Respironics/Remstar System Question

Hello,

Does anyone use the Respironics Remstar Pro/Plus/Auto CPAP machine? I am thinking of purchasing this particular model (hopefully, the Auto) and wanted to know what experience/comments anyone might be able to share about these uints. Does anyone know what the difference is between the Pro/Plus models? I believe the Auto means that it will automatically determine the correct pressure -- plus the Auto is supposed to have a more detailed readout of what happened during the night (I believe) that you can take to your doctor for a followup.

Thanks!

Hi Master Shake,

I've never used the Pro or Plus, but I do have the Respironics Remstar Auto. I purchased it as a back up machine and have been using it for the past several weeks. I also purchased the Encore Pro 1.3 software and "card reader" for it.

You are correct about all this:

I believe the Auto means that it will automatically determine the correct pressure -- plus the Auto is supposed to have a more detailed readout of what happened during the night (I believe) that you can take to your doctor for a followup.

If you purchase the software and card reader you can also see the overnight data for yourself, on your own computer. But.... downloading the data to your computer "erases" the data from the "smart card", I think. I think I've read about a way to make the smart card retain previous data after a download, but I haven't tried to do that. I'm not taking my data to a doctor anyway - just looking at it myself. But yes, the smart card can be easily carried to your doctor for a followup. Of course, whether the doctor actually looks at it himself is another question. I've heard about doctors who are not the least bit interested in reviewing the data from the smart card, or do not even have the necessary card reader or software in their office.

I've used the REMStar Pro for about two years. It is my first machine, so I can't compare it to others, but I can say that it has performed very nicely for me.

As I recall, the "Pro" differs from the "Plus" in that it includes the heated humidifier. I've found the humidifier vital in the high, dry altitude where I live in the Northern Rockies. The machine is quiet, smooth and includes every option that I needed as a cpap beginner. I no longer bother with the ramp, for instance, but I appreciated it during my first few months of use.

Good luck.

Master Shake wrote:Hello,

Does anyone use the Respironics Remstar Pro/Plus/Auto CPAP machine? I am thinking of purchasing this particular model (hopefully, the Auto) and wanted to know what experience/comments anyone might be able to share about these uints. Does anyone know what the difference is between the Pro/Plus models? I believe the Auto means that it will automatically determine the correct pressure -- plus the Auto is supposed to have a more detailed readout of what happened during the night (I believe) that you can take to your doctor for a followup.

Thanks!

I found both machines relatively noisey. I preferred in many ways, the Resmed Autoset for the data reading (on screen LCD). It has basic info that most will find useful such as how many events/hr, AHI index, min and max pressure including average. The main drawback with the Respironics is that I have heard and experienced are a lot of machine failures. I experienced three during my trial. I know of one DME that will only sell it to his customers if they insist.

I am considering trying out the Puritan Bennett Goodknight 420E but many people report that their hose gets a lot of moisture. Something I never got with either the Remstar or Resmed machines.

I am considering trying out the Puritan Bennett Goodknight 420E but many people report that their hose gets a lot of moisture.

I have read about that in posts on another message board, but mostly in posts by one person. It probably would have scared me away from that machine, but thankfully I had already bought a 420E.

The problem is if moisture gets into the narrow sensor tube that runs through the main hose of the 420E. Despite my early trials with heated humidifier turned up too high and getting a lot of rainout in the main hose, I've never ever had moisture from rainout within the main hose find its way into the little sensor tube, much less into the machine itself. The one and only time I got water into the sensor tube itself was my fault...washing the main hose without thinking about plugging the sensor tube. That night, when I turned the machine on, it wouldn't blow air. Droplets of water that apparently hadn't dried out completely in the tiny sensor tube itself were apparently blocking the feedback, so the machine simply thought the little tube was not connected - and wasn't going to work until it was. After I blew the sensor tube dry for a few minutes with an old straight cpap I had handy, everything worked fine. That sure taught me to plug the sensor tube at each end when running water through the main hose! heheh

My 420E has been absolutely reliable, and the software is second to none - sooo much data presented in so many ways that some call it complicated looking, but I like the many ways the Silverlining 3 software can display the data. After awhile you have a couple of favorite screens you use to see what you want to know.

The Remstar auto I have as a backup machine does fine for me too, but the extra settings available in the 420E have been invaluable for me in finetuning treatment of tricky limited flow situations (slight closing of the throat resulting in restriction in getting enough air, but not quite an hypopnea.) My normally slightly shallow breathing pattern makes the 420E extra effective for me. Also, the 420E has a special setting that can be used to override the default limit of 10 cmw for apneas. As far as I know, a safety limit of 10 for the pressure that will be delivered when any autopap senses an out-and-out apnea is built into all the major brands of autopaps no matter how high you have set the upper pressure. I don't think any of the other brands of autopaps provide a way to change that pressure throttle. My Respironics Remstar doesn't have any way to change that. I know of at least one user who was not putting a dent in his apneas until he began using a 420E and was able to change that particular setting, called "maximum pressure for command on apnea" in the "advanced" section of the clinical menu.

While most autopaps work fine for most people, there are some users who really need the features of one specific brand of autopap or another ...or even an entirely different type of machine altogether. So while I'm a big fan of the 420E, it might not be at all what someone else needs.

I've just (2 nights ago) started with a CPAP machine and the one I chose was the Remstar Plus with C-Flex. I also purchased the 'ComfortLite headgear and mask.

Having read all the posts about how long it takes to get used to CPAP treatment I was expecting a long haul, but in those two nights I've already clocked up over 10 hours machine usage. The mask really is comfortable - far better than the one used in hospital for the titration study, and absolutely no sore points at all.

I bought the heated humidifier too, since the air gets really dry in Jo'burg during winter, but although it's fitted I haven't used it yet.

I see one of the replies states that the machine is noisy. Mine is really quiet to the extent that my wife can't even hear it - perhaps the newer models are better.

Obviously it's far too early for me to really comment, but if I'm already sleeping reasonably OK with the machine that indicates that for me at least it was the right choice.

rested gal, I don't quite understand what you mean about this sensor in the hose? Any hose that I used I would simply wash in the bathroom sink and let hang to dry. None had any sensors??

What kind of humidifier are you using? Is it the PB official humidifier or another brand?

Since you have another CPAP machine, how do the two machines compare noise wise?

My apneas are in the form of hypopneas (very shallow breathing). No machine has been able to address them adequately. This is why I am looking at this machine. You mentioned an "overide"type setting? Is this the switch that it will allow the machine to respond to hypopneas above 10cm? This would be something that interests me.

Miko,

The PB 420E has a small clear plastic hose that runs inside the large coiled hose. This is used to sense the pressure at the mask instead of at the machine.

It must be kept dry because if it is obstructed in any way the machine will not properly operate. In my experience it either won't start or blows like crazy.

The hummidifier water in the hose problem seems to go away if you keep the temp setting at 2 or below (I use the F&P HC150). Take a look at the Oct news letter at cpap.com to see the new integrated heated humidifier for the ultra-small PB units.

My software has shown that I have more hypopnias than apneas also. The 420E seems to handle them well.

If you need more info rested gal is the "expert" on the 420E (and many other subjects) watch her posts and you will learn alot!

Hi Miko,

Wader described the sensor tube well. But, nice though he was to say what he did, he described me badly...there are many others - Nev, for example - who are far more experienced than I am with the 420E. I'm no expert at all, believe me. It's a machine that's doing a good job for me, and I'm merely relaying what I've picked up from people who are light years more techie and knowledgeable about the two autopaps I've used.

The Puritan Bennett 420E autopap has a very small diameter "extra" tiny hose that runs all the way down through the inside of the main air ribbed air hose. Respironics and ResMed autopaps don't use a sensor line. There's no extra tube inside their main hose, because...they don't need it. They're designed to interpret the flow (how you are breathing) from the main hose alone. PB chose to incorporate a separate sensor tube. Either way works fine - it just depends on how the manufacturers' designers decided to go at it. What really matters is how the brain of a machine interprets the air flow it gets, whether it received it via just the main hose or requires a separate sensor line inside the main hose.

Miko, the override thing I was talking about that is unique to the 420E is for special handling of apneas, not hypopneas. I did not have to change the default setting of that (10) - but that option was very important to another user who had been been getting way too many apneas no matter how he set the "regular" high-low pressures range.

The 420E does have two other separate settings that can be turned either on/off ("on" is the default) which have to do with "inspiration flow limitations". As I understand it, those are situations when a person's throat is just beginning to close and the person is getting a "limited flow" of air, without really being closed enough to qualify as an hypopnea yet. Dealing premptively with "limited flows" is crucial (just my guess, I'm not an expert!) in keeping hypopneas from happening. That seems (I don't really know) to be a very strong point in the way the 420E operates. I see fewer "limited flows" and fewer hypopneas on my overnight data from the 420E than I do on my data from the Remstar. But that's not to say the Remstar or other brands of autopaps might not do a better or equally good job at that for someone else.

I'll hasten to say here - I feel equally good in the morning after using either machine. So, the fact that the Remstar has no way to turn either of those flow limitation settings on/off doesn't seem to cause me a problem regardless of the overnight data showing a few more ticks. That might even be a result of how the two machines read flow from the mask I use most - the Breeze, which is made by Puritan Bennett. According to other people, the Breeze works fine with other autopaps (works fine for me with the Remstar), but PB machines are optimized to work well with the Breeze. Bottom line, imho, is really how you feel in the morning regardless of which machine's graphs look a tad "cleaner".

All the major brands of autopaps do a very good job for most people, and each has something about it which is more important or more convenient than another. Just depends on what's important to you because you'll probably get good therapy from any autopap. It would take an unusual problem for you to absolutely need one brand of autopap over another, imho.

Lastly, to answer your other question, Miko - the separate heated humidifier I use with the 420E is the Fisher & Paykel HC150. The Remstar has an integrated humidifier. Of the two humidifiers, both do an equally good job. My personal preference is for the separate HC150, not because it's "better", but because I can feel for the heat adjustment knob in the dark and turn the heat up or down.

Thanks rested gal! I really appreciate your info. I am seriously thinking of the PB 420E as this machine appears to fit my need as far as treating air flow limitations; however, I need to overcome the issue of "swallowing air" which I believe is attributed to my acid reflux. The Resmed didnt do a good job and I think the Remstar did a better but it was too noisey and lacked instant user info for me. I also didn't like the limited ramp time feature but loved the size.

One more thing, because I am a very very light sleeper, which machine do you find quieter? The Remstar or 420E?

One more thing, because I am a very very light sleeper, which machine do you find quieter? The Remstar or 420E?

Other manufacturing runs might be different, but going only by my two machines, the Remstar is quieter. The 420E is my favorite - does have that slight "rev up and rev down" as I breathe, though. The Remstar is quieter. (Except for a few random nights when the Remstar has made a steady whining sound which wasn't "too" loud but was discernible...dunno why.) I wasn't much help, was I?

rested gal,

You are much too modest.

I have learned a ton from you (just in this post).

You are very generous and timely in your replies. Probably 75% of all I've learned from this forum has come from your replies to my posts and reading your replies to other's posts.

Yes, there are probably many others out there that are far more knowedgable than any of us. But you do a great job of seeking out that knowledge and passing it along to this forum.

Give yourself a "pat on the back" from me.

I'll keep reading and learning - THANKS

Hi Miko,

You may find once you get comfortable with CPAP you are not such a light sleeper. Each day I have been sleeping longer and waking up more refreshed.

I can't give you a noise comparison between the PB and the remstar, but I can tell you I love the PB 420E that I have. The "reving" sound is very muted and has not keep me or my wife awake. I actually was all set to buy with the remstar but decided to go with the PB when I saw that they are coming out with the integrated humidifier (similar to the remstar). For now I'm using the F&P HC150.

I too have reflux and tried all the meds for (currently taking protonix) I know your concern related to CPAP. So far I have not seen any effects from the CPAP.

wading thru the muck!, you are most fortunate. At first when I started CPAP on the Remstar I didn't have any issues with swallowing air (aerophagia) then when I switched to a different mask/machine (Resmed Autoset Spirit), I began to have major symptoms. I tried the Remstar again with the original Respironics mask and machine and I developed the same problem.

Clearly, something changed physiological that my sphincter is easily been opened. I suspect my GERD got worse. At times, like last night while watching tv I could feel a similar sensation. So, CPAP only aggrevates what ever is going on. Apparently, 1 in 7 CPAP will suffer from aerophagia and many will not be able to tolerate CPAP. I was hoping that my condition has improved that I can use CPAP again, but now I am having my doubts.

On another forum, it was suggested to those that suffer from aerophagia to consider a BI-PAP but I don't see how that could help because the incoming pressure is still going down the pipe and forcing the sphincter to open.

I am currently using Nexium. Have you tried it?

Hi Miko,

Sorry to hear you are having difficulty with CPAP worsening your reflux. Before I got meds for my reflux it was very painful. I originally tried nexium and it worked great for me. I only switched to protonix because my doc gives me enough samples to take me thru my next appointment.

Has your reflux stopped responding to the meds since you've been on CPAP?

If so is there any surgery that can repair your esophogus? I'm suspect of any of the surgeries that hope to prevent apneas. If you can deal with your reflux surgically it my also eliminate the aerophagia and allow you to treat your OSA with CPAP.

Keep posting new threads regarding your CPAP/reflux problem. This forum is relatively new and growing every day. I'm sure there are CPAPers that will have some suggestions to help you.