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[Equipment] Is there a difference between ResMed and Phillips pressure algorithms
Good Morning

I am new to CPAP and to the message board.
I have recently been diagnosed with extreme sleep apnea. My home sleep study showed a 57 AHI but I do question the accuracy of these results.
After having a full polysomnography I was prescribed CPAP with 10 cm pressure. The machine was DME provided ResMed Airsense 10 CPAP with ResMed Airfit F20 mask (medium)
I tried this for a week with good results, AHI less than 5 most nights.
I decided to switch to an auto machine because I wanted to see more data and have a better sense of what was going on so I did two things:
1. I went to the DME and switched out the CPAP machine for a ResMed Auto with a new Large size F20 mask.
2. I went online and bought a Phillips Dreamstation Auto machine.

As I had the ResMed machine from the DME immediately I have been using that since last Friday with decent results, 4-6 AHI while attempting Auto mode treatment.
I received the Dreamstation yesterday and tried it last night and had AHI of 6 but my wife said it was the worst sleep since before I started treatment. A lot of movement and more snoring than usual.

After that story, my question is regarding the differences between how the two machines operate and adjust pressure.
From my limited experience it seems the ResMed makes more sensitive and smaller pressure changes which help promote a regular breathing pattern. The Dreamstation seems to make more abrupt pressure changes and does not adapt as quickly.

Does anyone have any more details on how the machines work or similar experiences with trying the two machines.
I will probably try the Dreamstation again tonight to see how things go but initial reaction is that it isn't as good as the ResMed.

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Yes, they have different algorithms. For most people, I don't think it's going to make much of a difference, but for some of us, it makes a huge difference. I was one of those people, so I'm happy I had a chance to try both and I stuck with my Resmed. The auto algorithm for the Resmed is more aggressive. This can actually wake people up with that difference, but for me, it works well. Most of the night, I'm at the lowest pressure because I only have apnea during REM and nearREM. I gave the Respironics about 5 days before switching to the straight pressure mode because it just wasn't working for me.

Most of the time, your AHI results are right. Look at your raw study information (ask for it if you were only given the summary).
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The Philips machines is much slower to increase pressure in the Auto mode than the Resmed in Autoset standard mode. It really depends on the settings you are using, and the pressure at which you are ideally treated. If you simply switched the Resmed to Auto at the default 4-20 pressure, you might get decent results. Doing that with the Philips would likely result in poor treatment. With a titrated pressure of 10, your Philips would need to be set to at least 8 cm minimum pressure to adequately treat your obstructive sleep apnea.

In addition to more rapid response, the two machines handle the pressure relief during exhale very differently. Post up some charts and maybe we can help you dial some things in. My signature shows how to orgainze and post charts from SleepyHead. You will need 4 posts to provide the images.

What are your machine settings. Your profile shows 10 fixed pressure. Clearly, you can use the auto mode and optimize your treatment needs which change with sleep position, sleep stage and health issues. Getting a single fixed pressure prescription is very common, but the auto machines can usually produce better results when properly adjusted.
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Hi doickle,
WELCOME! to the forum.!
It's great that you are trying both brands of machine so you can see which one you will like.
Good luck to you with your CPAP therapy, hang in there for more responses to your post.
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Thanks for your reply.
I was pretty sure after comparing the ResMed and Phillips data on Sleepyhead that there was a difference in how they operated.
For me it seems ResMed is more responsive and will make smaller adjustments to pressure allowing me to easily get back to a normal breathing pattern.
With Phillips it seems the pressure response to an OA event is a bit delayed and then quickly ramps up to max pressure and stays there (I had the Auto limits set at 8 and 13).
I plan to try the Phillips again tonight and see if it improves.
One other thing that my wife mentioned with the Phillips is that she could hear a lot of whistling from the mask as if it was leaking but she had never heard this with ResMed (I use the same mask for both machines). I did have some high leak rates last night but nothing registered as Large Leaks.

I will definitely post some data from Sleepyhead as soon as I can. I am very eager to get this dialed in and running smooth.

Thanks for the help
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I think you will find them very different, especially comparing EPR to AFlex. My preference, if you haven't figured it out is the Resmed for the auto CPAP. In any event, you should be able to tune in the machines to achieve better response in auto than in fixed CPAP, unless you are having mainly central events.
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(02-01-2017, 11:37 AM)Mosquitobait Wrote: The auto algorithm for the Resmed is more aggressive. 

There is now an option/setting on the Resmed Airsense 10 Autoset to change the response from normal to comfort, and therefore make the increase of pressure more progressive/less aggressive...
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I have compared the soft and standard pressure increases on the Resmed Autoset, and they are both faster than Philips. On soft mode following an OA event, the Autoset increases pressure 1.0 cm in 10 seconds, and pressure drops back over 30 minutes...very slowly. In standard mode, response is similar but drops back a bit faster in 20 minutes. The standard mode appears more responsive to flow limitation than soft mode. If you were to compare the pressure charts of a person on soft or standard mode, I don't think you could easily tell them apart.

On the Philips Auto, pressure changes are smaller in size (0.5 cm) and faster to recede back to baseline. Philips machines also routinely increase pressure by 1-cm and drop back over a 5 minute cycle at intervals of about a half hour. We understand these are not event related, and are built into the algorithm to test efficacy of higher pressure. The difference in a pressure chart is immediately recognizable between Philips and Resmed.
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