What is the best machine?

[Hosehead4ever]

Since Medicare pays the same price regardless of which machine I get, I was thinking of asking my sleep doc when I see him for a prescription for a better machine, if there is one. One thing I've heard before is to get an auto machine. Is there any reason to have say, a Resmed S9 Escape with EPR (seems to be the newest and bestest according to the limited reviews on cpap.com), over the PRS1 Pro I have now? Or is there even a better PR machine available?

[Ltmedic66]

Well,I personally think the answer depends on if your current machine is not providing something that you need. If you are doing fine on your current machine, there really is not need to change. If you NEED something that your machine lacks, then you really should to decide what features you want to have before you choose a particular model.

I have a very basic (high quality, but basic) CPAP that only reports hours of usage- no EPR, no Auto, no detailed data. The most important thing to me is a heated hose, which I have. I do perfectly fine with it. Would I enjoy looking at data? Sure, but it really doesn't seem to be worth $1,000 (whether I pay it or the insurance does) to get that.

Lots of people spend big bucks only to use the top of the line machine as a straight CPAP without using EPR or some of the other bells & whistles.

[Hosehead4ever]

Okay, so I would use EPR, I do want the very detailed data, and getting an auto now in case I ever really need it seems wise.

My question is targeted to those. Is there any significant difference in what I'm using now (and I definitely wouldn't want any less of a machine than I have now) and something snazzier? I'm not concerned with Crapria's bottom line and Medicare will pay the same amount for either machine. Nobody will lose except Crapria will make less money off of it. Boohoo for them.

Is there any benefit for Me to having a nicer machine?

[Ltmedic66]

Well, if you want to have all the bells and whistles on "standby" in case you ever need them, then I suppose you would want to look at the top of the line for each manufacturer, such as Resmed's S9 auto or the Fisher & Paykel Icon Auto or the PR System One REMStar Auto. Which flavor you prefer is really up to personal preference, though if you are happy with your current machine, then the PR is probablly the closest.

Keep in mind, I don't have any of those machines so perhaps people who do can tell you what they like or dislike about them. They all tend to be rated very highly, so from a preference standpoint, it's like asking if a Lexus, Mercedes, or Porche is the best car.

[Pugsy]

Avoid any ResMed machine with the word ESCAPE in it. No data available at all except hours of use.

EPR is exhale relief term from ResMed.

Your PR System One Pro has CFLEX plus.. the CFlex plus is exhale relief. Respironics and ResMed go about exhale relief differently but they both have some form of exhale relief.

The next step up or "better" from your existing machine would be the PR System One APAP with AFlex. Look at my profile machine to see it. My machine is auto and can be used in APAP or CPAP mode and offers exhale relief in the AFlex or CFlex modes. Difference in relief modes? Hard to describe how it feels but more of a breathing rhythm.
You can look at fancy description here. Your existing humidifier would work with this machine.
http://aflex.respironics.com/


The ResMed S9 Elite would be more comparable to your existing Pro machine since it is a straight CPAP machine.
The ResMed Autoset would be comparable in functions to the PR System One APAP.
Functions only. The algorithms are different but end result is the same.

Some people like the EPR relief better than Respironics relief. Other like Respironics better.
Both give effective therapy.

Do you NEED APAP? Some people do better with the auto ranges, some don't. It is nice to have just in case...
Some people don't tolerate the changes in pressure that the autos give. Some it disturbs sleep.

If you happened to have a "NEED" for the AUTO functions then it would benefit you to have the upgrade. If you don't need pressure ranges then there is no benefit. So how would you know? Hard to say. For me I am much, much worse in REM stage sleep and I need higher pressures sometimes there and sometimes I don't. I don't want to use 15 -18 cm all the time....so I have auto with a range that takes care if the run of the mill events and kicks in with more pressure when my REM stage events act up. Pressure changes have never bothered me. I use a range of 10 min to 20 max. It works for me. It might not work well for you or someone else.

If you can get an Auto machine that is wonderful. If you can't, you still have an excellent machine with full data available and exhale relief. You might not even like auto..it isn't for everyone but it is nice to have the choice.

[Hosehead4ever]

Thanks Pugsy, that was exactly what I wanted to know. Sounds like it would be more hassle than it is worth to switch at this point.

[LSAT]

Thanks Pugsy, that was exactly what I wanted to know. Sounds like it would be more hassle than it is worth to switch at this point.

If you have had your current machine for more than 30 days, it may not be possible to exchange it at Apria or most other DMEs. I have an auto that give me data and a low end Fisher & Paykel....I much prefer the low end machine. For me it is much more comfortable.

[Janknitz]

First, as already pointed out, the ESCAPE is a much WORSE machine than you already have. The Escape has no data, your PR S1 Pro does!

Secondly, if you are going to switch brands, it will cost you. Why? Medicare bought your humidifier, even though it rents (rents to own) your machine. So if you switch brands, you're going to have to BUY a new humidifier out of pocket and if you buy it from Crapria prepare to pay a few hundred dollars for it.

So if you stay with PR S1, the "better" machine is the auto. It's nice to have an auto, but your'e doing fine on straight CPAP and now convincing Crapria to take back your now used Pro to switch it out for an auto "just because" is not going to be an easy task.

IMHO--and I think you are already realizing this--it's not worth the money and the hassle. You're better off to buy your own auto machine used, Craigslist, or online if you want a backup machine--it will cost you out of pocket not much more and there will be no hassle with Crapria. You can probably get a good deal on a PRS1 auto on an auction site and use your existing humidifier, or go for a less expensive but equally good machine like a DeVlibiss auto.

[Hosehead4ever]

Thanks Janknitz! I had wondered that about the humidifier also.

[dtsm]

Everyone should buy a unit that has at least these two functions:

1. apap [auto adjusting] vs. just cpap
2. full data capability so that you can manage and monitor your therapy.

ResMed and Respironics both offer units that have the above two features along with other bells and whistles. If money is an issue, try secondwincpap.com - they offer reasonably priced 'open box new' units

[Emilia]

@dtsm: DeVilbiss Intellipap also has auto and full data capability....and is much less expensive. Secondwindcpap.com rocks....that is where I got my Intellipap AutoAdjust. Great customer service. And they do have gently used machines so the OP could find a PR Auto there, I am sure, and just use the existing humidifier.

[Otter]

@dtsm: DeVilbiss Intellipap also has auto and full data capability....and is much less expensive.

It doesn't let you look at breath by breath trace data, though. If not for that, I'd probably have gone with the DeVilbiss too.

Secondwindcpap.com rocks....that is where I got my Intellipap AutoAdjust. Great customer service. And they do have gently used machines so the OP could find a PR Auto there, I am sure, and just use the existing humidifier.

I agree on Secondwind. The level of CS is amazing. Unfortunately, the only PR1 Autos they have (or had a couple weeks ago when I inquired) are the older, noisier version without a backlit display and with a more aggressive diagnostic pressure pulse. But they get new machines in all the time, so that may have changed.
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