ResMed vs Respironics CPAP machines

[Stevoreno_55]

I spoke to a new DME yesterday; a locally owned one not far from my home; I informed them that I had a 6 year old Respironics DS400S CPAP machine and all of my supplies which I've been receiving from other DMEs in the past were also Respironics products. They told me they would be able to continue supplying me with Respironics supplies but when the time did come for a new CPAP machine and I was still one of their patients the only CPAP machines that they stocked and could provide me with were ResMed CPAP machines.

Right now all they stock is an S9 Elite and an S9 Escape; they told me they did not stock Respironics machines nor could they order me one if the time did come that I needed a new machine. I'm not familiar with ResMed machines; how do they compare to Respironics machines? About the same? Is one brand better than the other? Does one brand require more servicing than the other? My 6 year old DS400S has not required servicing yet although my humidifier might be starting to play out. Feedback on this would be appreciated before I decide to switch to this other DME who only stocks ResMed CPAP machines or consider giving Lincare DME a try.



Stevoreno_55
02/11/14

[-tim]

Avoid the Escape.

If you are buying the machine, get an Auto.

From an old post

So far on the pros and cons:
s9 easier to clean tank and hose. My resmed hose fits over the kitchen sink so I can flush the hose easily. The 560 heated hose has a clip that is in the way.
s9 has a better screen. Its brighter and has better contrast. Its also color while the 560 has a black and white screen that has a poor backlight.
560 has a much better filter design but still could use some improvement. Its design is far better than the s9 filter design.
s9 has a slightly longer hose but it attaches on the back of the unit so it needs it. The s9 hose also has its coils closer together so I expect its a stronger hose and it may heat better.
560 has a stupid humidifyer door design and needs a warning label to not force it all the way up. Another stupid design. What is it with bad industrial design and cpap machines? Industrial designers aren't that expensive. The s9 lid flips up and you lift the tank out (by putting your finger in the hole -- another bad design) and the 560 had a lid that flips up a bit and then you slide the tank out the front.
The 560 has some back flow prevention to limit how much water can go back into the machine. The s9 has no protection.
560 seems to have a slightly easier use interface based on the same concept of turn the knob and press the button.
s9 can reset the clock from the clinician's menu and I have no idea how to reset it on the 560. Did F&P get a patent on a clock on a cpap device?
560 has a "ramp now" button.
s9 goes full dark - 560 will keep its humidifier light on.
The 560 lets you use the dial to adjust the humidity level when its operating. It seems to adjust the heat level if you have the heated hose. I would love to have that knob adjust the pressure a bit.
Both machines only ramp up. If' I'm on auto 5->11, I want a 10 minute ramp starting at 6 and ramp down to 5 as I relax.
560 and S9 use colored lights to indicate heating status which is fine if you aren't colorblind.
The s9 is N ticked the 560 isn't. A N-tick is like the UL, FCC or EU CE certification. This means the 80 Watt 560 power supply isn't legal to use in Australia.
s9 works with sleepyhead, 560 doesn't (yet).
560 uses 4 gig card which older sd readers may not read.
560 doesn't give as much useful info on its screen. The s9 you need to turn on the useful info since it is off by default.
That average noise on the 560 is higher than the s9.
The exhale buzz on the The 560 is noisier than my s9 but quieter than the rental s9 I had. This is an area that needs lots of work from these two manufactures.

[CapnLoki]

A few points of old/misinformation (I have the 560, never used a ResMed)

From an old post

So far on the pros and cons:
s9 easier to clean tank and hose. My resmed hose fits over the kitchen sink so I can flush the hose easily. The 560 heated hose has a clip that is in the way.

one end of the heated hose has the power clip; just use the other end!

...
560 has a stupid humidifyer door design and needs a warning label to not force it all the way up. Another stupid design. What is it with bad industrial design and cpap machines? Industrial designers aren't that expensive. The s9 lid flips up and you lift the tank out (by putting your finger in the hole -- another bad design) and the 560 had a lid that flips up a bit and then you slide the tank out the front.

I fill the water every night and never had an issue. I thought the whole design of the 560 water tank was nice.

The 560 has some back flow prevention to limit how much water can go back into the machine. The s9 has no protection.

Major apparent plus since backwashing into the pump could be a killer. I wonder how often this happens?

s9 works with sleepyhead, 560 doesn't (yet).

560 works just fine with Sleepyhead now.

560 uses 4 gig card which older sd readers may not read.

Odd comment - mine came with a 1 gig card and works fine. More often the complaint is that an older device won't take the new cards.
Also, I may be wrong, but I think the ResMed is not forgiving of the extra file Mac and Win8 write on the card so you have to writeprotect them when reading.

That average noise on the 560 is higher than the s9.

My 560 is essentially silent at pressures up to 12 - can't say at higher pressures. Certainly the sound from different masks is much higher.

One difference not mentioned is that the Respironics 560 can run directly off 12v with a $30 cord. The ResMed uses 24V so it needs a $90 converter or an inverter. If you plan to run from battery power a lot, this is a major plus.

[Sheriff Buford]

Have the attitude of getting what YOU want... not what THEY stock. There are many DME's out there. They work for you. If you decide on a Resmed, get the S9 Autoset with humidifier. The Elite is a cpap - only machine and the Escape is a piece of cr.... er... sorry... I almost lost myself ... the Escape is junk.

Sheriff

[Pugsy]

The S9 Elite would be the machine equivalent to your M series Pro CPAP.

Avoid anything with Escape in the name..even the Escape Auto which is an APAP/CPAP machine because either no useful data as with the Escape or sorely limited data with the Escape Auto...so we just tell people to avoid anything with Escape in it.

The S9 AutoSet is the APAP/CPAP machine. Has 2 modes you can use CPAP or APAP mode.

I have used both the S9 and the PR S1 machines...both are great machines..minor pros and cons with either but none are deal breakers or deal makers for that matter.
People that are unhappy with the S9 for some reason are rare...
There is a difference in how the S9 delivers therapy with exhale relief.
They are different and one is not necessarily better than another...just different.
While there is probably going to be a few people who do better with one brand over another, I think that most people would do well with either brand.
So the S9 is going to "feel" different. If you don't like change...get a Respironics.

If this DME is only offering the Escape or Elite....I bet you will have an uphill battle for the AutoSet. Up to you if you want to fight that battle. You have been using a straight CPAP for 6 years now.
Yes, the APAPs are nice to have for various reasons and I always recommend that people get one when they can but you can get excellent therapy from cpap mode.
You can shop around for a DME that will supply an APAP (whatever brand you decide) and unless you live where choices are limited or if your insurance is Medicare and you live in a competitive bid area...there usually are several choices available and sometimes there are DMEs that even routinely supply the APAP/CPAP machines.

DMEs will tell you that you can't get an APAP machine because your RX only says a single fixed pressure instead of a range of pressures...that's hogwash...they could just simply dispense the machine in CPAP mode and fulfill the RX requirements that way.
The real reason is profit margin. APAP/CPAP machines cost more money and insurance companies don't pay by model number. They pay by HCPCS code and the code for the Escape to the Autoset (or equivalent in Respironics) is exactly the same. So if they get paid the same the want to supply the cheapest they can get away with.
APAPs can be supplied for single pressure RX...if they just would.

Finally APAP/CPAP machines are nice to have. Better to have that auto adjusting pressure mode available and have it and not need it than need it and not have it....but it isn't the end of the world if you don't have it.
I have always used auto adjusting mode (APAP) because I have a wide range of pressure needs on occasion.
Sometimes I might need 10 to 12 cm...sometimes I might need upwards of 20...having auto adjusting lets me use the lower pressure for most of the time and higher pressure only when needed. If I used cpap mode and a fixed pressure I would have to use the much higher pressure all the time which wouldn't be much fun at 20 cm.

[Stevoreno_55]

The S9 Elite would be the machine equivalent to your M series Pro CPAP.

Avoid anything with Escape in the name..even the Escape Auto which is an APAP/CPAP machine because either no useful data as with the Escape or sorely limited data with the Escape Auto...so we just tell people to avoid anything with Escape in it.

The S9 AutoSet is the APAP/CPAP machine. Has 2 modes you can use CPAP or APAP mode.

I have used both the S9 and the PR S1 machines...both are great machines..minor pros and cons with either but none are deal breakers or deal makers for that matter.
People that are unhappy with the S9 for some reason are rare...
There is a difference in how the S9 delivers therapy with exhale relief.
They are different and one is not necessarily better than another...just different.
While there is probably going to be a few people who do better with one brand over another, I think that most people would do well with either brand.
So the S9 is going to "feel" different. If you don't like change...get a Respironics.

If this DME is only offering the Escape or Elite....I bet you will have an uphill battle for the AutoSet. Up to you if you want to fight that battle. You have been using a straight CPAP for 6 years now.
Yes, the APAPs are nice to have for various reasons and I always recommend that people get one when they can but you can get excellent therapy from cpap mode.
You can shop around for a DME that will supply an APAP (whatever brand you decide) and unless you live where choices are limited or if your insurance is Medicare and you live in a competitive bid area...there usually are several choices available and sometimes there are DMEs that even routinely supply the APAP/CPAP machines.

DMEs will tell you that you can't get an APAP machine because your RX only says a single fixed pressure instead of a range of pressures...that's hogwash...they could just simply dispense the machine in CPAP mode and fulfill the RX requirements that way.
The real reason is profit margin. APAP/CPAP machines cost more money and insurance companies don't pay by model number. They pay by HCPCS code and the code for the Escape to the Autoset (or equivalent in Respironics) is exactly the same. So if they get paid the same the want to supply the cheapest they can get away with.
APAPs can be supplied for single pressure RX...if they just would.

Finally APAP/CPAP machines are nice to have. Better to have that auto adjusting pressure mode available and have it and not need it than need it and not have it....but it isn't the end of the world if you don't have it.
I have always used auto adjusting mode (APAP) because I have a wide range of pressure needs on occasion.
Sometimes I might need 10 to 12 cm...sometimes I might need upwards of 20...having auto adjusting lets me use the lower pressure for most of the time and higher pressure only when needed. If I used cpap mode and a fixed pressure I would have to use the much higher pressure all the time which wouldn't be much fun at 20 cm.

So if I tried to switch from a straight CPAP machine to an Autoset machine would most insurance companies require a patient to have another sleep study? All I've used since being diagnosed with sleep apnea back in 1999 are straight CPAP machines. My diagnosed pressure in 1999 was 16; my most recent study done in October 2007 increased that to 18; I had a sleep study done in between these 2 but the medical facility where I was tested was destroyed by Hurricane Katrina in 2005 and so were my records. So if I had an autoset machine with a diagnosed pressure of 18 would the new machine be set to 18 or a much lower pressure? Thanks for your comments.

[LSAT]

With a pressure that high, I would ask your doctor about using a Bipap. A CPAP/APAP will only go as high as 20. A Bipap will be easier to breathe at high pressures.

[Pugsy]

I am with LSAT....if you can get a bilevel pressure machine it would be so much nicer using that 18 cm but you would definitely need a new RX from the doctor.

Insurance companies don't do the requiring so and so for APAP vs CPAP though...DMEs will tell you that but insurance companies don't care because they pay by HCPCS code and the code for the S9 Elite or the S9 AutoSet is the same. E0601...

So it is the DME who likes to blame things on the insurance company that is the road block in getting APAP/CPAP machine.
Now if your doctor (doesn't have to be a sleep doctor..can be your family doctor) writes a RX...and is specific about what to dispense...the DME has to do it but most of the time the doctor just says
"cpap at so and so pressure with heated humidifier" which leaves a lot of room for the DME to play with.

So if I had an autoset machine with a diagnosed pressure of 18 would the new machine be set to 18 or a much lower pressure?

Yes, it is possible that using an APAP/CPAP machine in Auto adjusting mode that you wouldn't have to use 18 cm all the time.
You might get by with less pressure part of the time and only spend maybe an hour or so at 18...or heck you might not need 18 at all...maybe the highest you need would be 16...of course you might be like me and sometimes need 20.
The 18 cm is a worse case scenario pressure...like my 20 cm that I might see for 30 minutes out of 8 hours.
So it's possible that you could get by with less pressure but can't guarantee it.

Do you have a regular primary care physician who might write a new RX for you?
Sleep study results aren't as important and a RX from a doctor.
If you can't get someone to give you a bilevel pressure machine (definitely would need new RX)....then go with a ResMed S9 machine. It's exhale relief works like a bilevel machine would work but is just limited to 3 cm reduction...better than nothing.
And yes.....I would push for the Autoset just in case you could maybe get by with less pressure at least part of the night.
With higher pressure needs...I think that the S9 with its EPR exhale relief probably is a better choice.

[Sgwilliamson]

I am also in MS and wouldn't get supplies from LINCARE ever! Have heard to many bad things. I get my supplies from SleepLinks in Flowood near Jackson. Theyre all super nice and they will ship your items to you. And I do know they carry Resmed and Respironics products. Their number is 601-932-3744 if you want to check them out. Hope this helps

[teleute]

One other correction from the top post:

s9 goes full dark - 560 will keep its humidifier light on.

There is a setting on the 560 to turn the humidifier light off (but I believe it is on by default).

[Stevoreno_55]

I am also in MS and wouldn't get supplies from LINCARE ever! Have heard to many bad things. I get my supplies from SleepLinks in Flowood near Jackson. Theyre all super nice and they will ship your items to you. And I do know they carry Resmed and Respironics products. Their number is 601-932-3744 if you want to check them out. Hope this helps

Thanks for passing on the information. Would a DME provider located in Flowood agree to ship to Biloxi if they accepted my insurance?


Stevoreno_55
02/11/14

[Stevoreno_55]

One other correction from the top post:

s9 goes full dark - 560 will keep its humidifier light on.

There is a setting on the 560 to turn the humidifier light off (but I believe it is on by default).

I contacted my former RT who's still with Apria Healthcare; the DME who issued me my current CPAP machine in January 2008; a Philips-Respironics DS400S C-FLEX CPAP machine. She told me she stocks both Philip-Respironics and ResMed S9 CPAP machines; she also said not even consider the ResMed S9 Escape; get the Elite but she also recommended that I go with another Philips-Respironics CPAP machine instead of the ResMed S9 Elite. Both machines are good so she told me but the Philips-Respironic CPAP machines are more patient user friendly than the ResMed S9 CPAP machines. She also said if I tried to get a BIPAP machine that I would have to undergo a new 2 night sleep study to qualify for one; if I went with just another CPAP machine I probably would not but she said if I got a new script for a ResMed S9 Elite CPAP machine I might run into some interference finding a DME who would be willing to let me have one.



Stevoreno_55
02/11/14

[HerbM]

Any DME which ships (and most would) will ship it to you so the issue is if the particular DME is accepted by your insurance provider, and accepted at full value to you.

My former insurance provider (the one cancelled by Obama Care) would pay for ANYTHING from ANYBODY that was legitimately medical -- certainly anything prescribed by a doctor with NO extra requirements of their own (if the doc had said I had sleep apnea and wrote the prescription they would have paid.)

My current insurance company is also very good (I got lucky on the change over) and will pay for any DME to supply equipment but pays 80% for "in plan" (those they have contracts with) and only 60% out of plan.

Also note the math can be misleading on a quick read. 80% vs. 60% DOUBLES my cost (and doubles my deductiable so I can end up paying ALL of an item out of plan up to the deductible which I will do my best to avoid meeting this year.)

[So I probably shouldn't use CPAP.com when the insurance is going to pay even though they may be my best choice when *I* must pay.]

You must know *YOU* insurance plan and one excellent way is to just call and ask. Most insurance companies are honest and will follow the rules, but most of them will NOT call you and explain how to take advantage of the rules to your benefit and their detriment, UNLESS YOU ASK.

On this part of the machine being user friendly, I submit that is one of the least of your concerns if you are visiting here for advice.

Your first concern is of course to get the machine that will provide the therapy you need.

And to do that, most of us believe you need a machine with advanced or detail data collection that can be analyzed BY YOU -- the DME isn't going to expect, and may not even want, you to look at your machine from this perspective.

Dumber and less capable machines COST LESS. Most of the insurance companies have squeezed contracts with their "in plan" DMEs to pay a set cost, so the DME wants you to take a cheap machine, the cheaper the better. (This is also true in some cases where their is no contract but the DME just contacts the insurance company to find out how the payment will work.)

If you are on a fixed percentage this can be to your great advantage since the insurance company is (be accident) negotiating for not just themselves but also for you when the price (of a better) machine is determined.

I pay 20% -- if my insurance company pays the same for a dumb and stupid machine as a fancy one with all the bells and whistles (that also makes coffee before waking me up gently) then I probably want the better machine.

[Stevoreno_55]

Any DME which ships (and most would) will ship it to you so the issue is if the particular DME is accepted by your insurance provider, and accepted at full value to you.

My former insurance provider (the one cancelled by Obama Care) would pay for ANYTHING from ANYBODY that was legitimately medical -- certainly anything prescribed by a doctor with NO extra requirements of their own (if the doc had said I had sleep apnea and wrote the prescription they would have paid.)

My current insurance company is also very good (I got lucky on the change over) and will pay for any DME to supply equipment but pays 80% for "in plan" (those they have contracts with) and only 60% out of plan.

Also note the math can be misleading on a quick read. 80% vs. 60% DOUBLES my cost (and doubles my deductiable so I can end up paying ALL of an item out of plan up to the deductible which I will do my best to avoid meeting this year.)

[So I probably shouldn't use CPAP.com when the insurance is going to pay even though they may be my best choice when *I* must pay.]

You must know *YOU* insurance plan and one excellent way is to just call and ask. Most insurance companies are honest and will follow the rules, but most of them will NOT call you and explain how to take advantage of the rules to your benefit and their detriment, UNLESS YOU ASK.

On this part of the machine being user friendly, I submit that is one of the least of your concerns if you are visiting here for advice.

Your first concern is of course to get the machine that will provide the therapy you need.

And to do that, most of us believe you need a machine with advanced or detail data collection that can be analyzed BY YOU -- the DME isn't going to expect, and may not even want, you to look at your machine from this perspective.

Dumber and less capable machines COST LESS. Most of the insurance companies have squeezed contracts with their "in plan" DMEs to pay a set cost, so the DME wants you to take a cheap machine, the cheaper the better. (This is also true in some cases where their is no contract but the DME just contacts the insurance company to find out how the payment will work.)

If you are on a fixed percentage this can be to your great advantage since the insurance company is (be accident) negotiating for not just themselves but also for you when the price (of a better) machine is determined.

I pay 20% -- if my insurance company pays the same for a dumb and stupid machine as a fancy one with all the bells and whistles (that also makes coffee before waking me up gently) then I probably want the better machine.

Thanks for the advice.

[-tim]

That was from the 1st week with the 560. It is my spare now and I use it for a few days every once in a while to make sure it still works.

A few points of old/misinformation (I have the 560, never used a ResMed)

My 560 is essentially silent at pressures up to 12 - can't say at higher pressures. Certainly the sound from different masks is much higher.

One difference not mentioned is that the Respironics 560 can run directly off 12v with a $30 cord. The ResMed uses 24V so it needs a $90 converter or an inverter. If you plan to run from battery power a lot, this is a major plus.

[removed quoted text... it is above]

The power is a very good point. Power around here is stable so I don't care except last week when a possum was playing with the 22,000 volt line and they guys couldn't find the crispy critter.

I reposted that in full since I think people will find it. My feed back on your comments:
1) water going into the tube will drive anything else back towards the machine so I always run water in the direction of the machine.
2) I stand by the comment that the design is stupid. It will open more (by design) but it is breakable and there isn't a logical "it should stop now". You are lucky that you have full mobility, many people don't and attempting to open something and stop at an arbitrary point is something they simply can not do.
3) I have done several emergency repairs to S9 units. This point is a major plus to the 560. If you travel or stay in a hospital, put a label saying "empty tank" or add it to your checklist. The s9 is snap together and one of the pegs will break because they won't put a $.02 screws in a thousand dollar device.
4) The 560 does work now. Your welcome. Thanks to every one else who worked on getting that code working. Special thinks to JediMark for starting it.
5) I was reporting what I had. 4 gig cards can't be used with as many readers but that problem will go away in the future.. Both machines seem to be happy with either. I expect the new machines are using some of the 4 gig cards that only report being 1 gig.
6) The sound is very subjective. I own very, very good speakers because I like them better than others. I have sent Carver amps back because they were noisy. I stand by my comment but I'll say that the Aussie made S9 is quieter than the Singapore made ones which are worse than my 560.

Some people are a glass is half full, others are half empty. I'm in the group that thinks the glass was the wrong size and better engineers should have know that and they need to do better next time. I know the this forum is read by all the major manufactures and I think that this sort of comparative criticism is good for the industry.