First Resmed after 8 years

With new insurance, I got my first insurance replacement to the Respironics M-Series Auto I got from Apria in 2008. I have been purchasing my own machines off the forum and Craigslist for a while, and had gotten great results with the PRS1 Auto BiPAP 760TS. So I knew if I went back to a DME, for a new machine, I did not want to downgrade to CPAP. This was pretty challenging, and to prepare, I worked with my primary physician to document the efficacy and advantages of auto bilevel (using Encore), and incorporating this into my medical record along with a "determination" the patient does not tolerate CPAP. I provided the doctor with precise prescribing information and pressures.

For the new DME, I went to a new provider called REMworks. This looks more like a boutique storefront, than a DME, and they have a very knowledgeable and customer oriented staff. They took my prescription and started the insurance approval process in December 2015. In early January, they called with approval for auto CPAP which I declined. Following another routine doctor's appointment, I had them call for the bilevel justification they needed. Yesterday, the approval came in, and I made a noon appointment to pick up the new equipment.

I had a choice between the PRS1 auto BiPAP (which I already have), and a Resmed Aircurve 10 Vauto. The Dreamstation was not available in auto bilevel. I've never had a Resmed machine before, but there are fanatics here that sing their praises constantly, so I went for the big adventure of a new brand.

First night impressions, results and comparison between the PRS1 760 and Aircurve 10 Vauto: Both machines were setup similarly in auto mode with EPAPmin 9, IPAPmax 18, and PS 4 (PRS1 used a PS range of 4-6). AHI was low 1.07 compared to an average of 1.38 over the past week with the PRS1. That is within normal variation, so I don't expect AHI to increase or decrease with the machine change. Time will tell. The PRS1 scores more CA, and the Resmed more OA, with hypopnea about the same. The Resmed does not score RERA which is a bit of a disappointment.

Most treatment parameters are the same, with both machines recording the same average and 95% IPAP, but Resmed kept EPAP about 1.0 cm higher. Overall comfort is similar, however I am more aware of the PRS1 occasionally not syncing with inspiration and expiration. If I have a prolonged exhale with low flow at the end, the PRS1 will often boost pressure and I'll respond with an inhale. I don't get that with Resmed which is imperceptible and seems to work more closely with me.

QUIET! Resmed is far quieter, in fact the machine itself is inaudible compared to the PRS1 which can be heard changing pitch on each breath.

Resmed pressure changes are much faster, and of course IPAP and EPAP move together, and PS is constant, compared to PRS1 which seems to hold a much more even pressure through the night except for the 2-cm IPAP pressure fluctuations built into the algorithm. When the PRS1 changes pressure, it does so much more slowly.

I'll refine this as I get more experience. The take-away is both machines are equally capable of treatment, and differences are subtle, with a slight advantage to Resmed for being quieter and working more in sych with my breathing pattern.

Here are some pictures of what a DME should look like:

My dme provider store looks a lot like that but doesn't have clothes, are those nightshirts somehow specifically geared to cpap users and why? I'd love to know how they market that

Sleeprider wrote:The take-away is both machines are equally capable of treatment, and differences are subtle, with a slight advantage to Resmed for being quieter and working more in sych with my breathing pattern.

We're in the same camp here. Only difference is that my settings are fixed. I love my PR760 for travel and am glad I started with it for that reason but my Aircurve 10 Vauto is my home machine for the reasons you stated above.

OkyDoky wrote:

Sleeprider wrote:The take-away is both machines are equally capable of treatment, and differences are subtle, with a slight advantage to Resmed for being quieter and working more in sych with my breathing pattern.

We're in the same camp here. Only difference is that my settings are fixed. I love my PR760 for travel and am glad I started with it for that reason but my Aircurve 10 Vauto is my home machine for the reasons you stated above.

Absolutely agree. I will use the PRS1 for travel, especially on the motorcycle where I can use 12-volt battery power. One consequence of getting an insured device is I have to now show compliance and benefit, so the next 90 days at least will be all Resmed. By Summer I should be able to use the PRS1 for camping and moto trips.

Michelle-OH wrote:My dme provider store looks a lot like that but doesn't have clothes, are those nightshirts somehow specifically geared to cpap users and why? I'd love to know how they market that

Michelle, there are a lot of things being displayed that I wouldn't consider essential, like aroma therapy, chin straps, liners, pillows, P.J.s and other accessories. I think the point is that traditional DME has not been a place you "want" to go, and they certainly don't display things in a commercial "sales" floor. Also, this DME provides all kinds of services on a walk-in basis. Bring in your machine for repair, and walk out with a loaner. Get advise on a mask leak, or dry mouth or eyes or other comfort issue. They'll deal with it then and there.

No need to reach an anonymous central call center and make an appointment to talk to someone that probably doesn't want to talk to you. From what I can tell, these people work hard to get their customers what they want and need quickly. My last machine was through Apria, and other than having a delivery truck pull up, I only once met anyone at the DME.