What's the best CPAP machine?

Not removable, I think was referring to the fact the standard water tank on the Res 9 can't be taken apart to be cleaned (that might have been my typo not their words). But I saw online that one can be ordered that can be taken apart (though it said we pay for it or the Dr has to prescribe it - and that was thru a resmed site I believe).

The original version of the non-dishwasher-safe tank that came with the S9 humidifier (H5i)
in the US did not open. It has been replaced by a newer version that does open.

The dishwasher-safe tank has always opened.

Thanks for the info.
We are going with the respironics because I know that some people when changing machines have problems with the algorithm changes. The respironics auto series M has worked well, so I think we are not going to risk that the Resmed 9 algorithm might not work out.
The only thing I wish the respironics had was a report that shows api for the last day only (vs 7 day average), but since we are going to look at data regularly and with the last machine we knew the 7 day average so could look deeper if it was going up, it really shouldn't be a problem.
Ok, I really wish the machine itself would say the daily numbers and the last week average numbers and the last month average numbers so I could compare all three numbers at a glance, but neither of them do that.

CpapWife wrote:Ok, I really wish the machine itself would say the daily numbers and the last week average numbers and the last month average numbers so I could compare all three numbers at a glance, but neither of them do that.

The SleepyHead software does all of that for you if I remember right.

drj130 - yes sleepytime or other software would give those numbers, it would just be nice to have it all at a quick glance at the machine in the morning vs taking out the SD card, loading the data into software and looking at it there.

After thinking, I disagree about the rep telling me about respironics having stellar support staff and having seen some problems with resmed 9 just trying to give me garbage in order to have a higher profit. Now I heard tone of voice, etc. that you guys didn't so had more info. But she was just reporting what she had seen and as a company decided to go with a company that makes a little better machine. I have made the same choice when choosing what companies to buy things with or as a company deciding what venders I want to deal with (which means which parts my customers have to choose from).

I think the two units are close, but what the DME rep reported to me is accurate. It doesn't mean (and she didn't say) that the RESMED is a bad machine. She said there are some differences in quality and design and she really emphasized the support they get, and they choose to go with Respironics. What she said does fit with the machines, reported widely, so just because she said them doesn't mean her company cared more about the profit.

As a business owner, we chose our venders based on quality and ease of working with them and support. We sell being smart about the products and services, good quality parts, quality work, and less repairs needed in the future. Is our price more than some other companies, yup. Do we make more profit than some, probably yes (except for the companies out to rip people off up front, e.g. do garbage work with garbage products and cheap unskilled labor and no support when it all goes bad,those companies will always make the most profit but not a way I could run a business). We choose to run with high quality and attract customers with the same desires and we make money from making good decisions as well as doing good work E.g. I will pay more for a good vender I don't have to struggle with a lot rather than a vender with cheaper products but I have to spend more time finding parts, returning bad parts, correcting billing errors, etc. I just hate the hassle and it probably works out the same as my labor doing all that hassle work has to show up in the profits and/or customer costs. I have colleagues that do the same and I know others that get cheap materials and don't care the customer has problems 10 years down the road.

So taking a look at how repairs show up, how critiques review models, and the information available on the internet. A repair shop sees problems with models a few years after they are in use, in other words unless a car is a real lemon when first built it doesn't show up at the repair shop for a few years. The difference in well built cars versus not so well built cars shows up 5-6 years down the road, maybe 1/2 way into it's lifespan. And even in cars that are better rated (e.g. Honda CRV, Toyota Rav4, and Suburu equivalent), there are variations of quality and design.

Same with cpap/apap, repairs would not happen until a few years out unless it is really poorly made. the first year it doesn't show. So the problems we know existed as shown by online videos - the not so solid connection between the humidifier and the cpap/apap, shown clearly in the 2009 videos (one guys even wiggles it so show it is not secure) would cause more pressure on parts like the tube between the two pieces, which is what this DME said came up as problems. That doesn't mean they all break, it means this can break and has shown up in repairs. Fits exactly the video. Likewise with design, the tank that could not be taken apart to be cleaned anyone looking at that design could predict problems with this over time. While it is good they decided to supply the cleanable tank with the machine now, the way I look at things I would say why would they ever think to put in a tank that could not be cleaned in the original model? I have lived in humid environments and seen the problems caused by slight moisture like mold - I don't want that in my cpap/apap tank, so I want a design that makes sure it will not be a problem - e.g. Easy to clean!!
Also, several people talked about respironics being very solidly made with thicker plastic etc. So I don't know if resmed has changed the design of how the cpap/apap connects to the humidifier to correct that potential problem area.

In fact, even look at the vidoes the two companies did. Resmed focused on this nifty looking device, tech looking enough for people who wanted something that didn't look like a cpap and not so complex that for those that wanted just a cpap/apap would be ok with it. Whereas respironics did videos of how well they made the machines.
It shows the focus of the companies.

This is the same when I at new cars in the early 2000s and did my research. I wanted something reliable and better with crashes, with a next level of things I wanted being cost effective. That was more important than cute looking, gas mileage, sound system, seat material, etc. So looking at statistics, I focused on Hondas and Toyotas. I initially included Suburu, but within a week it fell off the list as it was a step below in quality and design. It was still high but a step below Honda & Toyota And yes, I paid more for my car and yes the dealer probably made more on the car than a Ford or Chevy dealer might make. And after having owned several Honda's and a Toyota, I lean more towards Hondas (though looking at recent data might change my mind as things really changed in how all companies made cars after 2006).

Now someone else might have different criteria than I, such as buying a new car every 4 - 6 years and not care so much about how well made it is. Or they want some other features I don't care about, so they balance that with the criteria I hold important.
And there are a ton of very happy Suburu owners, as well as tons of happy Ford & Chevy owners.
That doesn't mean they were all equal a the years I bought mine, and I know that while I still have my Honda CRV 2001 (just can't come up with a reason to replace it, even at 250,000 miles, not cost, not performance, not reliability, etc.), I would bet that same year Ford & Chevys at that mileage are not in as good of condition and have cost the owners more money/hassel/worry/concern.

So while both machines are very close (e.g. in the Honda, Toyota range for my car choices), each person has to make up their mind.
For me, with two similar machines, I would give a little extra points to a company that focuses more on a solidly built and designed device with great support, than one that focuses on neat design (shape, color screen), and a little better initial info (though still not quite what I want).
But way above that would be how well their product worked for me (e.g. algorithm fits better for me, support from DME & company supporting them to get better results for me, etc.).

I based my selection on the decibel level for my wife's comfort, prince that I am. At the time, the ResMed was the quietest.

Many DMEs are dropping Resmed equipment because they are more expensive and have a lower profit margin for the DME. As for algorithms, my hubby started with the Respironics M Series Auto and did OK even though he could never use the Aflex or Cflex feature because it rushed his breathing as others have experienced. When he had some medical issues and could not get back to decent treatment on the M. Series, I bought a gently used S9Autoset from a trusted forum member and it seems to have a "gentler" algorithm and he seems more comfortable with the EPR feature. And I love that I can see the daily report on the LCD screen in the AM. We also purchased the S9 Vpap Bilevel at a good price here,which he probably doesn't require but is even more comfortable for him using the Pressure Support. Our Dr just wrote an RX for us to receive a 5yr replacement for our original M Series and since Medicare won't allow a Bipap without another sleep study which our Drs don't want to put him through at this time, we're probably going to get the newest PRSOne 560 Auto through our DME and be happy with it. We have used the older PRS1 550 Auto model and he does OK with it but I'm still partial to the Resmeds.

Those many DME providers that are supposedly dropping Resmed products may change their tune when they lose out on competetive billing for Medicare. They might have to be glad they are selling ANYthing at all and decide to live with whatever profit margin they can get from those with standard insurance. Or, we could see even more "brick" sales when they dont have the medicare sales because they will only profit for uniformed people who happen to have regular insurance. A number of different scenarios could happen. Will be interesting though. My DME provider did not get the bid for medicare this round and they are complaining like crazy that they have to do all of this paperwork and send alot of paper on the patients who have medicare to the companies that were awarded the bid in my area.

XPAP machines are like cars. Everyone has a brand that they like.

I Had one of the older M Series, it was ok, I have my S9 and I love it. Could have gotten one of the new Pros, but wanted to try something new.

Since how well it takes care of our sleep apnea should be one of the top criteria (plus enough comfort to use it all the time), I sure wish these DMEs would let us borrow/rent different models to play with.
Some DMEs have loaner, some don't have apap loaners (apap a must for us).

Sure wish medical care would get to best health practices vs driven by venders (pharmacies, xpap manufacturers, etc.). E.g. Send people to nutritionists and gyms and that is covered for free vs pay for medicine and ignore some of the contributing factors. Or loan different xpaps and oximeters, teaching people how to use the software and get the best results and then fit them with the most effective machine.
Just MHO.

Monday I am going to try once more to see if I can get loaners of different types to try them out, have another good DME name in our town to try.

Any comments on quality/comfort of Fisher and Paykel machines, especially the ICON?

fisher_man wrote:Any comments on quality/comfort of Fisher and Paykel machines, especially the ICON?

It is difficult (if not impossible) to find the software needed to look at the efficacy data that the ICON Premo and ICON Auto records.

The F&P machines do not have a "traditional" exhalation relief system, but they do come with an optional heated hose. Instead of a traditional exhalation relief system like Resmed's EPR, PR's Flex, and DeVilbiss's SmartFlex systems, the ICON Auto has something called "SenseAwake" which reduces the pressure setting when the machine thinks you are awake. It also tracks how many times SenseAwake is triggered each night. The Premo doesn't even have SenseAwake.

I don't think many of us use the Icon so you probably wouldn't get as much help here. The S9 and PRSystemOne are the most popular.

Straight CPAP machine? Honestly, a lot of them are "best." Straight CPAP is pretty straightforward. I think it mainly comes down to things like the quality of the humidifier that hooks to the CPAP and "comfort features" if needed.

Its obvious that a "best" CPAP will be fully data compatible. I dont even think any company makes a CPAP anymore that does not have data (chip) compatibility.

If I had to choose one best CPAP, it would be the Resmed S9 CPAP. Whatever is Resmed's current highest level straight S9 CPAP. I dont keep up with just straight CPAPs anymore, as I use APAPs and once in a while, Bipaps/VPAPs.

Why Resmed S9 CPAP? In my experiences, the Resmed S9 machines have the best humidifiers, the best comfort feature...its called EPR or Expository Relief. Resmed S9 machines also allow you to get the tightest, most exact adjustment in the machine for the amount of pressure. The settings are in small .2 increments, whereas all other companies adjust pressure in large .5 increments. A .5 increase or decrease is a big change, a .2 increase or decrease not so much a big change. Therefore, you can get closer to your exact prescribed pressure with a Resmed S9 CPAP. For things like sufferers of aerophogia and people who are generally more sensitive to pressure side effects, that ability to adjust in .2 increments can be a big deal.

Finally, Resmed has a longstanding reputation for making THE best masks. In particular, Resmed has the best reputation for making the best full face masks, but their nasal masks have excellent reps as well. Using a Resmed mask with a Resmed CPAP syncs everything perfectly. So many people use a Resmed mask with a Fisher and Paykel or Phillips/Respironics CPAP or an Intellipap CPAP. I never understood that. Why not just use a Resmed CPAP as well????? <shrug>

So, after a ton of experience with two brands of machines, Resmed machines and Phillips Respironics machines and two brands of masks, I personally swear by Resmed.

Eric

sleepyirish wrote:Thanks everyone

I'm in the sleep lab currently - about to have my first night (I'm in Ireland )on cpap (they use an S9 auto with no humidifier and a std Resmed nose mask)

I thinking about renting either the Resmed "S9 AutoSet™ CPAP Machine" or the Respironics "PR System One REMstar Auto CPAP Machine with A-Flex".

Which is the best one?

Also I noticed when they hooked me up to the S9 earlier for 5 minutes, that I could hear a whooshing noise from the machine when I was breathing in and out - but a lady also having a study in the sleep lab tonight told me that only you can hear that. Your partner can't. Is that true?

My partner is a really light sleeper so the quieter the cpap the better. We sleep in separate rooms right now but hopefully that will change.

For that reason I might go for the nose mask as it seems quieter than the nasal pillows. The exhaust on the Resmed nasal pillows seems noisier. Anyone else found that?

thx
looking forward to getting some sleep!!!!!!

If you are in Ireland, I would absolutely consider the Weinmann line of products. They are German and high quality, and we cant even get them here, unfortunately.