ResMed S9 Elite vs S9 Autoset

I purchased the S9 Elite a couple of months ago. My brother has the S9 Autoset and he enjoys it.
Should I sell or exchange the Elite for the Autoset?
What are the advantages and disadvantages of each? Thanks

The difference is that the Elite only provides one continuous pressure all night long, while the AutoSet will automatically adjust the pressure between pre-set limits depending on what events its sensors detect. For some, this is a blessing while for others the pressure variations cause sleep disturbances.

A bit more information about your sleep study findings and experiences with your Elite will help people advise you further.

Only difference is the "AutoSet" mode where it will respond to your breathing across a range of pressure instead of a constant pressure.

Personally, I think everyone should have auto capability. My AHI would bounce between 3 and 7 with my initial constant pressure of 12cm H2o. A big improvement from my initial pre-treatment AHI o 114.4, but still room for improvement. Once I went auto, I pinned it down to under 2 and have stayed there the better part of 4 years.

I guess the answer for you depends on how well you do on a constant pressure and what your AHI high, low, and averages are.

JeffreyJitza wrote:I purchased the S9 Elite a couple of months ago. My brother has the S9 Autoset and he enjoys it.
Should I sell or exchange the Elite for the Autoset?
What are the advantages and disadvantages of each? Thanks

My surgical supply rep and three sleep physicians never told me of sleep disturbances due to the AutoSet which were not present in S9 Elite users.

Are you certain that the disturbances were solely due to the AutoSet unit and those issues completely resolved when changing to the S9 Elite ?



I have the S9 AutoSet and it is excellent except for the two issues I've posted above previously.

1. The EPR differential is immediate with the S8. One can feel it on expiration. Not sure I can detect EPR with the S9 AutoSet, yet it's set to FULL TIME at 3, the maximum.

2. The S8 goes immediately to the set lower limit pressure in AutoSet mode, That was excellent. For totally unclear reasons, in AutoSet mode in the S9, it takes ten seconds for the unit to go from start/zero to my lower limit set of 8. And there's no way to change that except to change to CPAP mode. In CPAP mode under the Clinical Menu ----> Options one can set "moderate" and "fast" climbs. BUT neither the "moderate" nor "fast" make any substantial difference. It simply takes too long to get to the minimum pressure and thus it feels a little suffocating. ResMed tech support concurred that the feature that allows immediate on to the full lower pressure limit has been deleted in the S9 when in AutoSet mode.

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The AutoSet doesn't actually vary... it simple titrates upward from the minimum pressure to reach the optimal pressure After that is reached, the pressure variation is minimal.

My concern about a Sleep Study + the S9 Elite is that a person's optimal pressure can go up or down with time, so why have a static pressure assigned to the unit, with or without RAMP ?

I started at 18 a month ago, now I'm at 12 and holding and AHI = 0.00. I';m a firm believer in Auto-titrating machines and I will use this unless and until I need a bi-PAP.

I have not experienced this myself, but there are many accounts of people who do better on straight CPAP than on APAP. One of their complaints is that the varying pressures disturb their sleep, but this does not affect everyone. I'm speaking of APAP vs. CPAP in general and not of any specific machines. All APAPs can be run in straight CPAP mode so APAP users can try both for comparison.

And the behavior of APAP is determined by both the machine's algorithm and the patient's events. You can't generalize your experience with APAP to everyone. I'm basing my response on what I have read on many threads here, not just on my own experiences. While your S9 AutoSet may find one pressure and stay there all night based on your response to it, for others the pressure varies significantly during the night. My S8 AutoSet will raise pressure quickly on detecting a single significant snore event. I'm fortunate in that the pressure changes do not disturb my sleep.

Please share some links re: sleep disturbances from autosets. How much has YOUR pressures varied ? Please elaborate on your S8 raising pressure quickly based upon one event. How do you know it went up quickly, and it was because of only one event, and to what delta ?

If you do a bit of searching, you can find many people who do better on straight CPAP than on APAP.

As for how I know what my machine is doing, it is called data. I have both the ResLink module and ResScan software and can graphically see the pressure increases due to snores. And I have posted some of it in other threads.

You seemed so disturbed at the mention that APAP in general (and your S9 AutoSet in particular) might have some negative effects that I have to wonder if you have some connection to ResMed.

I am going to disagree with Physicians statement that the S9 doesn't "vary" much, and works up to a pressure and then stays somewhat constant.

My data regularly shows the pressure going up in response to events, then back down when there are not events. I have a range set of 10 - 14, and it will swing from the low end to near high end 5-6 times or more a night. There are some nights where it is pretty stable for the night with only minor changes and others where the pressure graph looks like a roller coaster track.

I think it has a lot to do with a persons particular situation. There are nights I sleep in one position all night and other nights where I move from side to back to side again. Sometimes the pressure change corresponds to an increase in mask leak.

I know some people are sensitive to changes in pressure, and i can see where if they are sensitive to that they may not like an APAP. I have a coworker who doesn't like the change that C-Flex makes on the exhale. It may be comfort related, it may have a therapeutic difference, or it may be personal preference.

Bottom line, I think an Autopap is the better way to go simply because it gives you more options. They can be run in a constant mode, and given the small difference in cost, I'd rather pay a few more dollars up from and have the option than buy a CPAP only find out latter that an Autopap worked better for me and now i had to pay for a second machine.

WilsonVilleUSA wrote:I am going to disagree with Physicians statement that the S9 doesn't "vary" much, and works up to a pressure and then stays somewhat constant.

Go ahead and disagree, but I was referring to my unit and not yours. More importantly, does your pressure variation cause you to lose sleep or bother you ?

jdm2857 wrote:I have not experienced this myself, but there are many accounts of people who do better on straight CPAP than on APAP. One of their complaints is that the varying pressures disturb their sleep, but this does not affect everyone.
And the behavior of APAP is determined by both the machine's algorithm and the patient's events. You can't generalize your experience with APAP to everyone.

I started my therapy using an Mseries auto.
I titrated myself, using Encoreviewer,
from sleep study Rx 8cm to present 12.2cm.
Always running in auto mode, cflex set to 1.
I could never seem to tolerate straight cpap mode
w/the Mseries.

After a year of listening and learning here,
I got a Resmed S8 autoset II. I initially set it
up to mimic the Mseries settings. It only took a few
weeks to realize that my sleep was much more comfortable.
The EasyBreathe and EPR technology of the Resmed fit me to a T.
I also realized that due to the A10 algorithm of the S8,
my pressure was not jumping all over the place, as it did w/the Mseries.
Because of that, I set the S8 to straight cpap 12.4, EPR 1.
That is where I have lived for the past year.
Therapy has really stabalized and is very comfortable.

Would this work for someone else....maybe....maybe not.

You can speculate all you want and proselytize all you
want about what works for you, but the proof is in the pudding
for each individual. The only way to know is to try it.
I just completed a year on the S8, at the above settings.
My avg. AHI for the year was 2.5.

To be clear, if the OP asked before purchasing the Elite I would have recommended spending the additional bit for the AutoSet. The advantages far outweigh the disadvantages.

But this poster already owned the Elite. Selling the Elite to purchase the AutoSet will cost significantly more that the price difference between the two new. So, if he is getting excellent therapy from his Elite, keeping it might make more sense. I also wanted him to be aware that APAPs are not a panacea.

It also occurs to me now that the OP might try swapping machines with his brother for a few nights to see if the AutoSet improves his therapy.

Physician wrote:

WilsonVilleUSA wrote:I am going to disagree with Physicians statement that the S9 doesn't "vary" much, and works up to a pressure and then stays somewhat constant.

Go ahead and disagree, but I was referring to my unit and not yours. More importantly, does your pressure variation cause you to lose sleep or bother you ?

No, the changes in pressure don't bother me. As to the machine, I think it has more to do with the person using it than the specific machine. I have 2 S9s and they both report similar data.

JeffreyJitza wrote:I purchased the S9 Elite a couple of months ago. My brother has the S9 Autoset and he enjoys it.
Should I sell or exchange the Elite for the Autoset?
What are the advantages and disadvantages of each? Thanks

You didn't specify what your pressure is or what your data looks like. You DO have a fully data-capable machine with the Elite. You can see your summary data in the LCD in the morning or you can download the data with the ResScan program and see the full details.

The big disadvantage to having an APAP/Auto machine is that most of them are improperly configured and do NOT "automatically" go to the needed pressure to prevent events. If the minimum pressure is not set high enough, too many events can occur before the pressure gets to where it needs to be, because it can take too long to get there. Too much pressure changing during the night CAN disturb a person's sleep.

The big advantage to having an APAP/Auto is that they will run in CPAP mode.

My recommendation would be to either swap machines with your brother for a period of time (if he lives within a reasonable distance) or purchase an S9 Autoset out-of-pocket so you'll have a backup machine to use if or when your primary machine has a problem. There are lots of people who will vouch for the fact that being without a working machine is not good.

You can find them at reasonable prices on http://www.cpapauction.com


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