NEW MACHINE

[jomac30]

Next week I'm seeing my sleep doctor. I'm going to ask him to prescribe a new machine for me because I've had no relief since I started cpap 14 months ago. I was going to ask for a Respironics APAP with A-flex, then I read about the S8 vantage who some say is the Cadillac of machines. Is there a major difference in the APAP machines? I want to get the best I can, but I don't know which one that is. Any advice or comments whould be appreciated and help making my decision. Thanks

[Wulfman]

The S8 Vantage does NOT have exhale relief in APAP mode......the REMstar Autos DO.

The REMstar M Series Auto w/A-Flex is the top-of-the-line Auto/APAP as it has more features and modes of therapy than all the rest.

Den (not going to do car comparisons.....as I drove both Chevys and Fords)

[DreamStalker]

If anything, the AFLEX machine is the Cadillac. I have used both and they are both good machines but the AFLEX machine offers more options. The AFLEX offers two types of exhalation relief in APAP and one type in CPAP mode, the Vantage only has one type in CPAP mode.

[DreamStalker]

The S8 Vantage does NOT have exhale relief in APAP mode......the REMstar Autos DO.

The REMstar M Series Auto w/A-Flex is the top-of-the-line Auto/APAP as it has more features and modes of therapy than all the rest.

Den (not going to do car comparisons.....as I drove both Chevys and Fords)

I hear an echo again !

Maybe the "some" who say the Vantage is a Cadillac were refering to a 50's model with no AC or power steering?

[Wulfman]

The S8 Vantage does NOT have exhale relief in APAP mode......the REMstar Autos DO.

The REMstar M Series Auto w/A-Flex is the top-of-the-line Auto/APAP as it has more features and modes of therapy than all the rest.

Den (not going to do car comparisons.....as I drove both Chevys and Fords)

I hear an echo again !

Maybe the "some" who say the Vantage is a Cadillac were refering to a 50's model with no AC or power steering?

And, with no cruise control or radio......and one tire that's going flat with the engine on fire (referencing their recall).....

Den

[kayfouroh]

So the Vantage is that bad huh?

[Snoredog]

The S8 Vantage does NOT have exhale relief in APAP mode......the REMstar Autos DO.

The REMstar M Series Auto w/A-Flex is the top-of-the-line Auto/APAP as it has more features and modes of therapy than all the rest.

Den (not going to do car comparisons.....as I drove both Chevys and Fords)

I hear an echo again !

Maybe the "some" who say the Vantage is a Cadillac were refering to a 50's model with no AC or power steering?

And, with no cruise control or radio......and one tire that's going flat with the engine on fire (referencing their recall).....

Den

[DreamStalker]

So the Vantage is that bad huh?

No. The Vantage is not that bad. As I said it is a good machine but IMO (and others too) it is not the best.

[Slinky]

Not at all!!! I have the Vantage as well as the Elite straight CPAP and they are BOTH great machines!

The Respironics M Series Auto w/A-Flex "is" the "Cadillac" of autoPAPs IF you need or want the "flex" in all modes. W/an auto I fail to see the need - but .... The Respironics patient software, EncoreViewer, is easier for a patient to obtain.

The Respironics M Series has "its" problems: a badly designed integrated heated humidifer that still has problems DESPITE the Recall for the worst of the problem. The M Series power supply is on a separate platform w/wires. Many have complained of the blue lights than can't be turned off. There is a problem w/them dropping data a couple of days a month.

The Resmed S8 AutoSet Vantage can not provide EPR (expiration pressure relief) in auto mode. EPR is available only in straight CPAP mode. It has MUCH EASIER access to data on the LCD screen than ANY of the Respironics xPAPs. The software is MUCH EASIER to install. The software is easier to use and understand. The VOLUNTARY Recall of SOME of the S8s by serial number involved an out-sourced part and Resmed REPLACED the ENITRE xPAP unit. Unlike the Respironics humidifier problem which only fixed "part" of the problem w/a very poorly designed unit. The power supply for the Vantage is contained w/in the device itself. The Resmeds carry the data in the device not on the data card. The data card is strictly a data transfer item. I've never had either my Elite nor my Vantage drop ANY data. The ResScan software is a little more difficult to obtain but ... can be done. The AutoScan software is easier to obtain and works well. I have both.

There are advantages and disadvantages to both units. But both provide EXCELLENT therapy.

Most users here are Respironics users and many have a grudge against Resmed for their minimum ADVERTISED price policy for online DME suppliers in the USA. But that does NOT affect the quality of their devices nor the therapy they provide.

[Snoredog]

While I like my A-Flex, I would also consider the new devilbiss intellipap, devilbiss has always had pretty decent therapy in their auto's and it has been a sleeper for years.

https://www.cpap.com/cpap-machine/devil ... chine.html

Based upon your 13 cm pressure requirement, the S8 would most likely be a disaster for you, it doesn't respond to apnea above 10 cm pressure at all.

who told you the S8 was a Cadillac? When was the Cadillac made down under? Just because that moron company decides to rip off Americans by intentionally overpricing it by a factor of 2, doesn't mean it is a Cadillac.

[tangents]

If exhalation relief isn't necessary, I put in my vote for the Puritan Bennett 420E. Small, inexpensive, quiet, easy to program and great data output.

Good luck with whatever you choose!
Cathy

[DreamStalker]

Not at all!!! I have the Vantage as well as the Elite straight CPAP and they are BOTH great machines!

The Respironics M Series Auto w/A-Flex "is" the "Cadillac" of autoPAPs IF you need or want the "flex" in all modes. W/an auto I fail to see the need - but .... The Respironics patient software, EncoreViewer, is easier for a patient to obtain.

The Respironics M Series has "its" problems: a badly designed integrated heated humidifer that still has problems DESPITE the Recall for the worst of the problem. The M Series power supply is on a separate platform w/wires. Many have complained of the blue lights than can't be turned off. There is a problem w/them dropping data a couple of days a month.

The Resmed S8 AutoSet Vantage can only provide EPR (expiration pressure relief) in auto mode. EPR is available only in straight CPAP mode. It has MUCH EASIER access to data on the LCD screen than ANY of the Respironics xPAPs. The software is MUCH EASIER to install. The software is easier to use and understand. The VOLUNTARY Recall of SOME of the S8s by serial number involved an out-sourced part and Resmed REPLACED the ENITRE xPAP unit. Unlike the Respironics humidifier problem which only fixed "part" of the problem w/a very poorly designed unit. The power supply for the Vantage is contained w/in the device itself. The Resmeds carry the data in the device not on the data card. The data card is strictly a data transfer item. I've never had either my Elite nor my Vantage drop ANY data. The ResScan software is a little more difficult to obtain but ... can be done. The AutoScan software is easier to obtain and works well. I have both.

There are advantages and disadvantages to both units. But both provide EXCELLENT therapy.

Most users here are Respironics users and many have a grudge against Resmed for their minimum ADVERTISED price policy for online DME suppliers. But that does NOT affect the quality of their devices nor the therapy they provide.

Actually, there is a little more to their difference than exhalation options and design flaws. Their "auto" algorithms are different. In addition to SD's comment on response to apneas when pressure is over 10 cm (btw - I don't know anything about that ResMed characteristic so I'll assume SD knows what he is talking about), the ResMed auto algorithm is also more aggressive at raising pressure which can arouse (wake) some people. The Respironics auto algorithm is slower to respond but also less likely to arouse one out of deep sleep. So some people respond to the two auto algorithms differently which may be good or bad depending upon the person's response.

As tangents noted, if exhalation relief is not an option that one needs or desires, the 420E APAP may be a better machine. And Devilbiss just came out with their new APAP ... also without exhalation relief.

I don't have a grudge against ResMed (If they are proud of their machines, they can charge what ever they want -- but they have no right to tell others what to charge) ... but how one responds to the machine's auto algorithm does have an effect on the quality of the therapy that the machine provides. In an ideal world, you would want to try each of them out and see which one works best for YOU, but then again, in an ideal world, there would be no apnea condition right?

[ozij]

Posted this with slight variations on another thread today, but it's very relevant here too.

Clinical Comparison of Resmed and Respironics Automatic machines:

Respiration, vol 75 no. 1 , 2008

Background: Auto-adjustable continuous positive airway pressure devices are widely used in titration procedures to determine therapeutic pressure levels in obstructive sleep apnea patients. However, differences in operational characteristics may influence the effect on the apnea-hypopnea index (AHI). Objectives: We compared the titration performance of two devices based on detection of inspiratory flow limitation, i.e. the Respironics REMstar Auto (RR) and the ResMed Spirit (RS). Methods: Fifty obstructive sleep apnea patients were recruited for a double-blind randomized crossover trial. Both devices were employed overnight by means of split-night polysomnography. The primary outcome was the AHI. Secondary outcome measures were the snoring index, pressure profiles and subjective appraisal of sleep quality assessed the morning after the sleep study. The Wilcoxon signed rank test for matched pairs was applied to assess differences between treatment conditions. Results: No significant differences were found in sleep parameters, subjective sleep quality and snoring index. The use of the RR was associated with a significantly lower AHI in comparison with the RS [mean (SD) 6.9 (11.6)/h vs. 9.4 (9.2)/h, p = 0.004]. This result was obtained at significantly lower pressure levels [P95 9.2 (2.3) cm H2O vs. 10.2 (1.5) cm H2O, p = 0.001]. Conclusion: While the RR provided a lower AHI than the RS at lower pressure levels, it could not be assessed whether this difference was relevant for clinical outcomes. However, this face-to-face comparison of Auto-adjustable continuous positive airway pressure devices seems useful for the assessment of titration efficacy.

People were habituated to fixed pressure before the PSG for about 3 months, devices were put in boxes to hide them and used randomly as first or second device for the night. Pressure range was set at 4-14. And special problem subjects (uppp, copd etc. were ruled out).

The measurments were PSG measurements, not the machine's measurements.

Algorithms make a difference - the impact couldn't be assessed because the study was just one night long.

O.

[ColinP]

who told you the S8 was a Cadillac? When was the Cadillac made down under? Just because that moron company decides to rip off Americans by intentionally overpricing it by a factor of 2, doesn't mean it is a Cadillac.

I just can't resist commenting on that.

Firstly, Resmeds actually cost a lot more in Australia than they do in the US. If they were overpricing by a factor of two they'd be making more than $100 million profit on a turnover of $200 million instead of which they only posted a profit of just under $27 million, which is a fair profit in my opinion. Oh, and they are actually made in the states these days aren't they?

Secondly, a Cadillac isn't something to aspire to. Nor for that matter are any cars made down under. If you want a saloon, it's got to be German, and a sports car must be Italian. If you want to learn to be a motor mechanic, you can just buy British. I can't wait for Toyota to start making CPAP machines, then we'll have some price competition for the cartel.

It's obvious from SD's repeated vehement comments that he got fired from Resmed. Nothing else could cause someone to hate the company as passionately as he does...

Colin

with his tongue firmly in his cheek

[bigk]

Resmeds are manufactured in Australia.

Resmed wanted AUD$1899 for a S8 II (your Vantage II) I believe. If I got it from them.