RespironicsRemStarPro vs. ResMed S9 AutoSet

[Physician]

Hi everybody. First time user.

I have proven/documented OSA with AHI =25, RDI=36, and 4% of the time my P02 is <70. 60% of the time my snoring is >30 db. My optimal pressure is 15. I don't need a bi=level unit. I have been using a ResMed S8 set at 8-20 and doing fine. What an amazing difference CPAP has made !! No daytime sleepiness, just relentless energy.

I heard Respirionics has a few advantages over resMed. I want to purchase one of two new CPAP units, so please help me decide which one:

1. RespironicsRemStarPro System ONE
2. ResMed S9 AutoSet

I don't know the similarities or differences between these two, except I heard:

1. ResMed produces a color print out while Respironics is only in black and white.
2. Respironics software is "slightly better"--- don't have specifics
3. Respironics has CFLEX while ResMed has EPR-- I don't know the difference but a friend said CFLEX is better during expirations.
4. The S9 eliminated the "settling" mode, and S9 has "ramp". What's the difference ?
5. The RemStarPro has CFlex which is like variable EPR. My friend said this better than the S9 for this reason.
6. I don't use the humidifier at any time, but I was told the humidifier is easier to clean with the Respironics.

I have been using a friend's ResMed S8 and doing fine, but if the Respironics unit is better and has no disadvantages compared to the ResMed S9, I want it.

I don't trust calling these two companies since each will tout their's as being better. I am in the medical field, but sleep disorders are not my specialty.

[Wulfman]

One problem with a "comparison" is that one is a straight-pressure CPAP (the Pro) and the other is an APAP (the S9 Autoset).
The only way they could be compared is if the Autoset was run in a straight pressure. It would have been better if you would have selected for comparison the PR System One Auto and the ResMed S9 Autoset........OR......the System One Pro and the S9 Elite.


Den

[Physician]

One problem with a "comparison" is that one is a straight-pressure CPAP (the Pro) and the other is an APAP (the S9 Autoset).
The only way they could be compared is if the Autoset was run in a straight pressure. It would have been better if you would have selected for comparison the PR System One Auto and the ResMed S9 Autoset........OR......the System One Pro and the S9 Elite.


Den

Hmmmm. Okay. But I enjoy setting the ResMed limits at 8-20 because it's easier to go to sleep at 8 than my final pressure of 14-16.

Are you indicating that the Respironics can't get me that lower initial pressure ?

[snipsnsnails]

Phillips Respironics Remstar PRO is a cpap and is set at one pressure example 13cmH2O
Phillips Respironics Remstar AUTO can be set as you suggest

both use the System One humidifier. The shorthand around here seems to be PR1 pro or PR1 auto. I have the auto and am very happy with it. I was prescribed 14 but found I sleep better and have a lower AHI at 13-17.

It certainly appears to me that the Resmed software offers a greater depth of detail than the respironics software. I'm quite happy with the encoreviewer though and find it more than enough to monitor how I'm doing.

I'm a newb though so wait for some more experienced reviews!

[Wulfman]

One problem with a "comparison" is that one is a straight-pressure CPAP (the Pro) and the other is an APAP (the S9 Autoset).
The only way they could be compared is if the Autoset was run in a straight pressure. It would have been better if you would have selected for comparison the PR System One Auto and the ResMed S9 Autoset........OR......the System One Pro and the S9 Elite.


Den

Hmmmm. Okay. But I enjoy setting the ResMed limits at 8-20 because it's easier to go to sleep at 8 than my final pressure of 14-16.

Are you indicating that the Respironics can't get me that lower initial pressure ?

I think you're confusing "Ramp" with "a range of pressures" that an APAP/Auto can be set to.
ALL of the aforementioned machines have "Ramp". It's a setting that will allow a lower starting pressure that will increase during a defined time period to either the set pressure (with a CPAP) or to the minimum pressure (with an APAP/Auto).
With a CPAP, once the Ramp has reached the set pressure, it will stay there for as long as the machine is running.
With an APAP, once the minimum pressure is reached, it will work between the defined range of pressures according to the events that may increase or decrease the pressure.
And, ALL APAPs/Autos can be set to run in a single pressure (CPAP mode).


Den

[Slinky]

... I heard Respirionics has a few advantages over resMed. I want to purchase one of two new CPAP units, so please help me decide which one:

1. RespironicsRemStarPro System ONE
2. ResMed S9 AutoSet

I don't know the similarities or differences between these two, except I heard:

1. ResMed produces a color print out while Respironics is only in black and white.
2. Respironics software is "slightly better"--- don't have specifics
3. Respironics has CFLEX while ResMed has EPR-- I don't know the difference but a friend said CFLEX is better during expirations.
4. The S9 eliminated the "settling" mode, and S9 has "ramp". What's the difference ?
5. The RemStarPro has CFlex which is like variable EPR. My friend said this better than the S9 for this reason.
6. I don't use the humidifier at any time, but I was told the humidifier is easier to clean with the Respironics.

I have been using a friend's ResMed S8 and doing fine, but if the Respironics unit is better and has no disadvantages compared to the ResMed S9, I want it. ...

Personally, I can't think of a single advantage that Respironics has over Resmed. Not one. They do have a larger market share due in largest part to their being an American company until recently (now owned by a Dutch company) and Resmed being an Australian company that not too long ago moved their headquarters to the US.

As mentioned comparing the Respironics Pro to the Resmed S9 Auto is trying to compare apples to oranges. Since the Respironics M Series Pro is no longer available and isn't an Auto, as previously suggested you should be considering the Resmed S9 Auto and the PR SystemOne Auto for comparison. Or if you prefer straight CPAP, the Resmed S9 Elite and the PR S1 Pro.

1. Color print out? Eh, I use a black & white LaserJet printer so what do I care about color? I see it in color on my 'puter screen w/the software.

2. Software? I've used both Respironics EncorePro 2.2 (and earlier versions) and Resmed's ResScan 3.10 (and earlier versions). I detest EncorePro and love ResScan. Neither is perfect, of course, but I'll take ResScan any day of the week. Easier to install, easier to use, easier to understand. You can actually stretch the ResScan graphs out from 10 second intervals to 24 hour intervals.

3. C- or A-Flex vs EPR? I've not noticed that one is more comfortable than the other. I can vouch for the Resmed EasyBreathe technology being SMOOTH and EASY breathing in the transition from IPAP to EPAP w/a bi-level.

6. Humidifier being easier to clean? I can't comment on the S9 humidifier - but I can say that the humidifier tank on the PR S1 is a bit of a PITA in my opinion. I was used to the Resmed H3i humidifier tank. Since I just toss a PoliDent Denture Cleansing Tablet and very warm water into my humidifier tank when I get around to cleaning it (I only use distilled water) w/a vinegar and water rinse I fail to see the big deal about cleaning and ease of cleaning the humidifier tank.

[ozij]

With ResMed's "settling" you defined a time for the machine to idle at you minimum auto pressure and not respond to events. By you could never start out a less than the minimum. The S9's ramp lets you start out at lower than the minimum needed for therapy - like a ramp is fixed CPAP mode.

[Physician]

With ResMed's "settling" you defined a time for the machine to idle at you minimum auto pressure and not respond to events. By you could never start out a less than the minimum. The S9's ramp lets you start out at lower than the minimum needed for therapy - like a ramp is fixed CPAP mode.

BUT

1. I was told the S9 does NOT have "settling" anymore. It has "ramping" instead. Any comments on that ?

2. With my temporary S8 ResMed machine, I did get to sleep faster when the "EPR" was changed from OFF to "2" yesterday. What does EPR do ? Does the Respironics unit do the same thing ?

[PetrusKy]

Just get the S9 and be done with it. Really.

[topdragster]

EPR = (expiratory pressure relief) mode which drops pressure on exhalation so breathing feels more “natural”

I just got my S9 with H5I humidifier and climate line and I love it!!!! period. Setting the humidifier you don't just adjust to a number like 1-5 you set the actual temperature you desire. The climate hose helps prevent "rain out" though there has been some discussion on the climate lines durability and have also read that resmed is looking at redesigning it. The S9 auto set also has auto on and auto off feature which I love and when it does come on it lights up for a short time then goes dark again so you don't have bright lights to keep you awake or have to cover up. The LCD is color also which makes it nicer to read. I looked at both respronics and resmed and decided on the latter. Just my take on the S9 so far.

[carolyngoodman]

Physician,

On this page: https://www.cpap.com/cpap-faq/Machines.html

Scroll down to "What is exhalation relief?" - It gives an overview of the current different exhalation relief options offered by the different manufacturers with images that help explain their effect.

- Carolyn

[Uncle_Bob]

1. I was told the S9 does NOT have "settling" anymore. It has "ramping" instead. Any comments on that ?

2. With my temporary S8 ResMed machine, I did get to sleep faster when the "EPR" was changed from OFF to "2" yesterday. What does EPR do ? Does the Respironics unit do the same thing ?

There is no settling option anymore on the S9 but they have moved that feature into the ramp.

From the manual

Ramp time defines the period during which the pressure gradually increases from a lower more
comfortable start pressure to the minimum AutoSet pressure before the auto-adjusting algorithm
commences. In previous products in the AutoSet range, settling was the period where the device was at
a minimum AutoSet pressure until the auto-adjusting algorithm commenced.

EPR lowers the pressure on exhale,it is a comfort feature

You can set EPR to Off, Ramp Only, Full Time.
You can select an EPR Level of Patient (configurable by the patient), Off, 1, 2, or 3 cm H2O.
In CPAP mode you can set the EPR Inhale to Med or Fast.
When EPR is enabled, the delivered pressure will not drop below a minimum pressure of 4 cm H2O,
regardless of the settings.

[GTOJim]

My 5 year old Respironics RemStar auto with C-Flex just died. I replaced it a week ago with an S9 Autoset. So far I'm very happy with the S9. My average pressure has been lower with the S9, both machines set for the same pressure, both running in auto mode. My average AHI is also lower using the S9, mostlikely due to different intepations of events between manfactures.

Compairing a 5 year old machine to a new machine is probably like compaing apples to oranges. But this is the only experiance I have using the different brands.

I like the ResMed software better, it is compatable with more versions of Windows software including Windows 7, also easier to install. I like how it can generate reports, you can specify a date range, example: May 2nd to June 22nd. Respironics Encore Pro can't do this, don't know about the latest version 2 which has been updated for the new PR 1. Encore Pro 2 will not work on either of my computers, Windows 7 or Windows 2000 operating systems. Encore Viewer (the home version) latest version released earlier this year also isn't compatable with Windows 7 although some have found a possible work around.

For what it's worth my DME admitted they have seen an increase in returns of defective new model Repironics machines. Stated the old machines last longer. It is one persons statement so take it for what it's worth.

Yesterday I had a nice chat with a gentelman that is still using a 14 year old respironics CPAP. Said he only needs supplies, mask ect, evey 2 1/2 years.

Good luck, I'm sure either machine will provide comprable treatment. As with a lot of things, ask 10 people you will get 10 different answers.

[Physician]

Thank you for you excellent reply. I've decided on the ResMed S9 auto and among the reasons are:

1. New clinician software soon to be released.

2. The algorithm used in the EPR mode and how it is related to prior expirations

3. Supposed db level of machine noise

4. EPR said to be slightly better than CFlex

5. I have used the S8 and it has been perfect

6. A few other comments made in this thread

7. I haven't tried the Respironics



As an aside, my favorite mask so far has been the Activa. The Mirage Soft Gel was not comfortable as the lower portion swells and presses my upper teeth posteriorly. Second favorite = Respironics Classic. Swift pillows is my third choice.