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peppilappu wrote:Since no one has heard of this, then I can only assume my clinic is making it up to force me to buy their machines.

This just resurrected a flash of a memory I had put behind me. A year ago when I stumbled into a DME for the first time as a babe in the woods and at the instruction of my sleep lab...the RT told me in no uncertain terms, "No, you will not be able to order a cpap online." I said, "But I've already researched this, found an online supplier (cpap.com), and have confirmed that they only need my Rx." To which she replied with stern disdain...."But you don't understand! When you have placed your order, you will get a message right away or several weeks later that your order cannot be honored for our State." Yes I needed the machine ASAP and I guess she thought I was a brain dead bimbo who could not pick up a phone to verify the truth or lie of her statement.....Well yes, maybe half brain dead at that time, but not a bimbo....er, most of the time.

Phil, understand that it really is NOT necessary to buy a bi-level (Bi-PAP or VPAP) to get expiration pressure relief. Resmed's EPR and Respironics' -Flex act like a bi-level except that a bi-level can provide MORE expiration pressure relief than EPR or -Flex. I can understand wanting an APAP. My personal priority is 1] the right pressure(s) for me, 2] full data capability. Many find the constant pressure changes w/APAP bothersome (therefore bi-level pressure changes could be too). The nice thing about APAPs tho is that they CAN be used in straight CPAP mode. I like my VPAP Auto bi-level which can be used in CPAP mode, Spontaneous (straight bi-level) mode and Auto bi-level mode. But I NEED a bi-level due to COPD.

peppilappu wrote: ..........
So Ill call ResMed on Monday and get to the bottom of this.

...........

Why bother? You might just give their marketing geniuses ideas to experiment with.

As far as personal bashing on the forum, it feeds on response. Just ignore it and it starves to death quickly.

Any Bi-pap requires a script from your Dr. for a B-PAP, a APAP or CPAP script won't get a Bi-PAP. jim

rooster wrote: . . . As far as personal bashing on the forum, it feeds on response. Just ignore it and it starves to death quickly.

Rooster,

Does that mean I'm supposed to leave you alone when you ignore my giving you a hard time?

Rooster? . . .

Rooster? . . .

Did you hear me? . . .

Rooster? . . .

Why I'm I suddenly getting very hungry?

I guess it's true!

jeff

I expect people to post WETF they want to here that Johnny will allow. But in return, I expect the right to fire back. A little flaming every day helps keep the HDL at healthy levels.

rooster wrote:I expect people to post WETF they want to here :

It is easy to follow, but it is uninteresting to do easy things.
We find out about ourselves only when we take risks,
when we challenge and question.
--Magdalena Abakanowicz

Resmed's EPR and Respironics' -Flex act like a bi-level

Understood, thx.
I was reading that the EPR does NOT work in Auto mode.
Is it true only Respironics units can do that due to some patent infringement?

I like the ResMed because it seems to be the most quite. I have to wear ear plugs when any small noise is around like tree frogs or crickets.
So quiet is very important to me.
Seems like all the manufacturers are rating their machines in DB. Well that is meaningless. You need a DBM (Decibels per meter in distance) rating which specifies exactly how far from the machine the measurement has been taken. You can understand a measuring sound levels at 1meter away will be louder than the same sound 2 Meters away. And even that doesnt tell the entire story. THe machine may be louder in the front of the side that you sleep on versus where the measurement is taken. That is why I like to get a person listen prior to buying but thats not going to happen.

The S8 Auto EPR unit is rated at 24DB. Again, worthless but impressive it its measured at 1 meter. (24DBM)
Any comments on the two brands of machines regarding how quiet they are?

Peppilappu wrote:Resmed's EPR and Respironics' -Flex act like a bi-level

Understood, thx.
I was reading that the EPR does NOT work in Auto mode.

Ths was once true, but is no longer so. You can read about EPR in Resmed's site
http://www.resmed.com/us/assets/documen ... sa_eng.pdf

Is it true only Respironics units can do that due to some patent infringement?

EPR works differently from CFLEX (or AFLEX), and exists in the S8 series II Auto.

Any comments on the two brands of machines regarding how quiet they are?

The Resmed is very very very quiet.
O.

Ozij is correct. EPR was available only in CPAP mode w/the Resmed S8 AutoSet Vantage. But the Resmed S8 AutoSet II has EPR in both CPAP and Auto modes.

I prefer my Resmeds - but - the Respironics Rep had one of the new PR SystemOne Auto w/C-Flex Plus at our last apnea support group meeting. He turned it on at 15 cms of pressure and I sat w/in 2 feet of it the entire meeting. When he told me it was turned on and at 15 cms I didn't believe him as I could NOT hear a thing!!! He had to take the cap off to let me feel the air pressure before I really believed him. I was impressed despite I'm not a Respironics fan. You can find the SystemOne Auto for a little as $729 online complete w/integrated humidifier if you shop around for it. At least that is the cheapest I found it and I didn't look any too hard as I'm not in the market for an APAP. Supposedly this SystemOne Auto can do everything for you but sleep. The hype for it sounds good anyway. The only thing I can vouch for is that it is QUIET! And it is not a bad looking gadget if appearance has any import for you. And it does REQUIRE EncorePro v.2.1 which isn't all that easily available to even the most determined and innovative user - yet. NEVER underestimate a determined/innovative xPAP user tho. As I understand it the data via the LCD screen is still limited which is a detriment.

Peppilappu wrote:Resmed's EPR and Respironics' -Flex act like a bi-level . . .

I have read that EPR is closer to bilevel, but that some prefer the feel of C-Flex.

I don't know if all these statements are still true, but according to cpap.com:

"C-Flex decreases pressure at the beginning of each breath. The decrease lasts for less than a second and then returns to the base pressure. EPR decreases the pressure at the beginning of each breath also but keeps the pressure low throughout the exhalation. . . . C-Flex settings reduce the pressure relative to the patient’s exhalation strength and the machine pressure setting. EPR reduces the pressure by one, two or three centimeters of water pressure. . . . EPR has an Event Detection Circuit. When a sleep disordered breathing event is expected or has occurred, EPR stops until the event concludes and normal breathing resumes. C-Flex is of such short duration it is thought that is has no negative effect on sleep disordered breathing events and does not need to stop. . . . What is the difference between EPR and BiPAP (tm) or Bilevel? Bilevel machines . . . use rapid pressure changes to expand and contract lung volume. EPR uses slower pressure changes, so there is little ventilatory effect. However, EPR does feel very much like a Bilevel to the patient."

...and then there is A-Flex, which is different again. I have not tried a Resmed with EPR but I have tried C-Flex and A-Flex. I much prefer A-Flex.

I wonder if A-Flex is closer to EPR than C-Flex and Respironics added it to the newer M Series Autos to compete with Resmed? Just wondering.

Check at cpap.com and see if they've added any information on just how A-Flex works in relation to C-Flex, EPR and a bi-level. Or even check at the Respironics website.

Peppilappu wrote:Resmed's EPR and Respironics' -Flex act like a bi-level

Understood, thx.
I was reading that the EPR does NOT work in Auto mode.
Is it true only Respironics units can do that due to some patent infringement?

I like the ResMed because it seems to be the most quite. I have to wear ear plugs when any small noise is around like tree frogs or crickets.
So quiet is very important to me.
Seems like all the manufacturers are rating their machines in DB. Well that is meaningless. You need a DBM (Decibels per meter in distance) rating which specifies exactly how far from the machine the measurement has been taken. You can understand a measuring sound levels at 1meter away will be louder than the same sound 2 Meters away. And even that doesnt tell the entire story. THe machine may be louder in the front of the side that you sleep on versus where the measurement is taken. That is why I like to get a person listen prior to buying but thats not going to happen.

The S8 Auto EPR unit is rated at 24DB. Again, worthless but impressive it its measured at 1 meter. (24DBM)
Any comments on the two brands of machines regarding how quiet they are?

Something to keep in mind here is that the sound level that you will experience with your machine is directly related to how you use the machine. If you place the apap on a night stand that's level with the bed and right beside your head, it will be loudest. Many of us have successfully reduced noise levels by placing the apap either on the floor, or perhaps halfway from mattress height to floor level. It does not necessarily require a longer hose to do this. You will want to combine this setup with a hose manager such as the cozy hose from Pursleep, or other.

Hawthorne wrote: . . . I much prefer A-Flex. . . .

As does rested gal:

rested gal in another thread wrote:"I've used machines with no exhalation relief at all, ones with EPR, ones with C-Flex, and with A-Flex. A-Flex feels the most like natural breathing to me. Everyone's different, though, so what suits me perfectly might not suit someone else at all."