what should I pick for a new machine?

I have an opportunity to get a spare or travel machine. Turns out my spouse's insurance plan will pay for another machine and they don't care if it is a travel or home unit. Up until now I didn't think her company plan covered any CPAP related items.

That being said I could choose from the following:

1. Get another Resmed Airsense 10 autoset for her. I'm currently using this machine at home and I have great results.
2. I could get a Philips dream station auto to try out. Seems like a well made unit and there are plenty of folks here that use it. A relative of mine insists the algorithm is better than the Resmed. I know none the wiser since I've only ever used ResMed.
3. Get a Dreamstation Go
4. Get a ResMed Air Mini

I'm not concerned about getting a spare unit - my father has a Airsense 10 autoset for her the the refuses to use that is new so that is my spare unit should mine ever die after the warranty period is up.

I don't travel much per se and when I did travel on a bunch of trips this summer that I just took my AS10 with me. I do go winter camping at least 2x a year but it is really car camping and we have sites that are powered and we even run a space heater in our tent.

I'm tempted to get a DS Go b/c of the data recording capabilities but the lack of a humidifier kinda turns me off. The Air Mini is nice for size and the Humid X cartridges but when you add the brick and unit up that it is the same size as a DS Go but lacking the data recording and display screen. I also don't like the fact that the Air Mini uses a proprietary hose which means I have to use the 3 masks available for the Air mini (fortunately I can tolerate the use the F20 and the P10 without any issues).

So many great options but no unit is a clear winner. Any suggestions? I've called and confirmed with her insurance and they said "we don't care what you buy, you've never claimed any CPAP gear before so you're entitled to your coverage".

Cost from my DME is all the same they said whatever option I choose don't make any difference in cost to them.

Thanks

I’d go with #1, it’s a known-good solution for you.

A nice problem to have. If you truly had no backup or if you backpacked, the answers would be easy.

While the Respironics and ResMed algorithms differ, I am not sure I would argue one is better. I tried a DS auto bipap -- very nice machine -- but I personally slept better with the Aircurve 10. I suspect others have the opposite reaction.

I have not personally used a travel model. Generally, you give up features, humidification, and they are more noisy (both directly and sometimes via the tubing). That means I travel with a full size unit. OTOH, if size or weight are an important consideration, a travel unit might make perfect sense. With some models (DS and my older S9), you can leave the humidifier section at home and cut down the weight/size a fair bit. Not sure how a DS with no humidifier compares to the Go in terms of weight and footprint.

Your current back up plan is not ideal...if yours breaks at 11pm, you likely don't have the replacement in hand. And it is not programmed to your settings.

What matters here is what problems you are trying to solve. In your shoes (and I am not), I would either go:
a) DS and try leaving the humidifier at home. Not super huge or heavy and you get to see if you are more Respironics or ResMed. (And you take a heater camping so weight is not the biggest issue for you). The supplies are not interchangeable (filters, hose, chambers). Make sure you get a comparable DS.
b) Another ResMed (like you have). The good is that everything works exactly the same, settings are tuned in for you, and all of your supplies cross over. The bad is it duplicates that pseudo spare you already have and dropping the humidifier does not save much weight/volume.

How important is size and weight to you? Or power consumption? Are you OK with no humidification? Can you keep your Dad's machine at your house with your settings loaded in? Do really want to try the Dreamstation? Are ok with non-interchangeable supplies?

Snoregone Conclusion wrote: ↑

Sun Nov 25, 2018 10:23 pm

I’d go with #1, it’s a known-good solution for you.

I know... that was what crossed my mind as well but my relatives were saying that "since you have essentially access to 2 auto sets for her that will probably last you 10+ years that why not give the Dreamstation a whirl".

Good situation to be in for sure and I was blown away that we even had CPAP coverage through my spouses insurance. This entire time we thought no coverage whatsoever. We even got it preapproved already!

CPAPSteve wrote: ↑

Sun Nov 25, 2018 10:58 pm

Snoregone Conclusion wrote: ↑

Sun Nov 25, 2018 10:23 pm

I’d go with #1, it’s a known-good solution for you.

I know... that was what crossed my mind as well but my relatives were saying that "since you have essentially access to 2 auto sets for her that will probably last you 10+ years that why not give the Dreamstation a whirl".

Because of this: https://www.youtube.com/watch?v=lzCCgNLya_g

Personally I would go with a travel machine - it's nice to have the option if you need it, and it's still a perfectly good backup machine. DS Go vs AirMini is personal preference - I chose the DS Go because it's quieter, has data, and doesn't need proprietary masks/hoses. I did pair it with a heat-moisture exhanger, but I think the AirMini Humid-X is probably better. So if humidity is a big deal for you, I would try the AirMini.

TropicalDiver wrote: ↑

Sun Nov 25, 2018 10:50 pm

A nice problem to have. If you truly had no backup or if you backpacked, the answers would be easy.

While the Respironics and ResMed algorithms differ, I am not sure I would argue one is better. I tried a DS auto bipap -- very nice machine -- but I personally slept better with the Aircurve 10. I suspect others have the opposite reaction.

I have not personally used a travel model. Generally, you give up features, humidification, and they are more noisy (both directly and sometimes via the tubing). That means I travel with a full size unit. OTOH, if size or weight are an important consideration, a travel unit might make perfect sense. With some models (DS and my older S9), you can leave the humidifier section at home and cut down the weight/size a fair bit. Not sure how a DS with no humidifier compares to the Go in terms of weight and footprint.

Your current back up plan is not ideal...if yours breaks at 11pm, you likely don't have the replacement in hand. And it is not programmed to your settings.

What matters here is what problems you are trying to solve. In your shoes (and I am not), I would either go:
a) DS and try leaving the humidifier at home. Not super huge or heavy and you get to see if you are more Respironics or ResMed. (And you take a heater camping so weight is not the biggest issue for you). The supplies are not interchangeable (filters, hose, chambers). Make sure you get a comparable DS.
b) Another ResMed (like you have). The good is that everything works exactly the same, settings are tuned in for you, and all of your supplies cross over. The bad is it duplicates that pseudo spare you already have and dropping the humidifier does not save much weight/volume.

How important is size and weight to you? Or power consumption? Are you OK with no humidification? Can you keep your Dad's machine at your house with your settings loaded in? Do really want to try the Dreamstation? Are ok with non-interchangeable supplies?

Here is further context to your questions and comments:

1. My dad has basically given me his CPAP machine. He can't tolerate it and thus it IS at my house and I've already programmed my settings into it. Ironically it was me who found him a very gently used AS10FH.
2. I'm not too sure if interchangeability is really that bad between PR and Resmed. Masks for example are universally compatible (sans the air mini) between my current home unit the DS and the DS go. If my main unit fails then I still have an exact backup anyways.
3. Weight and power are considerations when travelling or camping. We tend to overpack a lot more than I'd like to admit and lugging less on a trip is always welcomed. I've only camped once with an AS10 and it wasn't too bad and travelling to another country for a week with the AS10 was also not bad.
4. Humidification - I do like moist air. Not sure if I could handle breathing in super dry air. Where I live the air is intensely dry in the winter due to forced air heating. That being said, if I do winter camping in a tent that is barely heated that I wouldn't be using any water in my humidifier if I had one anyways. Not sure about our summers... haven't used CPAP in the summer camping yet so I would have zero clue as to how dry it would feel. Summers here run around 40-60% humidity.
5. Power consumption COULD be an issue should I decide to do dry camping where there could be power but not directly at our site. We've done that in the past before I started CPAP therapy.
6. I wouldn't mind to try the Dreamstation but it isn't high on priority list of things. Only reason DS Auto even came us was my sisters insistence that the algorithm was better than ResMed. Obviously her opinion based on her trial between the two units but I keep reminding myself that I shouldn't fix something that ain't broke... I admittedly do like the fact that I COULD remove the humidifier off the DS Auto.

My answers probably don't help much as I don't think I'm any more confident knowing what I'd want before answering all of this. In reality I don't really have a problem to solve other than a dilemma to use m spouses insurance benefits before she loses them.

juaquin wrote: ↑

Sun Nov 25, 2018 11:24 pm

Personally I would go with a travel machine - it's nice to have the option if you need it, and it's still a perfectly good backup machine. DS Go vs AirMini is personal preference - I chose the DS Go because it's quieter, has data, and doesn't need proprietary masks/hoses. I did pair it with a heat-moisture exhanger, but I think the AirMini Humid-X is probably better. So if humidity is a big deal for you, I would try the AirMini.

how well did your heat/moisture exchanger work with the DS Go? I like the fact the DS Go has in integrated power supply and a screen and data logging. The Air mini does't have any of that (it technically has data logging that gets sent to resmed as of Nov 2018 via the app/smartphone data upload to ResMed Cloud where your DME can view compliance details).

Between the DS Go and Air Mini is there one that has better build quality over the other? The mini is super cool that it is TINY but that proprietary hose is the turn off and the fact that the power brick couldn't be integrated into the unit. Can't have it all I guess...

palerider wrote: ↑

Sun Nov 25, 2018 11:03 pm

CPAPSteve wrote: ↑

Sun Nov 25, 2018 10:58 pm

Snoregone Conclusion wrote: ↑

Sun Nov 25, 2018 10:23 pm

I’d go with #1, it’s a known-good solution for you.

I know... that was what crossed my mind as well but my relatives were saying that "since you have essentially access to 2 auto sets for her that will probably last you 10+ years that why not give the Dreamstation a whirl".

Because of this: https://www.youtube.com/watch?v=lzCCgNLya_g

NUTS! That was really neat to see PR! I completely get why you're a ResMed guy and why my DME pushes ResMed way more than Philips. That being said, do you think that Philips would've learned from their older units and incorporated better algorithms into the newest DreamStations? I would presume that companies continually refine their equipment with each successive generation or am I grossly mistaken? Not challenging ResMed's quality - I like their unit a lot.

CPAPSteve wrote: ↑

Mon Nov 26, 2018 12:10 am

how well did your heat/moisture exchanger work with the DS Go?

It's hard to tell. I didn't feel like the air was very humid, but I also had no problem sleeping with it. I did not find my nose to be any drier than normal. But I live in a somewhat humid place and my body might not need that much humidification from the machine anyway. Some people don't need the humidification at all. We'll see how it works when traveling to places with less humidity though.

Here's my full review if you're interested: viewtopic/t173310/Dreamstation-Go-Review.html

CPAPSteve wrote: ↑

Mon Nov 26, 2018 12:19 am

palerider wrote: ↑

Sun Nov 25, 2018 11:03 pm

CPAPSteve wrote: ↑

Sun Nov 25, 2018 10:58 pm

Snoregone Conclusion wrote: ↑

Sun Nov 25, 2018 10:23 pm

I’d go with #1, it’s a known-good solution for you.

I know... that was what crossed my mind as well but my relatives were saying that "since you have essentially access to 2 auto sets for her that will probably last you 10+ years that why not give the Dreamstation a whirl".

Because of this: https://www.youtube.com/watch?v=lzCCgNLya_g

NUTS! That was really neat to see PR! I completely get why you're a ResMed guy and why my DME pushes ResMed way more than Philips. That being said, do you think that Philips would've learned from their older units and incorporated better algorithms into the newest DreamStations? I would presume that companies continually refine their equipment with each successive generation or am I grossly mistaken? Not challenging ResMed's quality - I like their unit a lot.

Well, one wonders how many patents they have to skirt to try and make changes without infringing... for one thing.

For another, Respironics seems to *like* their way of doing things, even though it seems like there's a basic error in the way their auto machine behaves.

Beside the 'waiting longer before doing anything', they've got this thing where, when the user is having really smooth, undisturbed sleep, the Respironics autos start meddling with the pressure, raising it, then dropping it... the stated reason is to "see if it improves breathing", only... they only do that when breathing is really smooth and regular If breathing *isn't* smooth and regular, they do nothing... someone hypothesized "well, maybe it's because they think pressure changes would disturb the sleep"... but. the sleep is *already* disturbed, and that's the time to see if a little more pressure would make it better. To me, it's like they've got a check backwards in the software, and it's been like that for at least 9 years on three different model lines.

I think of Respironics auto machines like a bratty kid, who comes over and pokes at you while you're asleep, but the moment you stir, they run and hide.... waiting till you're still again, before coming to poke at you again.

Look at a bunch of other peoples sleepyhead posts, people with Respironics will have long periods of no pressure changes, even though they have event after event, and the machine sits there with it's thumb up it's butt, doing nothing to help.

Resmed machines, on the other hand, are right there with you, all the time. Look at the screenshots from them, and the machine is bumping pressure, tweaking, reacting, trying to make sleep better.

I'm not saying that Resprionics are crap, I think they're a solid second best, not engineered as well, not built as well, not programmed as well, not equipped as well... but people *can* get a good result, even though it often requires a higher minimum pressure, since they're much less responsive.

So odd that Philips would do such a thing. I am quite happy with my Resmed so if I were to choose a machine then it would likely be an autoset or maybe an air mini. It is really cool to have a tiny CPAP but the humidity... I’d hate to drop my portion of copay only to find out that I am not happy with it.

I am no burning rush to go buy one just yet but I would need to do so probably within the next month or so. First world problems I tell you...

I have zero experience with any of those tiny travel units and I have no need or desire to go down that road. I need my humidity too much to ever go with none or minimal humidity. My nose would make my trip miserable if I did that....learned that lesson the hard way.

But I have used both brands of apap machines....Respironics (my very first M Series machine and a couple of Respironics later System One models but no DreamStation) and ResMed (S9 and now AirSense 10).
Bear in mind that my OSA is mainly REM dependent...much worse in REM where I might need 6 to 8 cm more pressure during REM than I need other times of the night.

I can get good therapy with either brand and sleep good with either brand.
What is different are the settings that I get by using with each brand.
Respironics...minimum of 10 and max of 20 AFlex of 2 and I would see times where the machine often went to 15 to 18 during time frames which appear to be REM probably. AHI long term average around 1 to 2...mainly closer to 1.
ResMed...minimum of 7 with EPR 3 and 20 max and I get the same pattern where it goes to 15 to 18 during probable REM time frames.
AHI long term average for this past year 1.13 and I suspect a good chunk of that is probably SWJ because of poor sleep secondary to back pain.

When I used APAP years ago...I started with 8 minimum and it wasn't enough to keep the REM clusters prevented and the AHI was running 5 to 8....I quickly realized the need to increase the minimum to prevent dense clusters during REM. Ended up with the 10 minimum.

I get essentially the same results with the ResMed with lower minimums and even with even more exhale relief (I just like the way it feels)....while 7 minimum isn't earth shatteringly different from 10 minimum...it is different and a bit more comfortable .
Plus with the Respironics I always got more of the Darth Vadar noise than I get with ResMed. I could tune it out but it's nice to not have to tune it out.

Now I have never even seen the new DreamStation...much less use it but to my understanding the algorithm didn't change with the new cosmetic changes or minor changes in setting options.

You can probably do just fine with a Respironics machine...it's still a good machine and for some people probably a machine that better suits their needs.
If you really like EPR...you might not appreciate how Flex does the exhale relief....or you might really like the more subtle change.
No way to know until someone actually tries something.
You might need a little more minimum with the Respironics if you have some times where your pressure needs are markedly higher.
If you don't have anything like that...may not need much of a difference in that minimum at all.

Don't blame you for wondering...I do that all the time and its why I have tried so many machines over the past 9 years. I was just curious. I guess it just depends on just how much that curiosity itch needs to be scratched.
All my experimental machines were bought privately...steal of a deal prices that if I hated the machine I could sell it and get my money back or most of it. I have yet to use my insurance to buy a machine. I just don't want the hassle of having big brother over my shoulder messing with me and all those compliance things, etc.
I still own a Respironics PR System One 760 BiPap auto. It's my back up/travel machine. I can use 10 cm minimum EPAP if I have to and do well with it. I just kinda like not having to...that 7 IPAP and 4 EPAP that does a bang up job for me...is pretty sweet. Almost like not using pressure at all.

I say get get you already know works for you. If you get a different brand, the idiosyncratic differences might end up being a big deal.

Pugsy that is interesting feedback. I guess it is really a toss up in my case since I technically have two autoset for her machines at my disposal (and my and my dad’s machine are new) so really what are the odds of both my machines failing anytime soon? No harm I guess in trying Respironics machine. Given my OSA it isn’t like I had a lot of OSAs to begin with.

Decisions decision... definitely a first world problem and a good place to be for me. I was surprised they’d cover travel CPAPs As my insirance company would not.