Getting a new machine! Which one should I get?

andy88488 wrote:Ok, the Respironics seems to be the People's Choice, and it seems like a nice machine. Last night, I realized that the reason I am having trouble getting to sleep was the effort involved in exhaling, that it seems to take me a while now to get used to it, so exhalation relief would be very nice.

Since I am unfamiliar with the Respironics, one question: are you able to change all the settings yourself? The Resmed machines are theoretically "locked off", so the user is not supposed to be able to charge the pressure. Since the lock is easy to defeat, it's not an issue, but it might have been if I hadn't found out how to get in there.

Andy

Absolutely.
ALL PAP machines have special "Setup" keys (or key combinations) to hold to get into the programming functions. However, there are many occasions when the users need to get into those functions, so they SHOULD know how.
An informed user is a compliant user. One who takes control of their therapy is going to be more successful at it then if they rely on their "medical professionals". That's why it's not hard to find the instructions around here. Also, if you purchase your equipment from CPAP.COM, the instructions are included with the equipment.
And, if anyone ever tells you that it's "illegal" to change the settings on your machine.....that's not true.

Den

Wulfman wrote: And, if anyone ever tells you that it's "illegal" to change the settings on your machine.....that's not true.

Den

You know the old saying.... it ain't illegal unless you are caught.

So, even if it were illegal..... how would they ever know???

Andy, I posted this in someone else's thread but will put it here too. I'm posting this belatedly, since it looks like you've already decided on that very good machine!

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I'd get the Respironics REMstar Auto|A-flex M series machine. But I would not get the integrated humidifier for any M machine.

Instead, I'd get the separate Fisher & Paykel HC 150 heated humidifier. That humidifier can be used with any brand/model machine.

To monitor treatment, I'd buy the EncoreViewer software.

I'd buy the card reader Mako "Infineer" DT3500 USB here:
http://www.two-factor.com/shop/index.php?productID=115

I asked the same question about a month ago and took the consensus advice and bought the respironics with auto flex - need to update profile I think. I LOVE IT LOVE IT LOVE IT!!!! I am amazed at the difference from cpap to apap. Less gas and easier breathing.

I bought the encore smart card and reader. I have never seen the report shown in this thread. I will research it. I have enjoyed the data and analysis, such as it is. I feel in control with the knowledge. My doc hadn't heard much about apap but wrote the rx for me anyhow. He knows better than to argue with me without evidence to support his position. We agreed to meet in 60 days and review the data. He is a pcp so he admits to a learning curve with sleep apnea and believes it is significantly underdiagnosed. Nonetheless, I am glad I took the collective wisdom of this fine people.

I have been blessed by the change in my sleep and improved quality of my life. Truly a gift of health.

I think you will like the respironics machine because it addresses your issues. Please let me know how it works out.

I am worth it and so are you.

rested gal wrote:I'd get the Respironics REMstar Auto|A-flex M series machine. But I would not get the integrated humidifier for any M machine.

Instead, I'd get the separate Fisher & Paykel HC 150 heated humidifier. That humidifier can be used with any brand/model machine.

Is the main reason for this suggestion flexibility of use of the humidifier? Are there specific concerns with the integrated humidifier?

Thanks!

Gandalf....

The "issue" with the integrated "M" series humidifier has to do with a long, skinny O-Ring seal used between the top half and the bottom half of the water chamber.

I had one leak right out of the box....first H2O fill.....because there was a tiny little imperfection (mold mark) on one part of a tank half.......right where the O-Ring needs to seal. The imperfection pushed the seal away from the side of the tank....probably not more than the thickness of a fingernail....but that was enough to make it leak.

I put the area under magnification......smoothed out the imperfection with a sharp knife blade (scraped the raised area until it was flat)....then put it back together. No more leak.

The other reason people have problems with the "M" series tank is that it can be a little tricky to get the two halves of the tank back together without distorting the O-Ring seal. It almost takes a "mechanic's touch" to put it back together after cleaning.

Fortunately, if one uses distilled water.......and dumps the remainer every few days or so.....shakes the tank around with water in it.....then dumps again to expel any debris......it probably isn't really necesary to take the tank halves apart very often.

Gerald

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CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, seal

Thanks Gerald for the info!

I just wish they (maunfactures) would bring back the old style machines like the Goodknight 418 (circa 1997). They may not have all the whisltes and bells of the new wisbangs but at least it was quiet and was monotone. The new ones all seem to be louder, higher pitched and sound like a British ambulance with a two toned sound. The sound changes pitch between inhale and exhale. Iv'e tried them and could not stand the noise and tone changes.

Puritan Bennet representative says the new ones are smaller, lighter and better. Well I have news for you - I don't need smaller and lighter I just need a machine that doesn't keep me from sleeping with the high noise and tone changes.

andy88488 wrote:2. Should I get another Resmed? I have the S8 Compact, and I have basically liked it. If I get another Resmed, I don't have to buy another Humidifier.

That's what I did and I've been very happy with the overall result (especially the data collection capabilities), though I've ended up not using it in APAP mode, as APAP gave me worse sleep outcomes than CPAP.

andy88488 wrote: On the other hand, Resmed seems to be trying to stamp out Direct Sellers

That issue is endemically related to the nature of the US healthcare delivery system.

Most of the "evils" traditionally atttributed here to Resmed are now starting to be perpetuated by Respironics, so there is no moral high ground much left to fight over in that respect.

Cheers,

Bill

My M series humidifier was used as a passover during the fall months but I turned it on when the weather started getting cooler. By morning it would be nearly out of water on a setting of 1 or 2. I was afraid I would burn it up if it totally ran out of water.

I had read so many good reports on the Fisher and Paykel I advertised on craigslist and was able to purchase a Fisher and Paykel 100 and a 150 along with a new water chamber and hose for less than a new one and pocket about $50.00 to boot.

I am using the 100 model and love it. It moves enough water that I have continued to use it in pass over mode, yet with a flick of a switch can have it heated if needed. A couple of weeks ago we had a really cold snap and I was able to turn the humidifier on prior to going to bed and it felt good to have the warm humid air from the get go. In pass over mode I can get three or four nights out of one fill up.

rested gal wrote:Andy, I posted this in someone else's thread but will put it here too. I'm posting this belatedly, since it looks like you've already decided on that very good machine!

_________________________

I'd get the Respironics REMstar Auto|A-flex M series machine. But I would not get the integrated humidifier for any M machine.

Instead, I'd get the separate Fisher & Paykel HC 150 heated humidifier. That humidifier can be used with any brand/model machine.

To monitor treatment, I'd buy the EncoreViewer software.

I'd buy the card reader Mako "Infineer" DT3500 USB here:
http://www.two-factor.com/shop/index.php?productID=115

Thank you for the advice. I've seen a couple of people mention the F & P humidifier instead of the built-in. And I've never seen anyone mention problems getting the humidifier to fit together right with the Xpap the way that Gerald and I think someone else did. That's kind of sobering. Or maybe I'm spoiled. My S8 Compact fits the Humidifier flawlessly. That's about the only thing it does do!

I'm inclined against the F & P for two reasons. One is that it seems like it would be difficult to travel with, at least compared to the Respironics unit. Second is, I'm between girlfriends, and this will be the first time I've started a new relationship since I got on CPAP. To me, the F & P increases the "creep factor".

It just looks sort of mad-scientisty to me. The Respironics is just a blank box with a hose sticking out of it. I don't know. Maybe I'm overreacting. I'm certainly planning to mention my Apnea prior to us sleeping together. So it's not like the machine, mask, etc will come as a surprise, at least theoretically. But telling someone about it is one thing. Sleeping with them, with a mask on my face, and bubbling tubes next to me, seems a little off-putting. To put it mildly!

Andy

Wulfman wrote:My suggestion would be the REMstar Auto w/A-Flex......

I agree. If you got lots of money and want to get really fancy might even consider the Resperonics BiFlex Auto. Although the A-Flex is a excellent choice and simpler for setup.

jskinner wrote:

Wulfman wrote:My suggestion would be the REMstar Auto w/A-Flex......

I agree. If you got lots of money and want to get really fancy might even consider the Resperonics BiFlex Auto. Although the A-Flex is a excellent choice and simpler for setup.

To get a BiPAP Auto either from the DME or by purchasing online, the person would have to get his/her doctor to write a prescription specifying "bipap" (or "bilevel") and stating an IPAP (inhale) setting and an EPAP (exhale) setting.

So.... a consideration in favor of the Auto with A-flex over the BiPAP Auto is that if a person already has a prescription for "cpap" (rather than for bipap or bilevel) the person can buy an autopap from an online store like cpap.com with a copy of that existing "cpap" prescription. If buying online rather than through a local DME, there's no hassle over getting a new Rx written for "autopap." The simple "cpap" prescription will suffice.

Nor is there any need to have the single pressure on the Rx changed to state a range of pressures when buying online. The autopap leaves the manufacturer preset 4 - 20. That range encompasses any single pressure that might be prescribed. An instruction guide for how to go into the therapy setup menu comes with an autopap purchased online from most stores.

For an autopap, most bricks and mortar DMEs would probably require a new prescription from the doctor specifying autopap (or auto-titrating cpap) with a pressure range stated, even though they legally could (if they would...LOL!) simply give the person an autopap set for cpap mode and a single pressure per the original cpap prescription. Set for cpap mode, the autopap would work just like the cpap the person was exchanging. The person could do whatever they wanted to the settings after getting the machine home and checking this message board for info about how to access the therapy setup menu on the machine.

Andy,

I started with the integrated HH that I purchased when I bought my M Series, but it just didn't give me enough heat/humidity, so I upgraded to the F&P--what a difference! But, I'm keeping the integrated one just for travel.

Hey, your new girlfriend might just like the "mad scientist" look! Who knows? And, you can always cover your machine & F&P like RG does--very neat, out of sight!

If u r interested in reports from the New Encore Viewer from Respironics I can run it for you and Email you the reports.

Using the utility at http://www.mycpap.com you copy your SmartCard to disk and Email me the file to UPMCPAP@hotmail.com .

All you need to buy in that case is the card reader only. That's all.

Sam