 2 and I love the machine. Perhaps the best part of the resmed machine is you can track your results without the software (daily statistics on the lcd (AHI, AI, HI, leaks, 95% pressure). The respironics lcd display is a weekly average at best but who knows when it updates. You certainly will have no idea how you did first thing in the morning by looking at that display and you are forced to use a software to have any real idea on how it is going.

The resmed software is better in my opinion overall except that the resmed does not give you a snore index. Resmed does give you apnea duration which I find interesting. Looking at the resmed auto pressure response, the cause and effect relationship of pressure increases is not obvious and I suspect it may be strongly tied to the vibratory snore information which is not displayed.

My recommendation is to go with Resmed. One last point. If you have any problems with your Respironics equipment, Respironics is a pain in the ass to deal with. This is the reputation and also my experience when I had a comfort gel break on me (the infamous ball joint attachment bracket failure). They made good on it but not timely and without jumping through hoops with strong consistent follow up.

[rested gal]

Of the two machines you mentioned:

Respironics Remstar Pro (not the M series) and the Resmed Elite II

I would want the ResMed Elite II.

The Respironics REMstar Pro (not the M series) machine you were shown... was the full name of the machine actually Philips Respironics System One REMstar Pro? Or was the name just Respironics REMstar Pro (with no "2" at the end of that name?) I can hardly imagine a DME still having a "tank" model Pro or even Pro 2 on the shelf.

Even if the "Remstar Pro" is a PR System One machine, I'd still prefer the Elite II, mainly for the excellent display of overnight data the ResMed machines can show in the morning, in the little window on the machine -- without any need for software.

[el_zorro]

Lots of good advice here. I am new to CPAP (3 weeks) and have both machines mentioned here. PR System One Pro and a ResMed S8 Autoset II. I havent got into the software features yet so I can't comment on these.

Some observations:
1.) Both are excellent machines and give great therapy. You really can't go wrong with either. They are both built like tanks and will most likely last for many, many years.
2.) The PR System One humidifier is the best, they have engineered "Rain-Out" and eliminated it as far as I can see. If you live in a Northern climate or you like to keep it cooler in your bedroom this is a HUGE deal. I adjusted my Systen One between 2-5 and fine tuned the heat level, got good humidification at all settings and didnt have a drop of "Rain Out". When I have my ResMed H4i to 3 (a middle setting) I almost drown two nights ago. I turned it down to 1 and it was fine. I dont want to get into hose heaters and stuff like that so why not use a humidifier that has eliminate this problem. The ResMed does have a pre-heat, but on the PR1 you can just turn the humidifier to 5 and turn it on. If they had an auto-on option for the flow this would work better.
3.) The ResMed Autoset II is slightly quieter.
4.) The PR System One Pro CFLEX+ is slightly better. I found that the ResMed EPR has a few "hiccups" especially during ramp or settling. This is the time when its important because you are falling asleep and max comfort is important. CFLEX+ is so smooth you never notice even during ramp.
5.) ResMed has auto-on/auto-off, PR System One doesnt have auto-on/auto-off.
6.) The ResMed LCD Data Results reading is better for looking at everyday results without getting into the software. The PR System One only shows 7 day or 30 day averages on the LCD. I have almost no apneas (even without CPAP) but many hypopneas. The ResMed differentiates between the two and scores the HI higher, which is more useful for my condition. I have overall really good AHIs (1.1 on PR and 3.4 on ResMed) so the therapy is working on both machines.
6.) Great advice from others on APAP here, if you can get one go for it, it has everything a straight CPAP has and autotitration which helps if you lose weight or your condition changes. I also liked using the Autoset to validate the settings that the sleep lab put in prescription. They were spot-on. An APAP helps give you the warm and fuzzy feeling that the sleep lab did their job right. You can get APAP from either PR System One Auto or ResMed Autoset. I havent read a comparison between the two but the Autoset that I have used seems to do a great job. The only improvement I would make to it would be to have a separate setting for Ramp(Settling) minimum and Autoset Pressure minimum. A person might want a lower ramp start than overall minimum pressure and it would be great if you could set separate minimums for both. If someone who has an autoset and has figured this out, please let me know.

Good luck. The good news is you cant go wrong with either. I will comment on software once I get into that for both.

[SleepyGrant]

To clarify some answers. The PR one does have an auto on/off feature you just have to access it through the clinicians menu. You can also view nightly data but to do that you have to reset the 7 day average every day but it shows leak rate, ahi, and periodic breathing. Another thing I like with the PR one is that the humidifier has drybox technology which basically eliminates the possibility of water from the humidifier geting into the cpap machine if it gets moved with water in it. I like this because I'm in the Navy and when we have rough seas the water obviously sloshes around and I can't go months without my cpap.

[ozij]

You can go wrong with either machine -- their auto algorithms are different, and you may find out that one of them simply does not give you the kind of treatment you need.

I would try to rent each before deciding what to buy.

O.

[el_zorro]

: Respironics Remstar Pro (not the M series) and the Resmed Elite II.

I think both of the machines btesterman is looking at are fixed CPAPs. No auto algorithms here.

You can go wrong with either machine -- their auto algorithms are different, and you may find out that one of them simply does not give you the kind of treatment you need.

I would try to rent each before deciding what to buy.

O.

Of course of you, IF can rent each one, thats good advice.

[el_zorro]

To clarify some answers. The PR one does have an auto on/off feature you just have to access it through the clinicians menu. You can also view nightly data but to do that you have to reset the 7 day average every day but it shows leak rate, ahi, and periodic breathing. Another thing I like with the PR one is that the humidifier has drybox technology which basically eliminates the possibility of water from the humidifier geting into the cpap machine if it gets moved with water in it. I like this because I'm in the Navy and when we have rough seas the water obviously sloshes around and I can't go months without my cpap.

Hey thanks SleepyGrant, I turned my auto-on/off on now. You learn something every day here.