Comparison Resmed S8 AutoSet II vs Remstar M Series

dsm wrote:SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM

I believe Resmed is doing exactly what I have highlighted in that quoted red text above, and I believe that's what the earlier post very correctly echoed.

You're right. This seems like weaving, dodging, and dancing in swirls with words. Short of providing updated Resmed text to counter the corroborating Resmed quotes I have above, anything else really is dancing in swirls in my opinion.

Cheers.

-SWS wrote:

dsm wrote:SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM

I believe Resmed is doing exactly what I have highlighted in red above, and I believe that's what the earlier post very correctly echoed.

You're right. This seems like weaving, dodging, and dancing in swirls with words. My first sentence in this post very accurately says it all. I'm done with this thread short of anybody being able to produce material from Resmed that counters the direct Resmed quote encased above in that red underlined text. Short of providing updated Resmed text, anything else really is dancing in swirls in my opinion.

Cheers.

The artful dodger

You have merely said you won't contradict the 10 year old interview & dodged my question which if you answered honestly, you know would more accurately (in this forum for this audience) explain what the S8 II machine really does with OSA events over 10 cms.


DSM

Yeah, right. You are the only one who has made a statement about A10 without backing it up. He who will not provide one shred of evidential material is the only "artful dodger" and "swirl dancer" in this thread. Now you have some very vehement A10 "counter-claims" that are actually your burden to prove.

Quite frankly, it's no one's burden to disprove your earlier claims that have yet to be substantiated. And if someone says they haven't heard or read about your claims---and then they cite Resmed words to the contrary----that doesn't come close to making them an artful dodger. It simply makes them perplexed at the unsubstantiated counter-claims.

Cheers.

P.S. If Resmed is no longer observing that statistical 10 cm barrier, then their algorithm is no longer rightly called "A10".

dsm wrote:SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM

I agree with you.
I am only a AutoSet II user--according to DME I don't understand things like this...but I can see the AutoSet increasing pressure above 10 cms. This pressure increase prevents my hypos and flow limitations from become an apnea. I am doing very well with pressure right at and above 10cms every night. Most nights I have no apneas. Seem to be working for me, YMMV.

-SWS wrote:

Yeah, right. You are the only one who has made a statement about A10 without backing it up. He who will not provide one shred of evidential material is the only "artful dodger" and "swirl dancer" in this thread. Now you have some very vehement A10 "counter-claims" that are actually your burden to prove.

Quite frankly, it's no one's burden to disprove your earlier claims that have yet to be substantiated. And if someone says they haven't heard or read about your claims---and then they cite Resmed words to the contrary----that doesn't come close to making them an artful dodger. It simply makes them perplexed at the unsubstantiated counter-claims.

Cheers.

P.S. If Resmed is no longer observing that statistical 10 cm barrier, then their algorithm is no longer rightly called "A10".

SWS,

Lets go for some clarification. What do you believe the interviewer & interviewee were meaning at the time, by the word 'apnea' quoted in those interviews given back in the 2000-2004 period.

Would you concede me the point that the phrase 'OSA events' has far more relevance & significance in looking at what a machine responds to than insisting on relying on a word with so many meanings (apnea).

The reason why words are such an issue is that any newcomer who sees the word 'apnea' has every right to assume that means all OSA events when we who have been researching OSA know it is a spectrum from full obstruction (no-flow) through to flow limitations that are seen as FL scores in some brands & flattening patterns in another (apnea-hypopnea-flow limitation overlaid with snores & air vibration).

You know & I know that the S8 II responds to OSA events over 10 cms. I see your position as refusing to acknowledge that point, why ?.

Lets take a case of someone who has a titration of say 16. The incorrect conclusion someone can reach (and I have seen many do it) is that the Resmed machine musn't be able to adjust therapy pressure if I have 'apneas' at 16 CMs (over 10 cms). That is the misleading aspect of the statement in question. Because again we both know that an obstruction is going to have precursor events including flattening & snores & hypopneas & then if a no-flow apnea occurs the machine has already been adjusting pressure based on the precursor events. That is what Autos were designed to do. The A10 approach is to ignore a 'NO-FLOW' apnea above 10 but to prepare for it by responding to the normal and usual pre-cursor events.

DSM

hose head wrote:

dsm wrote:SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM

I agree with you.
I am only a AutoSet II user--according to DME I don't understand things like this...but I can see the AutoSet increasing pressure above 10 cms. This pressure increase prevents my hypos and flow limitations from become an apnea. I am doing very well with pressure right at and above 10cms every night. Most nights I have no apneas. Seem to be working for me, YMMV.

Thanks

You are stating the very point I am wanting to get across. The comment about A10 etc: etc: is very misleading to newcomers & I have long believed it was a ploy to scare particular people who were looking for an effective therapy machine. I still believe that A10 statement is being used for the same purpose today.

DSM

hose head wrote:

dsm wrote:SWS

We are dancing in swirls here all about semantics over meanings of one word first included in an interview given 10 years ago.

The heart of the matter is what the Resmed S8 II does when OSA events occur over 10 cms. Not what misinterpretation can be wrangled from 8-10 year old interviews.

Can you answer honestly with a yes or no
"Do you believe the S8 II responds to OSA events at pressures over 10 cms" If no then lets explore that.

DSM

I agree with you.
I am only a AutoSet II user--according to DME I don't understand things like this...but I can see the AutoSet increasing pressure above 10 cms. This pressure increase prevents my hypos and flow limitations from become an apnea. I am doing very well with pressure right at and above 10cms every night. Most nights I have no apneas. Seem to be working for me, YMMV.

How do you know? Not all flow limitations and hypopneas are destined to become apneas at whatever pressure and without increases.

However......if you're having flow limitations, hypopneas and snores, then the ResMed Auto will respond above 10 cm.

MY original post had that qualifier in it. It's the "frank" (abrupt, sudden) apneas that the A10 is not supposed to respond to.......according to everything that's been hashed out (and re-hashed, cussed and discussed) here (and the TAS forum) over the last four years or so.

If the ResMed Auto eliminates flow limitations and snores at "some" pressure above 10 cm. and there are STILL apneas, I don't believe it will respond to them. And, depending on how many "events" there are and at what pressure it takes to eliminate them, the minimum pressure may be too low to begin with.


Den

Good to see that the real authorities are participating, even if not if agreement. I believe I may have inadvertently raised an important question, the answer of which could be of significant value to those at this site. I try to avoid topics about which I know little or stating falsehoods, and qualify statements when appropriate as done here: "I understand that the ResMed machines do not respond to apneas over 10, because they are considered centrals. I'm not an authority on ResMeds." I raised the topic speculating it might be (and possibly still is) an important consideration in his machine selection.

I will attempt to contact ResMed directly and try to get a clarification on this question. Again, I'm no authority, but would like to help where I can.

Georgio

Georgio wrote:Good to see that the real authorities are participating, even if not if agreement. I believe I may have inadvertently raised an important question, the answer of which could be of significant value to those at this site. I try to avoid topics about which I know little or stating falsehoods, and qualify statements when appropriate as done here: "I understand that the ResMed machines do not respond to apneas over 10, because they are considered centrals. I'm not an authority on ResMeds." I raised the topic speculating it might be (and possibly still is) an important consideration in his machine selection.

I will attempt to contact ResMed directly and try to get a clarification on this question. Again, I'm no authority, but would like to help where I can.

Georgio

Georgio,

I agree it is an important topic - I too just got off the phone to Resmed (am keen to talk directly Dr Berthon-Jones as he is based here in Sydney).
But he is very hard to get hold of (busy man). I am hoping to get in email contact with him.

Re that statement on A10, I appreciate you were merely restating what others here have led you to believe. And, what gets believed is going to vary greatly among us based on what we think was meant by 'apnea' in that original interview.

So you have done us a favor in reproducing it as that very act shows to me that the comment catches people's attention and gets perpetuated,
even if for the wrong reasons

Cheers

DSM

I have an email off to Resmed as well. I'm glad I brought the subject up and that both you and SWS got involved.

Georgio

To recap:

1) Resmed's A10 algorithm will directly respond to FL above 10 cm (according to Resmed)
2) Resmed's A10 algorithm will directly respond to snores above 10 cm (according to Resmed)
3) Resmed's A10 algorithm will not directly respond to any apneas above 10 cm (according to Resmed)
4) Pressure-response strategies one above (FL) and two (snore) above can and will help prevent many apneas occurring above 10 cm

And to add:
5) claims in this thread that Resmed will directly respond to some apneas (as long as they are preceded by FL or snore) are so-far unsubstantiated. They are also in direct violation of what A10 has always been advertised by Resmed to do: namely hold the pressure steady as soon as any apnea occurs above 10 cm in statistical observance of the 10 cm barrier. That strategy is because Resmed's A10 to this day does not attempt to differentiation central from obstructive apneas at any pressure (which is why they statistically observe that apnea-at-10 cm barrier also known as the "A10" algorithm).

Now how the heck is any of that contrary to what was said and unjustifiably corrected earlier in this thread? Aside from vague unsubstantiated claims and reproach, does anybody have any evidence from Resmed that what was very wrongly corrected earlier in this thread deserves to be called misinformation?

I'm really stumped by all these corrections and allegations of propagating falsehoods that have yet to receive one shred of supporting Resmed material. If anyone on this thread would like to credibly reproach and correct with statements contrary to Resmed's, then please produce something/anything from Resmed to back up all the unsubstantiated correction and admonishment.

Counter-claims, correction, and reproach: Resmed proof please.

Georgio wrote:I have an email off to Resmed as well. I'm glad I brought the subject up and that both you and SWS got involved.

Georgio

That helps!

I think it's a personality thing. Respironics users seem a little more laid back about their machines. If you're not going to be "edgy" about your Resmed, they may not want you on their team... We don't care whose team you're on, unless you're gonna start whining about blue lights, the power brick, or a decibel or two on inhale. We've certainly got enough of those on our team.

It was my nickel so I went with what was cheaper. Made it pretty easy...

SharkBait wrote:I think it's a personality thing. Respironics users seem a little more laid back about their machines. If you're not going to be "edgy" about your Resmed, they may not want you on their team... We don't care whose team you're on, unless you're gonna start whining about blue lights, the power brick, or a decibel or two on inhale. We've certainly got enough of those on our team.

It was my nickel so I went with what was cheaper. Made it pretty easy...

Nah, it's everyone's penchant to nail down the correct information.

But A10 had some darn good epidemiology backing it up in 1999 for obstructive etiology (not inherently mixed, central, or complex etiologies). Human physiology hasn't changed one bit, with respect to that 10 cm statistical barrier. It's not as if Resmed all-of-a-sudden has modern-day access to signal-process those snore and FL signal components. Resmed was very handily signal-processing those same snore and FL signals back in 1999---and chose to leave all apneas alone above 10 cm simply because A10 didn't differentiate central apneas from obstructive apneas (and A10 still doesn't differentiate---but rather elects to "statistically observe" instead).

Hence the strategy of leaving apneas above 10 cm unchallenged, while still trying to prevent them with FL and snore signals as they did back in 1999. Resmed very wisely advanced their algorithms and detection methods for mixed, central, and complex etiologies on yet other Resmed machine models----but Resmed had absolutely no incentive to change the epidemiological essence of their basic-vanilla obstructive-apnea pressure response in A10. Statistical observance of the A10 barrier was epidemiologically smart then, and it's just as statistically savvy now.

As long as Resmed refrains from differentiating central apneas from obstructive apneas, then A10 will hold off on pressure increases every time it sees an apnea above 10 cm.

For me, having the reader and software already would lean me to ol' reliable. Keep in mind no matter which you choose, you will need new software. If choosing Resmed, you will also need a reader.

ps. I think there is something in Slinky's water. Scotch? Good thing she's not biased too!!

Another summary that avoids the 'apnea' double entendre so skillfully exploited by my good monkey business friend

The Resmed Auto machines will respond to OSA events over 10 cms. 'Apnea' has 2 meanings in the context of the claims & counter claims. Apnea can be interpreted as 'OSA events' which is what most newcomers are likely to assume, and apnea can specifically mean a no-flow block as typified by Medicare's definition. Blocks without precursor events (flattening (FLs) & snores) are so rare as to be worth ignoring or are centrals.

One claim implies the Resmeds won't respond to OSA events over 10 cms (which is the purpose of exploiting that claim) vs the fact that Resmed machines do respond to OSA events over 10 cms. This is all about how someone chooses to exploit the meaning of 'apnea' to the target audience.

DSM

Don't you just love word plays