? Alternatives to my old Respironics Remstar Pro Auto

[Justin Case]

I've had my old bulky CPAP Remstar Pro replaced once under warranty, but I am overdue for a new one. It's been about 6 years. I bought the machine through my DME and of course, I was "hosed" price was.

I've tried every machine made during that era as my Remstar Pro (APAP) with heated humidifier. Overall, this unit was the quietest for me. I tried the the Remstar M (it's first successor) a few years later, but it was too noisey for me and I could not endure the suffering of sleep deprivation it caused me. I even tried the next line of Remstar Machines. My DME said my therapy was better with the Remstar Pro.

Speaking of noise, the most sensitive aspect of noise for me is noise through the tubing and the machine itself. I am still using the same type of mask, just replaced the parts over the years: Mirage Activa.

I am intrigued by the Remstar 60 series as well as S9 autoset. However, I am reluctant to go back my DME who has been very good other than the pricing component.

Can anyone offer any suggestions on an APAP that would meet or (hopefully) exceed in every where

[archangle]

I am intrigued by the Remstar 60 series as well as S9 autoset. However, I am reluctant to go back my DME who has been very good other than the pricing component.

Can anyone offer any suggestions on an APAP that would meet or (hopefully) exceed in every where

Stop searching. REMstar PRS1 Auto and S9 AutoSet are the only two models to consider. Watch out that you don't get tricked into the S9 Escape Auto. There is no "S9 Auto." The PRS1 Auto (not 60 series) may be worth considering if you find it cheap enough to make up for no heated hose option.

[Justin Case]

Thanks for the reply. What is the difference between the PS1 and the PS1-60 series? What makes one more favorable than the other? The PRS1 looks like a tank in the pic: is the 60's series with dehumidifier.

The total price difference is $84 w/heated humidifier price tag? Does cpap.com still have the best prices on new CPAP machines?

PRS1:

PRS160:

[Pugsy]

Heated hose is the main difference. If you don't need or want the heated hose...there is no other real benefit other than the 60 series is the latest model just released last spring where the other has been around 3 years.

Both machines are the same size. About the size of a novel.

Cpap.com still has some great prices.
If you would consider a low hours used machine secondwindcpap.com has some good prices...along with some new but open box specials with no hours on the machines.

[Justin Case]

Thanks Pugsy, I never used a heated hose before. I am not sure I really need one. I didn't realize the PS1 is 3 years old. Is the technology and sound insulation improved in any way with the newer models?

One thing I dont like about the Respironics machines is they have in the past lacked one feature in their algorithm which the Resmed line has. The ability not to increase pressure above 10 cm when the machine registers centrals. That has always been a bit of an issue with me. That's why I don't top up my setting above 11. My sleep doc says my settings that I am using are fine. Perhaps Is looking at a Resmed Auto with EPR worth looking into? With my Resmed, I like how I can easily follow and download the data to my PC.

I've thought about getting a used Apap machine. However, I am creeped out by it because I have not found any way to sanitize the innards of the machine.

[Pugsy]

Is the technology and sound insulation improved in any way with the newer models?

Supposedly the PR S1 machines made after the start of 2011 are quieter than the prior machines. As far as technology goes...Respironics flags clear airway events (centrals), obstructive apneas, hyponeas, Flow limitations, snores and RERAs (respiratory event related arousals). Here's a link that shows examples of the reports which are super easy to get with the new SD card
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

One thing I dont like about the Respironics machines is they have in the past lacked one feature in their algorithm which the Resmed line has. The ability not to increase pressure above 10 cm when the machine registers centrals.

I don't understand your reasoning here. No APAP machine will respond to centrals alone at any pressure. Instead they rely on signs of obstructive events to trigger the pressure increases. If a person has a sign or symptom of an impending obstructive collapse of the airway they all respond with increased pressure. They just wouldn't respond to a central because they weren't supposed to.
I have had a M series APAP...my minimum was 10 cm and I often saw pressures of 18...then I got a PR S1 APAP...same deal and now with the bilevel machines..sometimes I need much higher pressures for the obstructive events of some sort.

ResMed never would either. In fact they had the infamous statement that confused a lot of people that above 10 cm the machine wouldn't respond to centrals and people thought that meant all apneas. ResMed did and still does respond to obstructive precursors or warning signs at pressures above 10 cm. Newbies would panic when they read about the infamous A10 thing. We used to have lots of discussion on the forum about it.

But no APAP will respond with a pressure increase when the only thing that is sensed is a central. They never have....none of them. Now if a central is accompanied by a obstructive collapse precursor (snore, flow limitation) that is a different story.
But the increase is in response to the FLs or snores...not the central.

The S9 Autoset is a great machine but the new PR S1 APAPs are great machines too. Minor pros and cons with either.
There is also the S9 bird call thing...noise upon exhale. Not everyone hears it but a lot of people do....I do but it is very faint and a non issue really.
viewtopic.php?f=1&t=77077&st=0&sk=t&sd= ... ird+sounds

If you are used to ResMed and EPR...then you might be happier with a ResMed machine. Flex relief on the Respironics machines is not exactly the same feeling as EPR. I have tested both because I own both brands.

[Justin Case]

Thanks for the clarification on the 10 cm pressure issue. In the sleep lab, indeed my centrals were accompanied by a obstructive collapse precursor.

Looks like I will have to do a trial then for both machines: S9 and a PR S1. I read a blog from DME about the 60 series and how there may be an issue to some in terms of “wind noise” coming from the intake of the unit on higher pressures or hard breathing.

My insurance company has a limit of $2500 for a xPAP (I have a prescription for either). Perhaps I would benefit in terms of less noise from a bilevel machine? However, iirc bilevel machines tend to be always noiser than regular APAPS?

[49er]

Thanks for the clarification on the 10 cm pressure issue. In the sleep lab, indeed my centrals were accompanied by a obstructive collapse precursor.

Looks like I will have to do a trial then for both machines: S9 and a PR S1. I read a blog from DME about the 60 series and how there may be an issue to some in terms of “wind noise” coming from the intake of the unit on higher pressures or hard breathing.

My insurance company has a limit of $2500 for a xPAP (I have a prescription for either). Perhaps I would benefit in terms of less noise from a bilevel machine? However, iirc bilevel machines tend to be always noiser than regular APAPS?

Hi Justin,

I have a PR System one 750 Bipap as a backup machine. It is definitely noisier than my DeVilbiss but that may be because it has 29 decibel rating vs. the 26 this machine has. Not sure what the deal would be if they had the same ratings although perhaps the bipap would still seem noisier due to the changes in pressure from exhalation to inhalation.

Even though I am quite sensitive to noise, I have had no problems falling asleep with the BiPap. Then again it could be because I am so sleep deprived that this isn't an issue. Hard to say.

That would be great if you could trial the PR1 and the S9 to see which one you liked better. I wish had bought the S9 initially for various reasons.

Good luck.

49er