Help - Resmed S9 Autoset or Respironics System One 560 TS

[Evergreen]

Hi Everyone,

First off, a big thank-you to all posters who have made this forum a valuable information source for CPAP users.

I have used CPAP for over 10 years and am currently on my second machine, the basic Respironics Remstar Series M and Respironics True Blue naselpal mask. I have a prescription getting a new auto machine with humidifier, and been given a choice of Resmed S9 Autoset or Respironics System One Remstar Auto 560 TS, both with humidifier and heated tube.

I have read some postings in this forum and reviews in other sites. As more I read, I'm more torn between the two models. My home care provider can provide me with either machine. They carry the Respironics System One Auto but have to special order the Resmed S9 Autoset for me if I pick the latter.

I read a lot of pros and cons of the two machines and agree that both are excellent state-of-the-art machines. I believe the cost of Resmed is higher that Respironics, but it does not matter to my out-of-pocket costs under my health insurance.

The technician my home care provider is more in favor of the Respironics. She pointed out one thing that I have not read from the internet: the Resmed S9's tube connection and humidifier design is more prone to water leak that will cause short-circuiting the machine, and said that Respironics is quieter that Resmed. One of my friends who just started using CPAP a couple of weeks ago has got the Resmed S9. He told me one night he accidentally hit the machine during sleep and water got into the tube and his nose. I don't know whether water spillage is a problem for Resmed S9, and hope someone out there can share their experience and thoughts. It will be a deal breaker for me if this happens easily.

The second thing I am concerned about is the tubing connection in the rear of the Resmed S9. One review points out this as Resmed big negative. Respironics (and Fisher & Paykel) have swivel connector.

At first I was set for getting the Resmed S9, but now I have second thought.

I have to make a decision on which machine I am getting this week. So I appreciate any prompt comments.

Thank you,
Evergreen

[RandyJ]

I don't think you have to worry about water leaking into the blower with the S9 unless you are lifting it up and turning it upside down with the water chamber inside (and no one does that) or pulling it off the night table during the night, sending it crashing to the floor. Are you a violent sleeper?

The tube connection on the rear of the machine has never been an issue for me, personally. I routed the hose through the headboard of my bed and I am not a violent sleeper (I never stressed the hose connection by pulling on the hose while I sleep). If you're a violent sleeper, this may be an issue.

Either machine is a great choice, but I would not personally let those 2 factors prevent me from getting the S9 if that is what I wanted. (Also, if a DME wants to steer you away from a certain machine they will say anything.)

[Pugsy]

I actually have both brands. The PR S1 and the S9. The PR S1 humidifier tank with the overhead swivel connection is superior but not a deal breaker. The rear connection with the S9 is no different from you have always used.
Only disadvantage to the S9 rear placement is if you fill the tank past the maximum fill line is that it will indeed blow water into the hose and up to your face. I have done that. Rude awakening.
For that reason I suppose it is possible that it might be a little more likely to spill should the machine be jostled around a bit. I haven't had that happen though even with all my tossing and turning and I do a lot.
It isn't a deal breaker. I am just more careful about overfilling the tank since I don't want a shower. I think I have done it twice and both time I knew I had too much water in the tank and did it anyway...sort of hoping I hadn't crossed the line.

I like both brands. Each does a great job. Lots of happy S9 users here so the problems with the tank are minimal and most often related to the user doing what I did.
If you want the added security of the top swivel with the PR S1 and yes, it is a superior design then go ahead and get it.
The tank is nearly impossible to overturn and cause a major leak. Even getting excess water out of it to clean is a job until you take the lid off (which is easy). It just doesn't leak easily. Respironics hit a home run with its design.
You are used to the Respironics algorithm. I used to have a M series APAP and then I got the PR S1 APAP.. it feels the same.

If you get the PR S1 60 series machine I can point you to software that you can use if you want to.

[brucifer]

The technician my home care provider is more in favor of the Respironics. She pointed out one thing that I have not read from the internet: the Resmed S9's tube connection and humidifier design is more prone to water leak that will cause short-circuiting the machine, and said that Respironics is quieter that Resmed. One of my friends who just started using CPAP a couple of weeks ago has got the Resmed S9. He told me one night he accidentally hit the machine during sleep and water got into the tube and his nose. I don't know whether water spillage is a problem for Resmed S9, and hope someone out there can share their experience and thoughts. It will be a deal breaker for me if this happens easily.

The second thing I am concerned about is the tubing connection in the rear of the Resmed S9. One review points out this as Resmed big negative. Respironics (and Fisher & Paykel) have swivel connector.

Your DME RT is trying to funnel you to Respironics because that is the line they carry, so she's giving you a line of nonsense. If you overfill the S9 humidifier reservoir while it is in the humidifier, then you could leak water into the hose. However, if you overfill your cereal bowl with milk, it will spill onto the table as well. As for the hose connection on the S9, it's true that it doesn't swivel, but it is a great solid connection. My mask has a swivel where it connects to the hose, so that's all the swivel I need. Nothing against Respronics, but I love my S9 and am very happy with it. Oh, and in terms of noise, the S9 runs silently.

Choose what YOU want, and try to put the sales hype aside. Best of luck.

[Pugsy]

BTW...noise levels....pretty much equal. Very minor in terms of decibels and I doubt that most human ears can really tell much difference. But then again I thought my M series machine was nearly silent so what do I know.
My husband says he has to really, really strain to hear either brand. I can't count the number of time he has poked me in the side to wake me up to tell me to turn the machine on...and it was already on.
This happened with the M Series and the PR S1 machine...by the time I got my S9 VPAP he had learned to put his hand over my face to feel the vented air to make sure machine was on.

Get the machine that you want. I bet you would like either one. The S9 feels a bit different with their EPR relief when compared to Flex relief but different doesn't mean uncomfortable. Both are quite comfortable. I found that AFlex best mimicked my own natural breathing but then I had used it for 2 years. It wasn't all that difficult to adjust to EPR though. Couple of nights and it was like I had always used it.

There are minor pros and cons with each machine. Your DME is blowing up one of the cons for the S9 out of proportion but that doesn't mean he is steering you to a total crap machine. The PR S1 machine is a great machine. I think that most people would be happy with either. I imagine that there are a few people who would do better with one algorithm over the other but I think those people are rare.

[Uncle_Bob]

Evergreen, I have both the S9 and the PR ONE Series 60.
I posted a comparison of them in the following thread which you may find useful.

viewtopic.php?f=1&t=76853&p=701082&hili ... 60#p701082

[Evergreen]

Hi Everyone,

Thank you so much for the inputs.

I have made my decision, and this afternoon I told my DME provider to order the Resmed S9 AutoSet with H5i Heated Humidifier, ClimateLine Tubing. I specifically wanted the Cleanable Water Chamber Tub. My DME tech said that she would set me up to use the machine at fixed pressure per my last sleep study for 30 days first, and would see what I actually needed.

I will report after I get the machine.

Best regards,
Ken

[splashofchlorine]

I'll start with.."I know nothing" about these machines other than what I have found on this site tonight. My insurance company wouldn't even approve a sleep center study but rather had me do an in home one so I haven't been able to ask questions. Today the insurance company called and said I could pick between an s9 auto and a PR System One REMstar BiPAP Auto with Bi-Flex . I think that's pretty similar to the 560 this post is about? They cover the entire cost so money is not an issue......what do you guys recommend?

[Pugsy]

Today the insurance company called and said I could pick between an s9 auto and a PR System One REMstar BiPAP Auto with Bi-Flex . I think that's pretty similar to the 560 this post is about

The PR S1 BiPap is actually a step above the PR S1 560.
The S9 Autoset and the PR S1 models are APAP/CPAP machines....single pressure delivery

BiPaps offer bilevel pressures...one for inhale and one for exhale. There is a heated hose BiPap Auto...model number 760 for the heated hose model...750 for the non heated hose model.
The bilevel ResMed machines are called VPAP....

If your pressure needs are rather high or have trouble exhaling against the pressure then bilevel machines are likely an advantage.

[archangle]

I'll start with.."I know nothing" about these machines other than what I have found on this site tonight. My insurance company wouldn't even approve a sleep center study but rather had me do an in home one so I haven't been able to ask questions. Today the insurance company called and said I could pick between an s9 auto and a PR System One REMstar BiPAP Auto with Bi-Flex . I think that's pretty similar to the 560 this post is about? They cover the entire cost so money is not an issue......what do you guys recommend?

There is no S9 "Auto". There is an Escape Auto and and AutoSet CPAP machines.

I suspect that they actually mean the S9 VPAP Auto BiLevel. It would be really odd to allow you the choice between a bilevel and a CPAP machine. They require different prescriptions.

BiPAP and VPAP are trademarks for "bilevel" machines.

It is also odd to go directly to a bilevel without trying CPAP first. They usually require you to "fail" CPAP.

I'm not that familiar with bilevel machines, but I suspect PRS1 BiPAP Auto vs. S9 VPAP Auto BiLevel is a tossup.

If your choice is really PRS1 BiPAP Auto vs. S9 AutoSet CPAP, I'd probably say to take the PRS1.

[-tim]

I did a review of the Auto versions of these two machines a few days ago. Your looking at more expensive machines but the rest of the review should apply.

[Pugsy]

not that familiar with bilevel machines, but I suspect PRS1 BiPAP Auto vs. S9 VPAP Auto BiLevel is a tossup.

I happen to own both the PR S1 BiPap Auto and the S9 VPAP Auto. Not quite a tossup as there is one difference that may or may not be of importance (beyond the normal minor differences between the brands) and that is the way that pressure support (difference between IPAP and EPAP) is handled in auto adjusting mode.

The PR S1 has the roaming PS in auto mode with the closest they can ever be is 2 cm and how far apart it can go depends on the PS settings. Default starting out the night while awake is 2 cm and it adjusts as the events drive the pressures. If someone has a PS of 6 cm...they could see a variation in PS as the night goes on anywhere from 2 cm to 6 cm..up and down within that setting all night long.

The S9 VPAP has a fixed PS in auto mode meaning there is always a fixed same difference between IPAP and EPAP.
What it starts out at the beginning of the night is what it has all through the night no matter what IPAP goes to...EPAP is always exactly same distance behind.

Don't ask me in which situation one or the other might be of more benefit. I haven't found any concrete reading that offers that information. There probably is something out there that might give some indication as to who would do better with one over the other but I haven't ever found it. I am thinking that someone with aerophagia problems might like the roaming PS of the BiPap but I have nothing to base that on. I have never been bothered by aerophagia so I can't draw on that experience.

My own personal preference happens to be something that is perceived while awake and has no bearing at all on how the machine actually do their jobs.
A PS of 4 is easier on the breathing while awake than a PS of 2. It is the difference that offers the comfort.
So in auto mode (remember I am someone who sometimes needs much higher pressures for short periods of the night) I like the VPAP's way of starting out the night just a little bit better than the way the BiPap starts the night.
It's a while awake perception for me. Someone else may not feel the same way. They both do their jobs effectively and I feel the same way each day no matter which brand I use.

I can't see any clearly defined benefit of one brand over the other and if buying out of pocket...the PR S1 BiPap wins hands down. If insurance is buying...they are both great machines and unless you liked the reporting features of one machine over another I don't think that there is enough difference to be a huge concern.

[Guest]

I did a review of the Auto versions of these two machines a few days ago. Your looking at more expensive machines but the rest of the review should apply.

Does the Resmed S9 offer an optional setting like the PR1 where it is in full auto mode for a month, then goes to fixed CPAP mode with monthly re-checks in full auto mode, to better fine tune the setings? It may be a gimmick on the PR1, I dunno. I just didn't see anything similar for the S9.

The S9 does have a $50 rebate until the end of September which is nice. However I called the local Respironics rep and he said they would do me a special favor and comp me a mask if I go with the PR1.... So its a tough call. I really like the color display on the S9, but the PR1 is made in the USA and to me that's almost more important than aesthetics. I only wish DeVilbiss had a similar cadillac machine.

[-tim]

I did a review of the Auto versions of these two machines a few days ago. Your looking at more expensive machines but the rest of the review should apply.

Does the Resmed S9 offer an optional setting like the PR1 where it is in full auto mode for a month, then goes to fixed CPAP mode with monthly re-checks in full auto mode, to better fine tune the setings? It may be a gimmick on the PR1, I dunno. I just didn't see anything similar for the S9.

The S9 does have a $50 rebate until the end of September which is nice. However I called the local Respironics rep and he said they would do me a special favor and comp me a mask if I go with the PR1.... So its a tough call. I really like the color display on the S9, but the PR1 is made in the USA and to me that's almost more important than aesthetics. I only wish DeVilbiss had a similar cadillac machine.

The try it "feature" is a gimmick. On the $1000 units, there is about a $40 difference between Auto and fixed pressure and its nothing more than different software (or more likely the same software told not to do the auto in the cheaper model). If the choice is between and apap or cpap, get the auto since the auto can do cpap or apap and the cpap machine only does cpap.

The Resmed hose is longer than the Respironics hose so the swivel may not matter.

The PR1 is assembled in the USA. Its mostly made elsewhere. The Resmed is made in Singapore or Sydney with a fair number of USA parts. I think the Australian made S9s are quieter than the ones from Singapore. The 560 is a cheaper unit at about 60% of the price but it lacks features such as telling you your AHI for last night. The S9 also has a number of other features that makes it a better unit but I'm not sure thats worth the extra money. I have both. I've been using the 560 for about a week and I my AHI has been going up but its just hit 2.0 so its not an issue yet. Its running much lower pressure than the S9 auto.

[Pugsy]

Does the Resmed S9 offer an optional setting like the PR1 where it is in full auto mode for a month, then goes to fixed CPAP mode with monthly re-checks in full auto mode, to better fine tune the setings? It may be a gimmick on the PR1, I dunno. I just didn't see anything similar for the S9.

What you are describing is the PR S1 Auto IQ machine which is a Model 450 with limited APAP capabilities.
Though as with anything...there are ways to make it have a renewable 30 day capability each month..

The PR S1 model 550 (or 560 with heated hose) has full time APAP and no limitation on time and would be similar to the ResMed S9 AutoSet as far as full time APAP or the choice to use cpap mode if you wished.

ResMed does not offer a model that would do a similar function as the Auto IQ machine offers with testing and doing adjusting once a month all on its own. Personally, I would prefer to do my own evaluation and adjusting if need be.