People who have owned resmed and responics machines

[track]

How much difference is there between these two machines in recording HI? If you have an HI of 4 on a resmed S7 or S8 what would your HI run on the remstar?

[Snoredog]

my opinion:

you cannot compare those two aspects between those machines. They use totally different algorithms and the Resmed machine doesn't detect Hypopnea (HI) at all (see below), those displayed on the LCD are calculated from FL's seen. That may also be why they show just a screwy line on a Rescan/AutoScan report.

According to their website, that machine only triggers on:

-Flow Limitation
-Apnea
-Snoring

so if the Resmed algorithm works the way it is supposed to, you should not have any HI's, the machine should be eliminating them before they ever reach that stage, but since it doesn't display FL's on the LCD or in its reports, it displays them as HI's. Apnea are sudden with the only indicator possibly being snore. That machine will chase down a snore until it blows your head off.

Resmed machine will always have a higher HI than a Remstar, but if you continue increasing pressure even those should drop. What you don't know is how many of those HI's are actually FL's. On the Remstar FL's are counted separately on the reports and not displayed on the LCD.

[Slinky]

It can vary w/the individual. MOST OSA patients do as well w/the algorhythm of one manufacturer as they do another. I'm one of those evidently, at least as far as the Resmeds and Respironics. I haven't had the opportunity to try the Puritan Bennett altho I would like to.

I saw no more than a .1-.2 difference in my AHIs between the two brands over a week's averages.

[mommaw]

Slinky, between the 2 do you have a preference? I had a PB 420E and did not like it at all so I have always wondered if a ResMed would work for me.




Snoredog,

Am I understanding you correctly in that the ResMed machines eleminate hyponeas before they happen? Can you eleborate more? I have mostly hyponeas and that would be great if that were the case. I don't know anything about the ResMed machines but have always wanted to try one.

Gilda[/quote]

[Bearded_One]

I have a Respironics M Auto with C flex and a P-B 420E, they both select the same pressure, but they seem to read AHI's differently.

[dsm]

[quote="track"]How much difference is there between these two machines in recording HI? If you have an HI of 4 on a resmed S7 or S8 what would your HI run on the remstar?

[Slinky]

As far as effective therapy between the Resmed S8 AutoSet Vantage and the "classic" Remstar Auto w/C-Flex? I noticed no difference at all. Both worked well for me.

Actually, I went from the Resmed S8 Elite to the "classic" Remstar Auto w/C-Flex to the Resmed S8 AutoSet Vantage. I still have the Elite and the Vantage, I sold the Remstar to my son in law for use when he travels as he has a big ole Virtuoso LX (I forget, maybe it isn't LX, maybe ST?, whatever) and a clumsy stand alone humidifier at home.

Altho I have both AutoScan 5.7 and ResLink for my Resmeds and the EncorePro v.5 something plus MyEncore for the Respironics I just preferred the easy access to the Resmed data via the easy to read, good size LED screen. Altho the Respironics M Series has increased the data available via the LED screen it is a PITA to access whereas w/the Resmeds it is so simple.

That's my only reason for preferring the Resmeds over the Respironics. It had nothing to do w/effectiveness of therapy. Since I don't use Ramp, EPR or C-Flex any more I really would like the opportunity to try the Puritan Bennet GoodKnight 420E w/their Silverlining software. On the other hand, by the time I am willing and able to spend the money to do so Puritan Bennet may have something newer and better available.

By the way, SnoreDog, I've been running 8.0 to 8.2 pressure (setting is 8.0) w/a leak rate from .62 to .70 (averaging .30) and an AHI of 5.5-6.0 and AI of 0.0 to 0.1 the past 4-5 nights since feeling better again.

[track]

Thanks to everyone that offered info. Unfortunately I didn't get any actual data comparisons so I will pose another question. I regularly read here about people that are below one or even zero in their AHI. Has anyone successfully got a resmed machine to record zero HI?

[DreamStalker]

Thanks to everyone that offered info. Unfortunately I didn't get any actual data comparisons so I will pose another question. I regularly read here about people that are below one or even zero in their AHI. Has anyone successfully got a resmed machine to record zero HI?

I never did get zero with the S8 Vantage during my first 4 months on the hose. However, it took me about 3 months of use afterwards with Remstar Auto Tank to get zero. Since Feb of this year, I now get zero AHI about two or three times a week with Remstar machines. Nonetheless, like Slinky, I was unable to tell the difference in effectiveness between either ResMed or Remstar machines. Unlike Slinky, I ended up selling my ResMed machine and kept both my "tank" auto and M w/ AFLEX.

I suppose if you have something other than plain vanilla "obstructive" apnea as I do, you may well notice a difference.

[track]

Thanks dreamstalker...I am not unhappy with my resmed machine or treatment. I do wonder though if I am striving for an unattainable goal in getting my HI below 2 or 3. I have had success lowering the AI to below one but not the HI. Some people say they don't feel their best until they get their AHI to one and I have some doubts if I will ever achieve that with my machine....maybe this is as good as it gets....but no reason not to strive for more..unless more is unattainable.

[ozij]

<snip>
The thing about HI data is what it actually is and it can be as simple as a yawn (S8 will score it). It can be changing position in sleep & thus taking a bigger than normal breath thus slowing breathing for a few seconds longer than normal. Or HI can score a genuine slowdown in breathing.

<snip>

According to the above, the following will be scored as hypopneas by a Resmed machine:

A yawn
A changing position in sleep
Slowing breathing caused by a bigger breath having been taken.

The technical word for describing this kind of response by a machine is "senstivity". A Resmed is more sensitive to all kinds of variations in the breath flow, and will report them as Hypopneas.

Even if they were yawns, or shallow breaths. It will also report a "genuine slow down in breathing" as a hypopneas. And the total AHI report will reflect the Resmed's sensitivity to all those events.

A burglar alarm reacting to every leave that drops on a car is also
extremely sensitive.

Both the burglar alarm and the Resmed machines may not miss anything they're supposed to report - they'll report all burglars or all hypopneas, and then some - there will be alot of noise (...) in the data, since we won't know if the reported incident is a leaf (to be disregarded) or a burglar (stop him!), a yawn (to be disregarded) or a hypopnea (raise the pressure and stop it!).

What it boils down to is that for some types of flow limited breathing style, there is no chance of achieving 0 AHI on a Resmed - and this has nothing to do with the quality of the therapy it gives - it may take care of all the genuine hypopneas, and still report other events as though they were hypopneas too.

Just like some people need to use the IFL1=1 switch on a PB to keep it from raising the pressure uncontrolably.
O.

[billbolton]

there will be alot of noise (...) in the data

"Noise" is data which is unrelated to the purpose of the "signal". In the case of xPAP treatment the purpose of the data is sleep breathing, so there is no noise involved, its all "signal"!

Also, all "data" needs some level of interpretation by the observer to decide if whether it is trivial or significant. Personally I'd rather make the trivial/significant distinction based on all available data, rather than have a machine making an arbitrary choice for me.

YMMV

Cheers,

Bill

[dsm]

there will be alot of noise (...) in the data

"Noise" is data which is unrelated to the purpose of the "signal". In the case of xPAP treatment the purpose of the data is sleep breathing, so there is no noise involved, its all "signal"!

Also, all "data" needs some level of interpretation by the observer to decide if whether it is trivial or significant. Personally I'd rather make the trivial/significant distinction based on all available data, rather than have a machine making an arbitrary choice for me.

YMMV

Cheers,

Bill

Bill,

Yup, but, my guess is that your spot on point will be somewhat lost here

DSM

[dsm]

[quote="track"]Thanks dreamstalker...I am not unhappy with my resmed machine or treatment. I do wonder though if I am striving for an unattainable goal in getting my HI below 2 or 3. I have had success lowering the AI to below one but not the HI. Some people say they don't feel their best until they get their AHI to one and I have some doubts if I will ever achieve that with my machine....maybe this is as good as it gets....but no reason not to strive for more..unless more is unattainable.

[ozij]

<snip>
The thing about HI data is what it actually is and it can be as simple as a yawn (S8 will score it). It can be changing position in sleep & thus taking a bigger than normal breath thus slowing breathing for a few seconds longer than normal. Or HI can score a genuine slowdown in breathing.

<snip>

"Noise" is data which is unrelated to the purpose of the "signal". In the case of xPAP treatment the purpose of the data is sleep breathing, so there is no noise involved, its all "signal"!

Both the burglar alarm and the Resmed machines may not miss anything they're supposed to report - they'll report all burglars or all hypopneas, and then some - there will be alot of noise (...) in the data, since we won't know if the reported incident is a leaf (to be disregarded) or a burglar (stop him!), a yawn (to be disregarded) or a hypopnea (raise the pressure and stop it!)

Emphasis added in both quotes by me.

No doubt the obesrver decides what is noise and what is not.

The bottom line is as always: Some machines are not as good as others for some people - as a matter of fact, a Resmed may be great for a majority, and not as good for a minority. The same is true of any other company.

If someone is into the AHI Olympics (let's see if I can get my AHI reports even lower) a Resmed Auto is probably not the best machine to try it on because of the way it reports events.

O.

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, AHI, Hypopnea, auto