Advise on S9 vs Resp PR System One and Auto vs regular CPAP

[liv2kite]

Two questions:
1) do people that know both prefer/recommend the S9 over the Respironics PR System One (I can request either)?
2) how do I get the sleep doc to write me the script for the AutoCPAP instead of basic (in case I want to do my own titrations etc). I have used auto for years but am pretty well treated at 7.0 psi

My new sleep doc prefers me to get a new Respironics PR System One REMstar Plus CPAP Machine with C-Flex instead of a new S9 CPAP Elite (but will give me either that I request). He like the data better on the Respironics (for his use) but I feel that it is my interest to get a machine that will work better for me (which includes aesthetics since I frequently hide my CPAP when we might have guests near our bedroom). He says that Respironics has done better on the machines while Resmed has done better on masks. His group likes the modem data upload (but he said he personally does not care and the card is fine for him). He also said Resmed has promised that modem upload is coming for them. Seems that Respironics is not nearly as nice looking and does not have as nice of a user display but does have a better water reservoir (opens for cleaning/draining) than Resmed.

I have been using Auto CPAP (S8 Autoset II) for years (but changed insurance and had to give it back so now using old Respironics). I just did another sleep study and had 0 events on back in REM sleep at 7.0 psi. So Sleep Doc wants to give me a conventional CPAP and not Auto. He did indicate I might be able to use more pressure if I have a cold.

[who]

Two questions:
1) do people that know both prefer/recommend the S9 over the Respironics PR System One (I can request either)?
2) how do I get the sleep doc to write me the script for the AutoCPAP instead of basic (in case I want to do my own titrations etc). I have used auto for years but am pretty well treated at 7.0 psi

My new sleep doc prefers me to get a new Respironics PR System One REMstar Plus CPAP Machine with C-Flex instead of a new S9 CPAP Elite (but will give me either that I request). He like the data better on the Respironics (for his use) but I feel that it is my interest to get a machine that will work better for me (which includes aesthetics since I frequently hide my CPAP when we might have guests near our bedroom). He says that Respironics has done better on the machines while Resmed has done better on masks. His group likes the modem data upload (but he said he personally does not care and the card is fine for him). He also said Resmed has promised that modem upload is coming for them. Seems that Respironics is not nearly as nice looking and does not have as nice of a user display but does have a better water reservoir (opens for cleaning/draining) than Resmed.

I have been using Auto CPAP (S8 Autoset II) for years (but changed insurance and had to give it back so now using old Respironics). I just did another sleep study and had 0 events on back in REM sleep at 7.0 psi. So Sleep Doc wants to give me a conventional CPAP and not Auto. He did indicate I might be able to use more pressure if I have a cold.

Relatively new machines, so few have used both. No special Rx needed for an auto, as long as the doctor does not forbid it on the Rx. All you need is a steadfast refusal to sign for anything but an auto with the DME. Both brands have good machines and good masks. Different people have different preferences. Data is the important thing.

[Rick B]

I have the Respironics System One with biflex and all it gives in the display for information is 7-day averages and 30-day averages. No daily information. Just thought you might like to know. I don't know what info it gives on the card.

[Uncle_Bob]

So Sleep Doc wants to give me a conventional CPAP and not Auto. He did indicate I might be able to use more pressure if I have a cold.

"Its my therapy Doc, I'll take the S9 please and make it an AUTO which i can run in CPAP mode if i so wish, thankyou"

[elena88]

I have had the system one with a flex
and now I have the s9 auto

I cover mine with a scarf, nobody knows its there, we have a ton of people in and out and house guests all the time.
You can hang your tubing in the closet, I hang mine from a curtain tie back, and hang the scarf over that so it drapes over the machine,
looks pretty cool! (this is a four foot long scarf)


what I liked about system one:
so easy to breath..
fabulous filter system, a disposable filter, plus one you could wash weekly.. so double protection
very quiet, but mine had a high tone, nobody else could hear it
only gave weekly averages on the screen, so nothing to check the night before, big misake they made there!
I believe that is one of the ONLY reasons people prefer the s9
but if you want you can download the information daily if youre into that..

S9 autoset
super quiet, no tone i heard.
extremely crappy filtration system, comes with only ONE filter, no double filter backup like system one.. so if you get it
order the hypoallergenic filters from cpap.com.. because the ones they come with get so dirty on BOTH sides, there is leakage,
The air intake is on the bottom of the filter case, and the filters do not fit in the case well. Because of this, dirt gets in the sides, then
it smells like you are breathing thru a dirty vacuum bag.. they really popped the weasel on the filter design..
YOU can see your ahi every morning right there on the screen, until noon, then it wipes it..
both are data capable machines..

If that system one had the nightly average, and I didnt hear that tone, I would trade it back in a minute..
Filtration is important to me, as this IS the only air we are supposed to be breathing..

[jdm2857]

Why all the concern about filtration? After all, when you are awake you breathe the air in your house unfiltered, no?

I've always thought the filters were designed to keep things like pet hair and dust bunnies (some people put their machines on the floor) out of the machine's innards.

[liv2kite]

I have had the system one with a flex
and now I have the s9 auto

I cover mine with a scarf, nobody knows its there, we have a ton of people in and out and house guests all the time.
You can hang your tubing in the closet, I hang mine from a curtain tie back, and hang the scarf over that so it drapes over the machine,
looks pretty cool! (this is a four foot long scarf)


what I liked about system one:
so easy to breath..
fabulous filter system, a disposable filter, plus one you could wash weekly.. so double protection
very quiet, but mine had a high tone, nobody else could hear it
only gave weekly averages on the screen, so nothing to check the night before, big misake they made there!
I believe that is one of the ONLY reasons people prefer the s9
but if you want you can download the information daily if youre into that..

S9 autoset
super quiet, no tone i heard.
extremely crappy filtration system, comes with only ONE filter, no double filter backup like system one.. so if you get it
order the hypoallergenic filters from cpap.com.. because the ones they come with get so dirty on BOTH sides, there is leakage,
The air intake is on the bottom of the filter case, and the filters do not fit in the case well. Because of this, dirt gets in the sides, then
it smells like you are breathing thru a dirty vacuum bag.. they really popped the weasel on the filter design..
YOU can see your ahi every morning right there on the screen, until noon, then it wipes it..
both are data capable machines..

If that system one had the nightly average, and I didnt hear that tone, I would trade it back in a minute..
Filtration is important to me, as this IS the only air we are supposed to be breathing..

Thanks Elena,
I think the S9 looks slicker and the least clinical of the bunch, though the system one has also improved. But looks would be a moot point if you cover CPAP with scarf - good idea.

It looked to me like the system one had a much nicer water reservoir from the standpoint of cleaning. what are your thoughts on this ?


Finally, is one able to exchange machines through DME (or was this more of a self-purchase situation).

[liv2kite]

So Sleep Doc wants to give me a conventional CPAP and not Auto. He did indicate I might be able to use more pressure if I have a cold.

"Its my therapy Doc, I'll take the S9 please and make it an AUTO which i can run in CPAP mode if i so wish, thankyou"

You are absolutely right re: "its my therapy doc, so please lets make it [the machine I want, still TBD]" ...because the feature would help me with compliance, feedback [data] and comfort.

As far as "lets make an AUTO" - I guess if he absolutely thinks I should be at 7.0 he would find an AUTO medically unnecessary and superfluous and subject to patient tampering. He also told me patients changing their settings voids the warranty (which even if it is true is the last think I am concerned with). I am not sure your comment helps me justify AUTO.

Did you mean to say " which I can run in CPAP mode if you [referring to the doc] wish" ???

[STL Mark]

Make sure if you require a machine that your doctor is willing to write the script for an auto CPAP type machine. You may find that your insurance won't cover the cost if the doctor does not write it that way. If your insurance does not require a referral from your primary care doctor to see a specialist you may want to investigate the sleep labs in your area and what those doctors are willing to write the prescription for. Also determine if you will get a copy of the prescription to shop medical equipment providers, or if you will be forced to go through their preferred provider. Many times the DME is where the inexpensive CPAP machines are forced on unsuspecting newbies.

There are ways to make yourself look a bit more in need of APAP vs. CPAP but it requires a few white lies to accomplish the task.

[jdm2857]

I'd be wary of any MD who told me that patients changing their own settings voids the warranty. That's nonsense.

[elena88]

the humidifier on the system one is a snap to clean, you do take it apart..
so you can clean it really well..

the s9 you CANT take apart with the one it comes with, but I do believe you can buy another one that will come apart..

Filtration is important to me because I have reactive airway disease (its like asthma but asthma meds dont help) and I can cough during the day
yes, and have trouble breathing, but I really would like the cleanest air possible at night while Im trying to sleep.
edit: also during the day I dont HAVE to breath thru a discusting, filthy, dusty, misfitting filter.. truly, it smells like a dirty vacuum bag.
Last night I slept without the filter, because I didnt have any new ones yet, and it was a thousand times better without it..
I wish the system one filter set up was in the s 9, or the quietness and the ahi daily screen with climate hose was on the system one.
whoever marries the best of these two is gonna make a killing.


Can someone please tell me why its so hard for some people to get an auto? I dont understand that? Why isnt it medically necessary for
anyone and everyone to have one? After all you can run it in apap or cpap?

I just asked for one, and the doctor said.. "oh most people prefer cpap, but if you want that, you can have that"

Im not sure MOST people prefer cpap, maybe thats just what the end up with when they are deer in the headlights newbies..

[jdm2857]

The insurance companies pay the DMEs exactly the same amount for a CPAP as for an APAP. So the DMEs make more profit by selling the cheapest machine they can get away with. And, many, but by no means all, sleep doctors have a "cozy" relationship with a DME. Hence they want to give your prescription directly to their preferred DME (and refuse to give it to you) and they prescribe what the DME prefers unless forced to do otherwise.

[Uncle_Bob]

Can someone please tell me why its so hard for some people to get an auto? I dont understand that? Why isnt it medically necessary for
anyone and everyone to have one? After all you can run it in apap or cpap?

Some doctors like mine have a financial involvement with the DME (and the sleep lab)
If he gives me a CPAP his DME makes more profit because they are cheaper than APAPs

I've never been able to trust my doctor because I don't know if his decisions are medically or financially motivated.

[Uncle_Bob]

Did you mean to say " which I can run in CPAP mode if you [referring to the doc] wish" ???

Nope, I'll listen to to the doc but the bottom line decision on what i do is mine.
Good luck with whatever machine you choose they are both very good machines.

I sent you a PM with some additional information

[cflame1]

I have the Respironics System One with biflex and all it gives in the display for information is 7-day averages and 30-day averages. No daily information. Just thought you might like to know. I don't know what info it gives on the card.

Rick... the software would give you more information.