Resmed vs. Respironics - Help

[DreamStalker]

Another thing to keep in mind is that some of the more experienced and successful members have more than one machine because we also discovered and/or realized that stuff happens ... so it's a good idea to have a backup machine. It's difficult for someone who has not started treatment or has just begun, to understand what the big deal would be to go a few nights without until they actually do it.

Why not get both machines and trial them for yourself while at the same time having a backup unit? Then there is the auction where you can always sell a unit and use the money to buy and trial still another. Grab as many options on the first round and still have options open for later.

[Slinky]

If you can afford it, that would be the way to go, buy both the Resmed S8 AutoSet Vantage AND the Respironics M Series Auto w/A-Flex. Whichever is the most expensive via the online DME suppliers let insurance buy from the local DME supplier for you, then you buy the other out of pocket via an online DME supplier keeping in mind that the prices you see advertised are the manufacturer's MAP (minimum advertised price). Be sure to negotiate the best price you can w/the online suppliers, most will have an "unadvertised sale price" for these devices.

I know I sure do enjoy just grabbing my xPAP carrying case and distilled water and walking out the door when traveling. And it sure is nice when I arrive home tired from a trip or vacation to just fall into bed and don my xPAP and mask that are just sitting there waiting for me.

[rested gal]

Really, can I go wrong with either the MSeries Auto or the ResMed Vantage?

Depends on what you're trying to treat and how you want to go about treating it.

Got plain old garden variety Obstructive Sleep Apnea?

Short answer is, "You can't go wrong with either one." If straight cpap mode suits you fine, which it probably does, you could always use any autopap in cpap mode if that suited you better than autotitrating mode.

I've used all three major manufacturers' autopaps. All of them treated me fine, with or without exhalation relief. I can also use straight cpap at a fixed pressure of 10, with or without exhalation relief, and be treated fine.

The MSeries machine scares me for one reason - the integrated humidifier performance seems to be lacking, or is it just that users are concerned / have experienced leaks?

It's about the leak possibilities, not the performance.

I am leaning toward the ResMed because it's what the tech at my SS recommended (he is an experienced RT) and also because the integrated humidifier seems to do a bit better.

Most RTs (and sleep doctors, for that matter) don't actually use "cpap" themselves.

If you had ever actually had your hands on the various humidifiers and were actually filling a humidifier each night, you might find you'd like using a separate humidifier better. The Fisher and Paykel HC 150 heated humidifier can be used with any machine.

Integrated humidifiers sound great on paper and look great in pictures, and take up marginally less room packing if a person travels a lot. But for every-night home use and occasional trips ("separate" is easy to pack, too) there's a lot to be said, imho, for a much easier to "add water to" separate humidifier.

Blue lights -- a sock tossed over them takes care of that.

If you're willing to use a separate humidifier and you have a spare sock, I'd take "leaky humidifier" and "blue lights" completely out of the list of concerns and think only about which machine and software I wanted.

When I think about it that way, the two autopaps I'd choose would be:

Respironics REMstar Auto with A-flex -- Encore Viewer software

Puritan Bennett Goodknight 420E auto -- Silverlining software

I love data

Then the software used by Respironics and Puritan Bennett machines would give you the kind of details you'd want to see. Software gives much more useful info, imho, than any machine's limited LCD data.

Back to your question:

Really, can I go wrong with either the MSeries Auto or the ResMed Vantage?

Nope. You could toss a coin.

[Needsdecaf]

Depends on what you're trying to treat and how you want to go about treating it.

Got plain old garden variety Obstructive Sleep Apnea?.

As far as I know, and with a titration of 8.

My pre-CPAP AHI was 26.8

Most RTs (and sleep doctors, for that matter) don't actually use "cpap" themselves.

The RT who did my studies has fitted himself, his wife and his son. Currently he and his wife are off treatment. I trust his opinion. But it is only one opinion.

If you had ever actually had your hands on the various humidifiers and were actually filling a humidifier each night, you might find you'd like using a separate humidifier better. The Fisher and Paykel HC 150 heated humidifier can be used with any machine..

I do fill a humidifier every night, two of them as a matter of fact. One in my 14 month old son's room, one in our room (during the winter). We have forced hot air heat, and a new house which is very tight. Despite the fact that we have a whole house humidifier, the humidity in our house struggles to get about 40% in the winter.

So filling a tank every night isn't too much trouble.

Integrated humidifiers sound great on paper and look great in pictures, and take up marginally less room packing if a person travels a lot. But for every-night home use and occasional trips ("separate" is easy to pack, too) there's a lot to be said, imho, for a much easier to "add water to" separate humidifier.

Blue lights -- a sock tossed over them takes care of that.

If you're willing to use a separate humidifier and you have a spare sock, I'd take "leaky humidifier" and "blue lights" completely out of the list of concerns and think only about which machine and software I wanted..

Blue light is annoying, but as you said, a sock can take care of that.

For perspective, in college, I was so sensitive to light at night that I used to put a book over my clock radio. Even now, I turn it to face my feet, not my head.

I do not travel often. When we go away, it's only for a weekend and by car. So coming home and setting something up isn't too much of a pain.

I can see how having a second unit at home would be nice, though.

Seems like the FP-150 can be had fairly inexpensively. I think I will try the integrated HH first and if it's a PITA, get the separate unit.

Seems like the Respironics is starting to sound better.

[Wulfman]

On page 5, in one of my posts, I mentioned that Respironics had redesigned the HH tank for the M Series.
Here's a link to some pictures of the new design.

http://s249.photobucket.com/albums/gg210/akcpapguy/

If it was me and I was going to HAVE to buy an M Series machine, I'd probably opt for the HC150 (or the equivalent in a non-heated model) for the extra capacity for home use and maybe keep the integral one for travel use (if that was going to be an issue).

Den

[Needsdecaf]

On page 5, in one of my posts, I mentioned that Respironics had redesigned the HH tank for the M Series.
Here's a link to some pictures of the new design.

http://s249.photobucket.com/albums/gg210/akcpapguy/

If it was me and I was going to HAVE to buy an M Series machine, I'd probably opt for the HC150 (or the equivalent in a non-heated model) for the extra capacity for home use and maybe keep the integral one for travel use (if that was going to be an issue).

Den

_________________
]

Your profile shows you have the integral humidifier? Do you like it?

[Hose_Head]

On page 5, in one of my posts, I mentioned that Respironics had redesigned the HH tank for the M Series.
Here's a link to some pictures of the new design.

http://s249.photobucket.com/albums/gg210/akcpapguy/

If it was me and I was going to HAVE to buy an M Series machine, I'd probably opt for the HC150 (or the equivalent in a non-heated model) for the extra capacity for home use and maybe keep the integral one for travel use (if that was going to be an issue).

Den

For the Respironics M Series Machine, how easy, or difficult is it to remove the integrated humidifier each time you come home, or to reinstall it each time you go travelling? n How does this compare to the S8's easy of changeover from integrated to external HH?

[Wulfman]

On page 5, in one of my posts, I mentioned that Respironics had redesigned the HH tank for the M Series.
Here's a link to some pictures of the new design.

http://s249.photobucket.com/albums/gg210/akcpapguy/

If it was me and I was going to HAVE to buy an M Series machine, I'd probably opt for the HC150 (or the equivalent in a non-heated model) for the extra capacity for home use and maybe keep the integral one for travel use (if that was going to be an issue).

Den

_________________
]

Your profile shows you have the integral humidifier? Do you like it?

Yes I do. I started 3 years ago.....before the M Series came out. I prefer the simplicity of the "Legacy" models. The humidifier tank just slides into the front of the machine on the humidifier tray.....and it's got a decent water capacity. The way they got the M Series "smaller" was to take the power converter out and made it a separate "brick". All in all, I don't think they gained a whole lot. There are still some Bi-PAP models that use this same type of (Legacy) case.
Also.....no blue lights. And, the M Series has a reputation for dropping a couple of days of detailed data occasionally.....which the older ones don't. (The compliance data is still there, but for some reason the detailed data isn't.) I think there's a way around it, but I've never had one, so I can't say for sure.

But, even with the quirks of the M Series, I'd still take them over the ResMed machines.

Den

[Wulfman]

On page 5, in one of my posts, I mentioned that Respironics had redesigned the HH tank for the M Series.
Here's a link to some pictures of the new design.

http://s249.photobucket.com/albums/gg210/akcpapguy/

If it was me and I was going to HAVE to buy an M Series machine, I'd probably opt for the HC150 (or the equivalent in a non-heated model) for the extra capacity for home use and maybe keep the integral one for travel use (if that was going to be an issue).

Den

For the Respironics M Series Machine, how easy, or difficult is it to remove the integrated humidifier each time you come home, or to reinstall it each time you go travelling? n How does this compare to the S8's easy of changeover from integrated to external HH?

There are some pictures in this link that shows the M Series Pro and the humidifier tank......separately and together. It's just a modular unit with a lid that opens up to access (insert and remove) the humidifier tank. It looks pretty simple to add or remove. With any external humidifier tank, you have to have a short, separate hose to connect between the machine and the humidifier tank.

https://www.cpap.com/productpage-bundle ... undle.html

Den

[rested gal]

For the Respironics M Series Machine, how easy, or difficult is it to remove the integrated humidifier each time you come home, or to reinstall it each time you go travelling?

Actually, in packing for travel there's no need to remove the integrated humidifier from the M series machine. All one needs to do is empty the water chamber and insert it back in place...empty.

The whole thing -- M humidifier and M machine -- can stay together for packing and traveling.

[-SWS]

You just piqued my curiosity with that quote, Bill. Smile Actually, that section does not describe the machine's response to an apnea. Rather that section describes the algorithm's premptive search for optimum versus critical pressure. That little pre-emptive search toward an optimum "pressure holding pattern" occurs when the algorithm is not otherwise preoccupied responding to a sleep event, NR, variable breathing, etc. (all different parts of the algorithm).

OK, -SWS, I'll start at the top, if I may,....<snip> Did I miss something?

Regards,
Bill

Bill, I think you just missed the correct patent description. That's all.

Do you remember that Norelco commercial where the CEO used to say that he liked Norelco shavers so much that he bought the company? Well, that's exactly what happened with the above patent embodiment. Respironics liked that Healthdyne embodiment so much that they bought the company. Then Respironics proceeded to use bits and pieces of the above patented embodiment in their much more modern Remstar Auto.
(And ironically, many years later Philips/Norelco makes a decision to buy Respironics. )

Anyway the above 1993-filed Healthdyne patent description is missing very many control layers, temporal variable tracking, probability-based weight voting, and even immediate and repeated pressure responses to detected apneas. So take a peek at U.S. Patent Pub. No. US 2004/0187810 A1 to see what's really happening with the Remstar Auto these days (functionality might even be updated from that description--I haven't checked lately).

I found this cool text and graphic description on the Respironics web site showing the Remstar Auto's proactive pressure seeking test in action (but note this is while the modernized algorithm is not preoccupied with responding to higher control-layer priorities):

Proactive Performance
As the chart shows, the REMstar® Auto algorithm can determine the optimal therapy level by proactively performing two types of tests (Pcrit and Popt). These tests not only help maintain pressure at a level in which obstruction is unlikely to occur, they also ensure that the pressure never becomes unnecessarily high.

For what it's worth, Bill, I think you did a great job with the Healthdyne patent! .

[rested gal]

Respironics M series machine with humidifier:




ResMed S8 machine with humidifier:





Self Adjusting CPAP Comparison Chart:
https://www.cpap.com/cpap-compare-chart ... sting-CPAP

[-SWS]

So take a peek at U.S. Patent Pub. No. US 2004/0187810 A1 to see what's really happening with the Remstar Auto these days (functionality might even be updated from that description--I haven't checked lately).

The above is a 2004 patent application that can be found on Derek's web site at: http://lewiston.mit.edu/sleep/autopatent.pdf

But I just spotted the January 2007 approved patent as U.S. patent number 7168429. Here are just a few quotes regarding that updated (non-Healthdyne) algorithm's capabilities related to direct apnea pressure response:

...an apnea/hypopnea control layer that monitors the flow signal, the pressure signal, or both to determine whether the patient is experiencing an apnea, a hypopnea, or both, and causes the pressure generating system to adjust the pressure of the flow of breathing gas responsive to detection of apnea, hypopnea or both;

...the apnea/hypopnea control layer has a higher priority than the variable breathing control layer, and the auto-CPAP control layer and has a lower priority than the flow limit control layer, the snore control layer and the big leak control layer; and (5) the variable breathing control layer has a higher priority than the auto-CPAP control layer and has a lower priority than the flow limit control layer, the snore control layer, the big leak control layer, and the apnea/hypopnea control layer.

...a controller coupled to the monitoring system and the pressure generating system, for controlling the pressure generating system based on the output of the monitoring system, wherein the controller is programmed to: (1) determine whether the patient is experiencing an apnea/hypopnea based on the pressure signal or the flow signal, (2) set a pressure treatment limit based on a pressure at a time an apnea/hypopnea is detected, (3) cause the pressure generating system to increase a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being below the pressure treatment limit, and (4) cause the pressure generating system to decrease a pressure of the flow of breathing gas delivered to a patient responsive to a current pressure being at or above the pressure treatment limit.

There's a lot of other very cool stuff in there, Bill! I'll bet you're really going to love poring through it... .

[NightHawkeye]

The above is a 2004 patent application that can be found on Derek's web site at: http://lewiston.mit.edu/sleep/autopatent.pdf

Well, now that explains why my patent searches on that number came up empty. An open google search didn't even turn up Derek's website (either that or I just missed it).

There's a lot of other very cool stuff in there, Bill! I'll bet you're really going to love poring through it... .

Yeah, that's the problem with getting started on these little endeavors. No rest for the insatiably curious. Oh well, too late to turn back now ...

The other question which comes to mind is that with an application date of 2004, it seems unlikely that the innovative features of the algorithm were included in my Remstar-auto. If Respironics had been using them much more than a year before filing, then they wouldn't have been eligible for patent protection. Likely to be in the M-series though. Algorithm changes could also explain some of the weird/missing data folks have posted about with the M-series. (I had to say that, -SWS. )

Regards,
Bill

[Guest]

Algorithm changes could also explain some of the weird/missing data folks have posted about with the M-series. (I had to say that, -SWS. )

LOL! I agree with that speculation, Bill.

And that Remstar reporting bug kind of reminds me of the PB420e data reporting bug that ozij discovered a while back. Amazing that neither bug seems to be fixed yet (though, I could be wrong about that last statement).

My own guess is that the CPAP companies feel the fix-related expenditures yield no positive impact on revenue. Of course, in any other "real world" industry those bugs would have been long ago fixed. Oh well... .