Is it worth it to switch from Resmed S8 to S9 autoset

Not an expert in this area, just a newly diagnosed OSA patient that happned to luck out and came into this problem at a time in which the best CPAP machine ever made came into the market (In my humble opinion). Positives of the Resmed S-9: - As quiet as a baby sleeping
- As you wake up, you can instantly check how you did in your nights sleep by pressing a button (AHI, Hours Slept, Smily face indicating no mask leaks)
- With the Resscan 3.11 software, you can access your data anytime you wish.
- The portability of this machine is such, that you do not need a 2nd "travel CPAP" piece of equipment; thus, no need for an extra expenditure.
- In the opinion of several Pulmunologist that happen to be involved in sleep medicine (yes, I have spoken to several of them, since I am also in the health care industry): The Resmed S-9, is Machine they recomend to every new patient.
- This machine is also a the top of the recomendations for 3 separate DME's, who's reps I have spoken to.
This is no Knock on the the other brands and previous models, Im sure the are excellent machines & most folks have had Great results with them and would not trade them for anything else. But, to me, when selecting technology to serve an important purpose; one should use the same approach that is used for computers and Digital cameras: Get the very latest and best that is out there now; cause that segment (technology), moves so fast, that what you buy now may become obsolete in a few years.
Insurance/economics/affordability issues aside; if all things are equal, the Resmed S-9 is been reported by users and reviewers, as the most technologically advance CPAP machine ever made to this point. And No, Im not a rep of any kind; I'm a Physician in a separate specialty, that considers himself very blessed to have found this forum & this machine.
Just a Newbies 2 cents; you guys are the experts, please fell free to make corrections or rectify any misinformation on my part. Thank you for all your help; this OSA guy is always willing to listen and learn..

soldes wrote:As quiet as a baby sleeping

The S8 II radiated sound pressure is measured at < 24 ± 2 dBA at 10 cm H2O at 1 m according to ISO 17510-1, same as the S9.

soldes wrote:As you wake up, you can instantly check how you did in your nights sleep by pressing a button (AHI, Hours Slept, Smily face indicating no mask leaks)

You can do the same on the S8 II, but without the annoyingly chirpy and condescending smiley face.

soldes wrote:With the Resscan 3.11 software, you can access your data anytime you wish.

I use the same software to check my S8. And it actually gives useful HI info, unlike the S9 which fails to give enough info to be useful for trending and tweaking therapy, in my also-just-as-humble opinion.

soldes wrote:The portability of this machine is such, that you do not need a 2nd "travel CPAP" piece of equipment; thus, no need for an extra expenditure.

Same with the S8 II, except you don't have to worry about fooling around with the stupid power brick that the S9 has, when you travel. For that and other reasons, the S8 II is the better travel machine, I think.

That being said, if I couldn't find an S8 II, I might settle with a S9. But only if ResMed dumps their idiotic internet-price-control policy. If they don't, I will buy whatever machine is least expensive at the time online, purposefully avoiding the big-R companies, just for the principle of the thing. Because I am like that.

But hey, that's just me.

Many people on this board have given positive reviews of the S9 and its' accessories for good reason.

Borck... you have to weigh the features you want versus the price you will pay.
When you buy New... you get full warranty and no questions replacement... a great and expensive feature.
When you buy Used... you get less cost to you... but at a price including maybe no warranty.

The S9 has the latest and certainly some of the best features available but you may not need some of them... and save money.
For me after all was said and read... the S9 made the most sense.
I could only compare to Resprironics M Series... but that was no contest for me.
I don't like rainout.
I don't like noise.
I don't like C Flex (I haven't tried C Flex Plus)
I like Full Data Capability.
I bought the S9 with Climate Control. It's not perfect but is is damn good. And the warranty works perfectly when needed.

Nord

soldes wrote: - The portability of this machine is such, that you do not need a 2nd "travel CPAP" piece of equipment; thus, no need for an extra expenditure.

The S8 is much better for travel - no brick to carry along for power!

soldes wrote: - In the opinion of several Pulmunologist that happen to be involved in sleep medicine (yes, I have spoken to several of them, since I am also in the health care industry): The Resmed S-9, is Machine they recomend to every new patient.
- This machine is also a the top of the recomendations for 3 separate DME's, who's reps I have spoken to.

Said it before, let me repeat again here: this is the classic case of medical reps or therapists from ResMed sampling and pushing the S9 to DME and docs. They probably offer better margins, easier return policy/warranty policy, etc. No doubt ResMed's new price policy is also to prevent folks from buying S8 directly from on-line dealers.

borck wrote:Sorry if it is a bit long (and again sorry for my english).

I have not used the S9 machine myself (only the S8 Elite II), so I cannot contribute to this conversation. I just wanted to welcome you, Borck, and tell you that your English skills are excellent! I have had no difficulty understanding anything you have written.

borck wrote:

carbonman wrote: .....are you no longer a newbie when you can
control de lure of de'machine?

Sorry, didn't get that one, definitely not native English...
Best, borck

Posted 3/2/10
de lure of de machine, it calls to me.
It's shiny and glows, like baubles and beads.
All silver and blue, it calls out,
"I'm better....I'm new."

I have all my reasons, in order, of course:
I need to be first,
it fits my scene,
it's a much better scheme,
it will tell me all of the things,
that I need to know, while I sleep.
This....this is the one.

As I lie here and ponder, wonder and wake,
it gnaws at me....

it's a much more primal need.

It's not de lure of de machine,
that calls to me.....
it's not the glow of baubles and beads,
that beckon to me....

On the edge of the desperate, black inky night, it lurks,
it's the burning eyes of the beast....

it's de lure of sleep.

Hope this helps.

These things can well be subjective, but I've noticed that those who've made the switch from the 8 series to 9 have reported considerable improvement. Those reports have been numerous and positive enough so that I'll be making the switch myself. For me, the crucial factor is that the algorithm in the S8 APAP tries to correct centrals via increasing pressure, which in my case means that the machine keeps increasing pressure until it hits whatever I set as the upper pressure limit. That makes it useless for self-titrating, which was my main purpose in getting an APAP rather than a CPAP. Supposedly, the S9 recognizes centrals for what they are.

Raj wrote: . . . the algorithm in the S8 APAP tries to correct centrals via increasing pressure, which in my case means that the machine keeps increasing pressure until it hits whatever I set as the upper pressure limit. That makes it useless for self-titrating, which was my main purpose in getting an APAP rather than a CPAP. Supposedly, the S9 recognizes centrals for what they are.

Hmm. Not so. [NOTE: I WAS WRONG] At least, not as I understand it, if it is going above 10 cm, which I assume your "upper pressure limit" is above [NOTE: TURNS OUT THIS WAS A FLAWED ASSUMPTION ON MY PART, AS RAJ EXPLAINS IN THE POST BELOW] :

The S8 will not increase pressure in reaction to any apnea that occurs when the machine is operating with a pressure above 10 cm, obstructive or central. So you may want to recheck your reasoning and your conclusions about what you think is happening. If the S8 is raising pressure above 10 cm, it must be because it believes it thinks it sees indications of obstruction in the way you breathe, since that is what it assesses, rather than the apneas themselves, which it ignores above 10 cm.

The S9 will react to apneas above 10 cm if it senses that the airway is not open. It will not react to an apnea above 10 cm if it senses that the airway is open. But the S8 does not react to either one (open airway or closed airway, since it doesn't know about that) above 10 cm. So if your pressure is running away, I know of nothing in the tweaking of the algorithm (the "enhancement") in the S9 that would make the machine less likely to raise pressure. If anything, the likelihood is increased, if we're talking reaction to apneas, that pressure will be raised.

Of course, I could be very wrong. But you may want to think about my words anyway, just on the slim chance that I may have some small idea what I'm talking about sometimes a little.

I too have heard the S9 does very well. But if any are judging how well the S9 treats them based on the S9's own estimates of "hypopneas" as opposed to how the S8 estimates its "hypopneas," I believe such ones may be comparing apples and oranges. The two machines create their trending data very differently it seems. The S8 always gives you some trending data to use. The S9 occasionally gives none in giving 0.0 for AHI. O.O means no data, not better treatment. In my opinion.

I could be wrong, but so far I think we have:

1) people who have tried both S8 and S9,
2) people who have tried S9 but not S8,
3) people who have tried S8 but not S9

Of that first category---people who have tried both models----we have some people who have reported preferring S9. Is there anyone who has tried both, but prefer the S8? I'm sure there has to be some...

Please raise your cyber hands now or forever hold your peace...

JNK, nothing wrong with your reasoning but with your assumption: I'm not close to needing 10.

Raj wrote:JNK, nothing wrong with your reasoning but with your assumption: I'm not close to needing 10.

Ah, that makes sense, then. Thanks. I ASSumed. I forget there are people needing much less pressure. The S9 over the S8 makes sense to me then, if you get pressure-induced centrals when the machine is below 10 cm, if the S8 is reacting to those pressure-induced central apneas, which I guess ( ) it would.

As for my reasoning not being flawed, I bet -SWS sees some small flaws in it there somewhere, but I bet he is being too nice to say so. I prefer it when he says so.

soldes wrote:As you wake up, you can instantly check how you did in your nights sleep by pressing a button (AHI, Hours Slept, Smily face indicating no mask leaks)

From the Clinicians manual "Mask-fit indicates 'Good' if the 70th percentile leak rate is less than 24 L/min"
Thats far from no mask leaks at all. I consider good if the 95th percentile leak rate is less than 24 L/min"
I don't know who decided on 70th percentile for the leak or the reasoning for it.

soldes wrote:With the Resscan 3.11 software, you can access your data anytime you wish.

The S9 machine will provide you additional data over the S8 II. You can get an indication of the number of centrals that contribute to your AHI. You'll get more detailed data such as flow and snore index. You can zoom into each breath you take on the flow chart and make your own decisions on how the machine is scoring events or responding to them.

carbonman wrote: .....are you no longer a newbie when you can
control de lure of de'machine?

We all have a different response to different machines/algorithms. I tried to resist the S9, I was feeling OK but the lure was too strong. I got greedy, I took a gamble but I'm glad I did

-SWS wrote:I could be wrong, but so far I think we have:

1) people who have tried both S8 and S9,
2) people who have tried S9 but not S8,
3) people who have tried S8 but not S9

I'm now wondering if my feeling better is just a result of my continued therapy and nothing to do with any edge the S9 has over the S8 in treating me. Maybe I should fall back to my S8 Auto for a period of time, then ignore the higher AHI and just judge how i feel .

4) people who have tried both the S8 and S9 and the S8 again

Uncle_Bob wrote: I'm now wondering if my feeling better is just a result of my continued therapy and nothing to do with any edge the S9 has over the S8 in treating me. Maybe I should fall back to my S8 Auto for a period of time, then ignore the higher AHI and just judge how i feel

[/quote]

Bob, if you decide to do that I hope you post your results. I don't use the S8 or S9 but I'm interested in all the news about this new machine and the PR System One just in case the "de'lure of de'machine" really pushes me over the edge!

Uncle_Bob wrote:From the Clinicians manual "Mask-fit indicates 'Good' if the 70th percentile leak rate is less than 24 L/min"
Thats far from no mask leaks at all. I consider good if the 95th percentile leak rate is less than 24 L/min"
I don't know who decided on 70th percentile for the leak or the reasoning for it.

You can see more detail on leak than that from the screen, though, right, if you want to?

Uncle_Bob wrote:You'll get more detailed data such as flow and snore index. You can zoom into each breath you take on the flow chart and make your own decisions on how the machine is scoring events or responding to them.

Now THOSE THINGS I like. A lot. Big step forward. They deserve credit for that.

Uncle_Bob wrote:Maybe I should fall back to my S8 Auto for a period of time, then ignore the higher AHI and just judge how i feel

Even though it would be a subjective judgment, I personally would consider that useful information from you, along with any comments you would have about the specifics of what felt different from the two machines.

Maybe we could hire someone to sneak in and change out machines on random nights behind a blind so that you wouldn't know which machine was on the other end of the hose . . .

-SWS wrote: . . . or forever hold your peace...

-SWS,

I'm curious, if you don't mind my asking: Do you consider the "0.0 AHI" reports to be a good thing, or a bad thing, for self-dial-wingers like us?

BTW, a friend of mine says (claims?) he got 0.0 on his S8 II the other day , although he has not yet produced photographic evidence of it.