I have been using a PRS1 since early April, and I'm doing OK, but every time I see graphs posted here by S9 users it seems that their machine responds to events faster than mine does. Mine has older firmware (1.04) that can't be upgraded, which may be part of the issue. Plus, with the older firmware it has no setting to use the newer 15 mm hoses.
When I say I am doing OK I mean that I have got my diagnosis of severe sleep apnea (63 events per hour on my back) down to an average AHI of 1.76 and I never go above 5. And about once every ten days I manage zero obstructive events; although I have never had an AHI below 0.4 because of hypopneas. I know that if you go by the book this is good enough, but I'm still hoping for a zero AHI. Plus, I want the skinny hose.
So I'm thinking about getting an S9 Autoset from Secondwind, or perhaps waiting and getting an S10 when they come out. This will be out of pocket, but I don't mind if it really makes a difference. However, I have some questions that I hope S9 users can answer.
1) Do I understand correctly that some S9 humidifiers have a removable tank and others do not?
2) I don't need the Climateline hose, as rainout has never been an issue for me. Do they all come with the Climateline hose, or is that an extra accessory that I could opt out of?
3) The only software that will run on my computers is SleepyHead. Any problems importing the data into SleepyHead?
4) What is the latest firmware?
5) Does anyone know when the S10 might be scheduled to come out and/or about new features that it might have?
6) Any other hints, suggestions, observations or warnings?
JJJ--I'll take a stab at answering a few of your questions. Both the climateline tubing and openable humidifier tank are optional. My Autoset (from my DME) came with the climateline but with the sealed humidifier tank. BTW--I've had no problem keeping my humidifier tank clean even though it doesn't open. Just a few fill and empty rinses with warm water and Ivory liquid soap do it nicely. I do that daily when I'm cleaning the mask. I haven't had no problem importing data from the machine to Sleepyhead. But I'm surprised to read that you cannot get ResScan to run on your computers. I'm running Windows 7 (64 bit) with no problem running it. I know others, including zonk, can provide info on firmware. My only experience along that line is that my first Autoset, a loaner, had earlier software and the screen booted with plain type Autoset i.d. The autoset I got after that one was returned boots displaying a ResMed logo on its screen. I know how to find the firmware number has been discussed here not long ago. Hope this helps even a tiny bit.
Excuse that terrible grammar, JJJ, where I wrote "I haven't had no problem..." poor editing on my part, for sure!
1) All have a removable tank...the difference is that you can either get a tank that doesn't come apart (easily) for easy cleaning or one that is made to snap apart easily for easy cleaning. They call the latter "washable" or "cleanable" tanks.
2) Usually if you buy it with the H5i humidifier as a combo you will either get just the ClimateLine or both the ClimateLine AND SlimLine. If you just buy the PAP or buy them separately you will usually just get the SlimLine. It should tell you in the product description.
3) Sleepy Head works fine. I favor it over ResScan.
4) I think the latest is SX474-0905.
5) Nope...but I would sure like to hear from someone who does have that info.
6) I'm not so sure it's gonna help get you to 0 AHI. I come in below 1 AHI most nights and have learned to settle for that as good enough.
What others have said so far.
At some point, I plan to get the "Washable tub for the humidifier, however, I haven't had any trouble keeping the one you can't take apart clean but I think it will be easier to really clean the washable tub..
Best of luck ifn your decision to purchase an S9.
(12-10-2012, 12:16 PM)JJJ Wrote: I know that if you go by the book this is good enough, but I'm still hoping for a zero AHI.
zero AHI is not possible all night every night with ANY machine also even with zero AHI doesn't mean you had no such events
just did not meet the definition of 10 sec or more to get scored
I believe the S9 has only been out for just over 2 years so, based on previous upgrades and the average 5 year lifecycle of a CPAP I don't think it will be upgraded anytime soon, ResMed might do what they did with the S8 and create a S9 AutoSet II, ResMed tech support is tight-lipped about any upcoming releases in the pipe.
On the ClimateLine hose, it's also the smaller diameter 15mm (like the SlimLine) and I love it, if you order from Secondwind I'm pretty sure they always include one at no additional cost, then there's the added bonus - it's 6 inches longer than the SlimLine.
The one thing I'd recommend is to order the Hypoallergenic filters if you get an S9, you get 0.5 micron filtration as opposed to the 7.0 micron standard filters.
If you really like to scrub the insides of your water tank the only option is the dishwasher safe "cleanable water tank" that comes apart, it's also more durable with a stainless steel bottom instead of aluminum, I'm going to get one but haven't yet, I pour-out any leftover water every day and let it air dry, then, once a week it gets a soak in my big cleaning bowl along with mask and hose.
I've read somewhere that ResMed' AutoSet algorithm IS faster to react to an event than the Respironics algorithm but, they both do their job very well, whether or not it would give you a lower average AHI - you'd have to tell us after using one for a month or more.
When viewing the flow data in SleepyHead from your PRS1 it will look more saw-toothed than the the S9 flow data, it's the byproduct of how the PRS1 Automatic algorithm does its hunt and peck titration whereas the S9 AutoSet just maintains its flow rate and tries to keep lowering the pressure to the bottom end of the minimum pressure setting until an event occurs, you can even see the tiny oscillations caused by the forced oscillation technique ResMed uses when determining which type of apnea is occurring, then it reacts accordingly (I read way too much) and after breathing is restored it starts all over lowering the pressure shortly after an event and on and on.
Maybe someone here has done a side-by-side comparison and can definitively state whether one automatic machine was able to treat them better than the other, I can only attest to the efficacy of the S9 AutoSet being vastly superior to my previous S8 AutoSet II, my lower average AHI (1.03) and then how much better I feel are proof to me.
(12-10-2012, 12:37 PM)jgjones1972 Wrote: 1) All have a removable tank...the difference is that you can either get a tank that doesn't come apart (easily) for easy cleaning or one that is made to snap apart easily for easy cleaning. They call the latter "washable" or "cleanable" tanks.
4) I think the latest is SX474-0905.
I have the cleanable tank which makes washing it easier because it comes apart and it is also dishwasher safe for anyone who wants to wash it that way.
I bought my S9 autoset from supplier 10 in September and that is the firmware my machine has.
Thanks for all the responses! Now at least I know what to specify when I place the order.
I'm going to wait a bit before ordering, though. In the meantime I'm going to bump my minimum up to 10 cm., starting tonight. I base that decision on the fact that my 95% level is almost always at least 10.0 and usually 10.5 cm.
(12-10-2012, 12:16 PM)JJJ Wrote: I have been using a PRS1 since early April, and I'm doing OK, but every time I see graphs posted here by S9 users it seems that their machine responds to events faster than mine does. Mine has older firmware (1.04) that can't be upgraded, which may be part of the issue. Plus, with the older firmware it has no setting to use the newer 15 mm hoses.
I don't think PRS1's get faster with software updates, it's sort of a difference in philosophy about overreacting and bothering the user with pressure changes vs. fixing things before they happens.
I find I feel better if I up my minimum pressure even though it doesn't improve my AHI.
(12-10-2012, 12:16 PM)JJJ Wrote: When I say I am doing OK I mean that I have got my diagnosis of severe sleep apnea (63 events per hour on my back) down to an average AHI of 1.76 and I never go above 5. And about once every ten days I manage zero obstructive events; although I have never had an AHI below 0.4 because of hypopneas. I know that if you go by the book this is good enough, but I'm still hoping for a zero AHI. Plus, I want the skinny hose.
If your AHI is below 5, don't worry much about lowering it, but you may find that adjustments in your therapy will make you feel better, even if they don't change your AHI, in particular, a higher minimum pressure.
Also, what is your Flex set at? That helps some people.
I understand the newer S9 "non-washable" tanks open, but aren't intended for the dishwasher. New washable tanks are $40 or so online.
By the way, it's not that difficult to open the non-openable tank. There's a youtube video showing how to open it. Buy at least one spare tank first, because you could break the tank trying to open it, and you need a spare anyway.
My guess is S10's are quite a way away, but I have no inside info.
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If it's midnight and a DME tells you it's dark outside, go and check it yourself.