REMStar w/Cflex vs Resmed w/EPR

SleepDaddy · Post by **SleepDaddy** » Sat Mar 18, 2006 8:19 am

Does anyone know why Resmed elected to design their machine so that the pressure relief (EPR) only works in straight CPAP mode?

Is there a patent issue that prevents them from using it in APAP mode or is there a technical reason they couldn't do what Respironics has done.

This seems like such an obvious difference that would cause people to prefer REMStar machines over their product, that I don't understand why they would make that design choice.

wading thru the muck! · Post by **wading thru the muck!** » Sat Mar 18, 2006 8:47 am

It's likely that the ResMed algorithm, as originally written, was not compatable with EPR. My guess is that Respironics originally wrote their auto algorithm so that it would allow the future incorporation of c-flex.

SleepDaddy · Post by **SleepDaddy** » Sat Mar 18, 2006 9:26 am

So was Resmed just in to much of a hurry to get EPR to market to compete with Respironics to revise its algorithm? Still seems like a poor choice from a marketing perspective. If they would have included EPR in Auto mode, Resmed could claim to be a clearly superior machine in that it would pretty much do everything the Respironics machine does in a signficantly smaller package. Now with the introduction of the REMStar Series M, they have lost the ability to claim any advantage at all.

wading thru the muck! · Post by **wading thru the muck!** » Sat Mar 18, 2006 10:03 am

SleepDaddy wrote:So was Resmed just in to much of a hurry to get EPR to market to compete with Respironics to revise its algorithm?

As far as I know, the Algorithm is the same as has been used for years. It may be that it can not be incrementaly upgraded and still use the original FDA approval.

Brent Hutto · Post by **Brent Hutto** » Sat Mar 18, 2006 4:06 pm

The Resmed relief functions during the entire exhalation interval. It would be a major challenge to make APAP function when the inhale and exhale pressures are different. That's basically an auto-BiPAP. The Respironics relief only functions for a second or less a the inhale/exhale transition. I doubt they have to account for that at all in their APAP algorithm.

johnnygoodman · Post by **johnnygoodman** » Sat Mar 18, 2006 6:01 pm

Howdy,

Here is your answer, second article down.

https://www.cpap.com/DisplayNewsletter/22

Johnny

NightHawkeye · Post by **NightHawkeye** » Sat Mar 18, 2006 6:25 pm

SleepDaddy wrote:This seems like such an obvious difference that would cause people to prefer REMStar machines over their product, that I don't understand why they would make that design choice.

Market pressures force responses sometimes. ResMed's response may seem quick and dirty to those who have studied it, but remember that the educated folks on this forum are a small percentage of potential buyers. Superficially, EPR seems as good as C-Flex. One would have to dig deeper to find out that it doesn't work in APAP mode.

By offering EPR, ResMed has provided a potent argument for their DME's to use whenever a patient requests C-Flex; "Take this machine, it has EPR, which is even better." My hunch is that providing that argument was the real motivation for EPR. In the world of marketing, appearance is often more important than substance.

Regards,
Bill

Darth Vader Look · Post by **Darth Vader Look** » Sun Mar 19, 2006 1:16 am

Brent Hutto posts - The Respironics relief only functions for a second or less a the inhale/exhale transition. I doubt they have to account for that at all in their APAP algorithm.

Typically speaking and from my experience in electronics, algorithms cycle continuously many times a second. Decisions are made in milliseconds or even shorter times based on clock speed and sensory data present. It's most likely that Resmed didn't want to revise the algorithm for its auto as that would have been a big task, expensive and may have required further FDA approval.

john5757 · Post by **john5757** » Sun Mar 19, 2006 1:33 pm

It also may means that Resmed wanted to have the feature added with less time to market but may add the feature to the auto mode in the future . Keep in mind that not everyone find that C-flex is useful and it took me quite a few months to find that C-Flex while nice to have in the beginning was detrimental for my needs in the long term.

Goofproof · Post by **Goofproof** » Sun Mar 19, 2006 1:46 pm

[quote="SleepDaddy"]So was Resmed just in to much of a hurry to get EPR to market to compete with Respironics to revise its algorithm? Still seems like a poor choice from a marketing perspective. If they would have included EPR in Auto mode, Resmed could claim to be a clearly superior machine in that it would pretty much do everything the Respironics machine does in a signficantly smaller package. Now with the introduction of the REMStar Series M, they have lost the ability to claim any advantage at all.

SleepDaddy · Post by **SleepDaddy** » Sun Mar 19, 2006 4:16 pm

I agree that smaller is not necessarily better, but for those of us who travel a lot, having a REMStar Auto w/Cflex in a small package is a definite advantage .... all other things being equal of course.

There seem to be three to four main marketing advantages that are in play when selecting among the three leading APAP machines (which all appear to do a good job).

1. Expiration Relief (Respironics Cflex vs. Resmed EPR)
2. Size (Goodnight vs. Resmed)
3. Software (Silverlining vs. Encore Pro)
4. Price (all three are pretty close)

If any one manufacture can figure out how to come out on top in all three/four areas then I would give them a clear market advantage. This of course assumes you buy into my assertion that all three machines provide equally effective basic APAP functionality.

Goofproof · Post by **Goofproof** » Sun Mar 19, 2006 6:46 pm

5. Discounts or kickbacks to Dr,'s and DME's.

WallShaker · Post by **WallShaker** » Mon Mar 20, 2006 7:55 am

john5757 wrote: Keep in mind that not everyone find that C-flex is useful and it took me quite a few months to find that C-Flex while nice to have in the beginning was detrimental for my needs in the long term.

Just curious what your "detrimental" experience was? I've been using a REMstar Plus with C-Flex for about 3 months now, and I'm not noticing anything negative.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX

john5757 · Post by **john5757** » Mon Mar 20, 2006 11:29 am

The issue is breath stacking as desicrbe by "WillSucceed"

Panting. Breathing rapidly with none of the breaths being 'full' and satisfying. Breathing increases in speed and less carbon dioxide is blown off with each breath. User is trying to play 'catch-up' with the machine but cannot as the machine ALWAYS (by design) begins the pressure increase before the user has fully finished exhaling. Also, if the user has any pause between exhalation and beginning the next inhalation, C-FLEX is intolerant of this.

I wonder why RemStar plus with C-flex was making me grasping when I wake up in he morning like I was having a bad dream. When I happen had the chance to try a ResMed Machine which did not have the C-Flex I could not believe the difference it made. I call it the Dalai Lama effect.

It took me a long time to realize that the C-Flex was not for everyone since I was under the impression you had to have it. I glad that I had the foresight to try something else and surprise myself in the process.
Currently at 13cm I can not feel any pressure in exhaling at all and I have to make sure that the machine is running at times.

Guest · Post by **Guest** » Mon Mar 20, 2006 12:04 pm

john5757 wrote:The issue is breath stacking as desicrbe by "WillSucceed"

Panting. Breathing rapidly with none of the breaths being 'full' and satisfying. Breathing increases in speed and less carbon dioxide is blown off with each breath. User is trying to play 'catch-up' with the machine but cannot as the machine ALWAYS (by design) begins the pressure increase before the user has fully finished exhaling. Also, if the user has any pause between exhalation and beginning the next inhalation, C-FLEX is intolerant of this.
I wonder why RemStar plus with C-flex was making me grasping when I wake up in he morning like I was having a bad dream. When I happen had the chance to try a ResMed Machine which did not have the C-Flex I could not believe the difference it made. I call it the Dalai Lama effect.

It took me a long time to realize that the C-Flex was not for everyone since I was under the impression you had to have it. I glad that I had the foresight to try something else and surprise myself in the process.
Currently at 13cm I can not feel any pressure in exhaling at all and I have to make sure that the machine is running at times.

Mask	Humidifier

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REMStar w/Cflex vs Resmed w/EPR

REMStar w/Cflex vs Resmed w/EPR

Re: REMStar w/Cflex vs Resmed w/EPR