Switching to ResMed S9 from System One–what should I know?

[satsumass]

Hi all,

I went to stanford sleep center and after my SD card reader broke in my 2 year old System One device, I am getting a new machine and I asked to try the ResMed S9. I'm wondering what I should expect in the changeover. I've had quite a tough time getting the System One to work effectively–mostly, even with heated tube, I don't get enough moisture, though I did just try using the hibernite and that helps. In addition, the CFLEX comfort setting, I realized, I didn't need and worsened thing, so I have set that down to the lowest level.

I'm at 10.5-14 and my AHI comes in around 2.5-4 depending on the week. Big issues for me are getting enough moisture in and to a lesser degree pressure comfort.

Dr says "the machines are the same, people who like tracking data/are more technical like the S9 a bit better"...excited to get a new machine and hope it helps my sleep but just curious as if anyone has any thoughts.

The one thing I am especially curious is whether AHIs on ResMed vs SystemOne "match up"; e.g. is a 2.5 the same on both? Does one tend to be higher than the other over the exact same sleep (hypothetically). I do recall reading somewhere I believe that they code central apneas differently....true???

Thanks!

[turbosnore]

What I remember seeing: there is no "read-only" data reading mode (Patient menu) in System One.
The data is there to be read, but you can accidentally change some settings.
And leaks are expressed in percentages, I recall (vaguely - I might be wrong here).

[Janknitz]

I haven't switched from one to another personally, but I have seen posts here from people who have, and the biggest complaint is that the algorithms are different, so the feel of the machine at the end of the breath and how the pressure comes back after exhalation is different. Expect it to feel a little different and understand it may take some getting used to.

I'll let the ResMed people weigh in on the humidifier/heated hose thing. It sounds like you can get a lot of warmth with the ResMed, the PR's NEVER feel warm.

When you mention "getting enough moisture" it begs the question--are you mouth breathing? Even if you are in a full face mask so that you won't lose pressure, mouth breathing is the most likely reason behind dry mouth. No machine is going to fix that.

[JDS74]

You don't list which PR machine you will be replacing.
The biggest difference that gets reported is the changeover between exhale to inhale.

If you are getting a bilevel machine, then note that Respironics can change both EPAP and IPAP independently while ResMed does not.

Those things contribute to the "feel" of things.
I haven't heard of any criticism of either brand in giving good therapy.
My only suggestion is to try to make sure that you can swap back if the difference in feel is too great.

[Pugsy]

The new 60 series machines with the heated hose...much better humidity delivery and temperature control than using the Hybernite on the 50 series.
It's going to be comparable to the S9 with the Climateline except the 60 series offers 90% specifically.

[jmrobert48]

I made the same switch in Jan. Both machines were/are asv. I also have periodic breathing (changing breath frequency) and the PR machine would get out of sync and wake me up on average 3 times a night. Also, with the PR system, I would get frequent rain-out. My current S9 doesn't wake me up, and I've not had any rain-out. I would not go back to a PR system! AHI is supposed to be measured the same for all systems, not just PR and Resumed. The difference would be how each machine determines what is an apnea/hypopnea.

[robysue]

I switched the other direction several years back when I was a newbie. My guess is you won't have any serious problems to contend with.

That said, here are the things that I think you need to be aware of with the S9:

1) The S9 does not store ANY of the detailed data on-board the machine; it just stores the summary stuff. So if you forget to put the SD card back in the machine after downloading data into SleepyHead or ResScan, the detailed data is gone forever and SleepyHead won't be able to get at the summary data. So there will be a hole in your data in SleepyHead. (The PR stores everything except the wave flow data on board, and so if you forget to put the card back in the machine, you still have everything else show up in SleepyHead or Encore without any problems since the rest of the detailed data will be written to the card as soon as you put it back in the machine.)

2) The S9 overwrites the high resolution data, including the wave flow data, every seven days. It also overwrites the other detailed data every 30 days. If you want the wave flow data, you have to download at least once a week. If you want the other detailed data, but don't care so much about the wave flow, you have to download at least once a month. (The PR never overwrites the data as near as I can tell.)

3) The S9 is extremely picky about anything at all being written to the SD card, whereas the System One does not seem to care. So get into the habit of locking the SD card before putting it into your computer and unlocking it before putting it back in the machine. (My System One doesn't seem to care about whether the card is locked when I put in the computer or whether I even remember to unlock it when I put it into the machine. I noticed ths morning that the card's switch was in the locked position when I took it out of my BiPAP, but all last night's data downloaded into SleepyHead without any issue.)

4) The hose connection on the S9 is in the back of the humidifier. And it doesn't rotate. So if you are someone who thrashes around a bit in your sleep, you may find that the machine moves around more on your nightstand. You may also find that you need to inspect the hose couplings more carefully because there's some extra stress put on them by where the hose connection is on the humidifier. (I kept having hoses rip right above the coupling when I was using an S9; I've never had a hose develop that problem in over 3 years with my System One.)

5) If you ever use your machine with a battery, the S9 is far pickier about how it must be connected. The PR machines can run directly off 12v power, and so all you need is the DC cable; the S9s use 24v power and hence an inverter of some sort is needed. That typically means the battery won't last as long.