New APAP user without sleep study looking for advice

[Pugsy]

Refurbished where...at factory or by the seller?
If refurbished at the factory it should be zero hours unless someone used it since being worked on at the factory.
Most sellers won't have the equipment to do an official refurbish because refurbish usually involves bringing the unit back to "like new" conditions which mean zero hour.
At least that's what happens here in the US...hours get reset.

If the seller is doing the refurbishment....exactly what does he do would be a question I would ask.

I personally wouldn't have a problem with even a factory refurbished unit with a few hours on it.
As for just being "used" without official refurbish....pretty much all my machines I have bought have been used. I am not afraid of them and one even had 2700 hours on it. That was high I know but it was a special kind of machine and I got a more than fair price and the seller was someone who knew me and let me pay it out in monthly payments.

I consider anything less than 1,000 hours used fairly new and anything less than 100 hours just like brand new.....but that's me.

Now you are in a different part of the world so your choices are going to be different and might not be the same as mine.
But if you can get a ResMed AirSense 10 AutoSet either used with modest number of hours or refurbished for less than the System One....no brainer....better deal. The System One models were discontinued 5 or 6 years ago and even now the replacement for System One models (the DreamStation) is now being sold so the DreamStation 2 will eventually replace the DreamStation.
Discontinued models...less demand...so lower value no matter how many hours on it.

[gadgetmaniah]

Refurbished where...at factory or by the seller?
If refurbished at the factory it should be zero hours unless someone used it since being worked on at the factory.
Most sellers won't have the equipment to do an official refurbish because refurbish usually involves bringing the unit back to "like new" conditions which mean zero hour.
At least that's what happens here in the US...hours get reset.

If the seller is doing the refurbishment....exactly what does he do would be a question I would ask.

I personally wouldn't have a problem with even a factory refurbished unit with a few hours on it.
As for just being "used" without official refurbish....pretty much all my machines I have bought have been used. I am not afraid of them and one even had 2700 hours on it. That was high I know but it was a special kind of machine and I got a more than fair price and the seller was someone who knew me and let me pay it out in monthly payments.

I consider anything less than 1,000 hours used fairly new and anything less than 100 hours just like brand new.....but that's me.

Now you are in a different part of the world so your choices are going to be different and might not be the same as mine.
But if you can get a ResMed AirSense 10 AutoSet either used with modest number of hours or refurbished for less than the System One....no brainer....better deal. The System One models were discontinued 5 or 6 years ago and even now the replacement for System One models (the DreamStation) is now being sold so the DreamStation 2 will eventually replace the DreamStation.
Discontinued models...less demand...so lower value no matter how many hours on it.

Ah, I see. The seller says that the machines have hours on them, and I've asked him to confirm the number of hours on the machine before he sends it to me. I asked him about where the machines are refurbished, and I think he said that they are refurbished from where they come from (he said he imports them Australia and some Asian countries). I think it should be good a deal. He's also giving a one year warranty (he actually has a shop). Hoping it turns out to be ok!

[gadgetmaniah]

Refurbished where...at factory or by the seller?
If refurbished at the factory it should be zero hours unless someone used it since being worked on at the factory.
Most sellers won't have the equipment to do an official refurbish because refurbish usually involves bringing the unit back to "like new" conditions which mean zero hour.
At least that's what happens here in the US...hours get reset.

If the seller is doing the refurbishment....exactly what does he do would be a question I would ask.

I personally wouldn't have a problem with even a factory refurbished unit with a few hours on it.
As for just being "used" without official refurbish....pretty much all my machines I have bought have been used. I am not afraid of them and one even had 2700 hours on it. That was high I know but it was a special kind of machine and I got a more than fair price and the seller was someone who knew me and let me pay it out in monthly payments.

I consider anything less than 1,000 hours used fairly new and anything less than 100 hours just like brand new.....but that's me.

Now you are in a different part of the world so your choices are going to be different and might not be the same as mine.
But if you can get a ResMed AirSense 10 AutoSet either used with modest number of hours or refurbished for less than the System One....no brainer....better deal. The System One models were discontinued 5 or 6 years ago and even now the replacement for System One models (the DreamStation) is now being sold so the DreamStation 2 will eventually replace the DreamStation.
Discontinued models...less demand...so lower value no matter how many hours on it.

Ah, I see. The seller says that the machines have hours on them, and I've asked him to confirm the number of hours on the machine before he sends it to me. I asked him about where the machines are refurbished, and I think he said that they are refurbished from where they come from (he said he imports them Australia and some Asian countries). I think it should be good a deal. He's also giving a one year warranty (he actually has a shop). Hoping it turns out to be ok!

Ok, so the seller's is saying that the machines he has usually have about 4-5k hours on them. I thought that was normal but from your comment it seems 2000+ are a lot? I have already ordered Resmed from him though but have told him to send one with the least amount of hours. Apparently here it seems sellers don't take the machine's hours into account when setting the price.

[Pugsy]

We have a place here in the US that sells used machines (and new open box zero hour machines)...they buy used machines from where ever they find them.
Secondwindcpap.com
They won't buy any used machine with more than 2,000 hours on it.
You can check their prices to get an idea what they run.
You could buy from them if you wished as they do international sales.
They don't do any actual refurbishing beyond generic clean up though. Refurbish to me means you take something that is broken and repair it and fix it and make it function like new.

I don't have a problem with high hour machines as long as the price reflects the hours of use.
But here I sit in a country where I have many options. You may not have those same options where you sit.

The "refurbish" part...we don't know what part of the machine that was broken got fix...if it was the blower then even if the overall machine had high hours...we might be looking at a low hour new motor. Or if it was the computer chip inside the machine that got messed up and replaced then the fixing might just involve the computer hardware and there might still be a high hour motor in the machine. Part of the problem and a con when looking at anything refurbished...we don't know all of what might have been fixed or not fixed...but if the price is acceptable then we take the risk.
This guy offers a 1 year warranty...pretty good actually on any used machine. Secondwindcpap.com only offers 6 months on the used machines they sell but then they won't even stock any machine with more than 2 K hours on it so small risk of anything happening.

You have to look at what is available where you live and evaluate the costs from this seller. Obviously high when compared to such sellers here in the US but that really is an apples and oranges comparison because of where you live.
Maybe when compared to other similar sellers available to you where you live his prices aren't so bad.

[gadgetmaniah]

Ah, I see. Yeah, my buying options here in Pakistan are quite limited. I did have a look at the website that you've mentioned - didn't know that they did international shipping but thank you for letting me know!

I do have some relatives in the US so I guess I could have ordered it through them as well. But I needed something immediate so the Resmed Auto that I ordered seemed like a good deal (though now I realize not a very good deal judging from the US CPAP market's perspective).

I think it should be better than buying the Philips System One machine that I have on rent right now. The Philips has fewer hours on it (about 1200) but I don't think $400 is justified for it. I also read that Resmed may offer better therapy due to it responding better to events so I was inclining more towards it.

[gadgetmaniah]

Ok, so I wanted to ask about my breathing pattern from part of my sleep today. The sleep wasn't good, probably because I had too many large leaks (almost 40%). But what I wanted to ask is about my breathing pattern from 13.15 to 13.30. It seems like there was some issue with my breathing but the machine hasn't marked any events. Does it look like there was something wrong here? The pattern that you see in the picture lasted from 13.15 to 13.30.

Also, I noticed that during large leaks my breaths were much shallower than when there were no large leaks (i.e., in periods of large leak there was only a tiny upwards curve but in normal periods there is a large upward and a large downward curve). I guess that's due to inadequate pressure due to the mask leaking?

[Pugsy]

Any data shown during periods of large leak is questionable because we don't know how much the leak is affecting the machine's ability to sense anything. So the differences in flow rate during large leak we don't know if they are because of difference in real breathing or simply the machine not being able to do its job. We have to ignore it.

From 13:24 to 13:26 .....I don't think the flow rate is as subdued as it appears. I think the issue is partly the scale of the graph causing the flow rate to look decreased along with the chance that this is awake breathing flow rate and thus we have to ignore it.
I don't think you are asleep.

[gadgetmaniah]

Any data shown during periods of large leak is questionable because we don't know how much the leak is affecting the machine's ability to sense anything. So the differences in flow rate during large leak we don't know if they are because of difference in real breathing or simply the machine not being able to do its job. We have to ignore it.

From 13:24 to 13:26 .....I don't think the flow rate is as subdued as it appears. I think the issue is partly the scale of the graph causing the flow rate to look decreased along with the chance that this is awake breathing flow rate and thus we have to ignore it.
I don't think you are asleep.

Oh right, I see. So it's nothing to worry about. Thanks!

[gadgetmaniah]

Since I'll be getting the Resmed machine in a couple of days, could you please let me know whether there any differences in its settings compared to Philips' machines? I have heard of EPR which I think is exhale relief. I'll probably be using that, so what minimum pressure would I need to set the Resmed at so that the minimum pressure is actually 6 cm? (I read that the actual minimum pressure is derived by subtracting the EPR from the pressure setting - or something like that).

Will I also need to get a new memory card or can I just use the memory card that I've been using with the Philips machine? I think I'll have to format it first if I want to use it with my new machine.

[gadgetmaniah]

Ok, I received the Resmed S10 machine today. I'm not sure which version it is, but it has both auto and auto for her modes available. It seems to be a Japanese version actually judging from the branding but it's interface is in English.

Anyways, I've set it to a min of 6 cm pressure with EPR at 2. I'm not sure why, but the machine's pressure seems to be much stronger than the pressure of the previous Philips machine that I was using when I tried it for a few minutes. Maybe it's because I've removed the bacteria filter from the end of the hose which had accumulated cat hair (though not much). I've also set it to autoset for her mode since I've read that it may be of benefit.

I've also noticed that the transition between the exhale and inhale seems more abrupt with the Resmed. The Phillips machine's transition was smoother, and its pressure also felt gentler. But anyways, let's see how the new machine fares for me.

[gadgetmaniah]

Further update: So the version of machine is called 'Respond W' and though I've found little information about it online, I have seen it need it mentioned in some of Resmed's leaflets online.

About the transition bring abrupt between inhale and exhale pressure, it seems that that was due to EPR being set to function during ramp only, which I was not using. I ticked the option of EPR working 'full time' and now I can feel that the transition is smoother and more similar to the previous Philips machine that I had.

The pressure still seems stronger than the previous machine though, even though the minimum is set to the same value (6 cm). Also, does anyone know whether the Resmed machines have any way of managing large leaks?

Lastly, there has been some issue with importing the data to Oscar from the machine. The SD card was in the machine while I slept today and the machine detected it as well, but when I inserted it into my laptop and tried to import the data, Oscar did not import anything. I think I figured out the problem though - the machine was set to a future date (21 May though today is 20 May). It was one day ahead in time. I had to erase its data to be able to select the correct date. Hopefully now I can retrieve the data.

[Pugsy]

Yes, the machine couldn't import from a future date. Fixing the calendar should resolve this issue.
Unfortunately you lost past data with the erasing needed to fix the calendar but there wasn't much data from you there anyway.
It is the only way to fix the calendar issue though. I have had to do that myself...some dummy set the calendar one day ahead while changing the clock one time.

The perceived differences between the pressure settings between the 2 machines even though the same 6 cm...that's because the exhale relief available on the 2 brands is simply different so it will feel different.
Flex exhale relief on the Respironics simply doesn't work the same as the ResMed EPR even if the settings are the same.

[gadgetmaniah]

Yes, the machine couldn't import from a future date. Fixing the calendar should resolve this issue.
Unfortunately you lost past data with the erasing needed to fix the calendar but there wasn't much data from you there anyway.
It is the only way to fix the calendar issue though. I have had to do that myself...some dummy set the calendar one day ahead while changing the clock one time.

The perceived differences between the pressure settings between the 2 machines even though the same 6 cm...that's because the exhale relief available on the 2 brands is simply different so it will feel different.
Flex exhale relief on the Respironics simply doesn't work the same as the ResMed EPR even if the settings are the same.

Thanks for the reply! So I think the machine I got was faulty - the pressure felt too much even at only 6 cm and my mask kept leaking even though I had it on pretty tight. This did not happen to me with the Philips. I will be receiving a replacement tomorrow which hopefully will work alright.

I'm also curious how loud your breathing through the mask with the S10 is supposed to be. When I inhaled, my breathing was loud enough to be heard by others in the room. With the Philips, there wasn't any audible noise from the mask when breathing. I also wonder whether it could be a problem with my mask perhaps? I washed with soap and water before using it with the Resmed, though I did properly dry it.

You can see the pressure and leakage in the pictures attached. This is despite having properly tightened my mask.

[gadgetmaniah]

Ok so I received my replacement today and it seems to be delivering the pressure fine. There was clearly something wrong with the previous machine's pressure that the vendor had sent. However, I'm still experiencing some noise from the mask when I inhale. It's kind of a rough, fluttering noise. I don't think it's due to the machine as I've tried changing the machines. Anyways, I will be visiting the vendor's shop soon so I can test the mask and see whether there is a problem with it.

[MaskMan8888]

If you are looking to find a good mask to use either now or in the future, try downloading MaskFit AR on the App Store. IT's a free app that helps suggest the best mask for you from all makes and models. Truly an objective and unbiased system.

https://www.youtube.com/watch?v=t8c-BIT4TjA&t=1s