S9 VPAP?

[falvesjr]

I currently use an S8 VPAP Auto 25 which is a bi-level machine, but with the advent of APAP machines, I don't know that there is a "real world" difference between VPAP and APAP anymore, especially since the advent of pressure support on VPAPs. I use my VPAP with an EPAP of 10.4, IPAP of 24.4, and pressure support of 4, so essentially, my IPAP pressure can vary between 14.4 and 24.4, with exhalation 4 cm/H2O less than the auto-calculated pressure. But newer APAP machines, like the S9, also have a minimum and maximum treatment pressures to constrain your pressure range, and with EPR, the basic function can be very close to a VPAP machine. I guess the main difference between the two is that a VPAP machine can have a greater difference between IPAP and EPAP by either using straight bi-level settings with no pressure support, or by using the VPAP mode with pressure support like I do -- and since pressure support isn't limited to 1, 2, or 3 cm/H2O like EPR is, you have even more latitude to play with.

I guess this was a long-winded way of asking my question: Is there going to be an S9 Series VPAP machine or is Resmed going in the direction of only having AutoSet machines that can sort of "do it all"? I think that for me, if my doctor cooperates, I could switch to an S9 AutoSet and wouldn't notice any difference in comfort while possibly getting even better therapy. But if an S9 VPAP is coming soon, maybe I should wait...

What do you all think? Any insights appreciated!

[dave21]

Hi falvesjr,

Forgive me as I'm not as clued up with the VPAP's as the APAP's, but the S9 currently only supports 4-20cm pressure, so I'm not too sure that the S9 will be of any use to you? Likewise the EPR relief for the S9 probably wouldn't be as good as the VPAP you're currently getting. But I guess it depends on whether you truly need the pressure support for exhale? Your signature suggests the pressure stays at 19.4cm for 99% of the time, this means you would be in the very high end window for an S9.

I would believe that ResMed will make an S9 equivalent VPAP, I guess it just is a matter of how much time will it take.

In terms of switching to an S9, if pressure wise you only need up to 20cm then it might be an option, but it also depends solely on the main reasons why you have been given a VPAP instead of an APAP? e.g. Whether you get more Centrals, whether you have other respiratory conditions like reduced lung capacity etc.

Thanks
Dave

[Slinky]

Our local Resmed Rep said that there WILL be an S9 VPAP Auto available w/in months, certainly before the end of this year.

[falvesjr]

Dave, Slinky,

Thanks for the comments! I'm glad to hear that there will be an S9 VPAP! As for my pressure, Dave, I forgot to change my sig... A while ago, I decided to try a lower pressure, Auto @ 10.4/24.4/EPR4, and found that it actually worked much better for me than my much higher titrated pressure. It now stays at 14.4 most of the time and my AHI is almost always lower than 5, sometimes lower than 2! Also, my leak rates are *much* better too, of course!

Anyway, I don't see why the manufacturers don't just start making one machine type. Since all these units are basically the same hardware, and only the software changes, I bet that if they concentrated on making just one model they could probably save a lot of money in not having to maintain several different product lines, so the machines would not have to be absurdly priced, even though they would all be "top of the line" machines... Yeah, I know, not gonna happen, but one can dream...

[dave21]

I forgot to change my sig... A while ago, I decided to try a lower pressure, Auto @ 10.4/24.4/EPR4, and found that it actually worked much better for me than my much higher titrated pressure. It now stays at 14.4 most of the time and my AHI is almost always lower than 5, sometimes lower than 2! Also, my leak rates are *much* better too, of course!

That's really good! So in theory if there's no other good reason why the VPAP is working better for you over say a regular APAP than an S9 might be a good viable alternative. If the VPAP was really only used to give a good viable alternative to pressure relief, than in theory the S9 might work out for you. Depending on how good your sleep doctor is, I would suggest discussing it with them.

Anyway, I don't see why the manufacturers don't just start making one machine type. Since all these units are basically the same hardware, and only the software changes, I bet that if they concentrated on making just one model they could probably save a lot of money in not having to maintain several different product lines, so the machines would not have to be absurdly priced, even though they would all be "top of the line" machines... Yeah, I know, not gonna happen, but one can dream...

A lot of time when it boils down to hardware and software, a machine would be made for a given market, to address a particular problem, but then they make tweaks to the software or add additional changes to the hardware and evolve the machines that way. I see this a lot in the software and hardware industry that I'm currently in. If more time were taken to bring a machine to market then everything could be encased into a single unit, the problem usually is cost. To compete in any market you need to have entry level machines, mid range machines and machines at the top of the scale that have all the bells and whistles on, which probably the latter would relate to the VPAP where as the regular S8/S9 would probably be somewhere between entry level and mid range.

Unfortunately consolidating onto making a single model doesn't really save them much money, because the hardware doesn't change much, it's just a slight variance. Most companies unfortunately are driven by money (and they're in the business to make money) so they want to push new machines out at a given rate to market to ensure they continue to not only keep the same level of income moving forward but to increase it. The way they keep their income up is to release new products year in year out, having people switch to them, that in itself generates a lot more income when they release a new machine.

Thanks
Dave

[robysue]

Hate to revive such an old thread, but this caught my eye: Back in April,

Our local Resmed Rep said that there WILL be an S9 VPAP Auto available w/in months, certainly before the end of this year.

Any updates or rumors since it's now November and the end of the year is near?

I'm really curious since I may be moved to a bi-level machine real soon. I'd really hate to have to be forced to choose between an S8-based VPAP (wiht it's propriatary data card and possibly less data than my current S9 AutoSet) and the PR System One BiPAP, which will require me to switch software systems and use something that doesn't seem as "complete" as ResScan.

[Slinky]

I haven't checked w/my local Resmed Rep yet. I missed the last two local apnea support meetings that the Resmed and Respironics Reps usually attend. I'll have to e-mail her to see what the latest scuttlebutt is on when an S9 VPAP Auto will be available. I would suspect the "inventory" of (S8) VPAP Auto 25s still on hand would have some influence on an S8 VPAP Auto release.

I am currently using an (S8) VPAP Auto - it was released in January 2008, I got it in March of 2008. The (S8) VPAP Auto 25 was released in July 2008 - which was a great surprise. I suppose they don't want to make that mistake again.

For the last 6-7 months I was using a PR SystemOne BPAP Auto w/Bi-Flex. I liked it - a lot. W/the Resmed VPAP Auto I found I could NOT use it in Spontaneous (straight bi-level) mode due to too abrupt a transition from IPAP to EPAP. But I could and do use it in VPAP (auto) mode w/the Pressure Support set to the exact same distance as the difference between IPAP and EPAP, i.e. IPAP 13, EPAP 8, PS 5. W/the PS set in this way the transition between IPAP and EPAP is smooth, easy, comfortable breathing. That is because the new EasyBreathe technology isn't available in Spontaneous (straight bi-level) mode but is in VPAP (auto) mode. Other than having to use the VPAP Auto set that way in VPAP (auto) mode I found the PR S1 and the VPAP Auto to be equal in comfort of therapy. I really like the extra data available w/the PR S1 but I hate the limited data via the stupidly unbacklighted LCD screen. And I really do prefer the ResScan software over the EncorePro software.

So ... therapy-wise, six of one, half-dozen of the other. I really like both bi-levels. You really wouldn't go wrong w/either one for therapy. The difference is w/the software (other than the software is more needed w/the PR S1 than w/the VPAP). And the preferences between the two software are as much personal preference as not. I've always found the Resmed software easier to install and use than the Respironics software - even when I used the MyEncore and EncoreAnalyzer freeware w/the older versions of EncorePro.

One thing that disappointed me w/the PR S1 is that they've gone w/the Mask Selection bit as Resmed has been doing and I'm not at all sure that that is such a plus. I haven't found that it is very easy to know which Mask Selection to use if you are not using a Respironics mask. But then, that was a bit of a PITA w/the Resmed software too. If these two manufacturers would get their act together and make it easier to select which Mask Selection to use if you are using a mask other than theirs the Mask Selection feature would make a lot more sense and be a lot easier for us because I have found that various Mask Selections make one h*ll of a whole lotta difference in the reported data - so much so that it really can and does make the reported data totally unreliable if you are using the wrong Mask Selection.

[robysue]

slinky

Thanks for the update. Could you the resmed rep who shows up occasionally at your apnea support meetings and post any update?

robysue

[Slinky]

I missed the September and the November meetings and the next one isn't until sometime after the first of the year, usually NOT in January possibly as late as March since we are in the snow belt. However, I did e-mail her so I should hear from her w/in a day or two.

[robysue]

Thanks slinky!