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New Machine
#1
I have been using a Respironics BiPap Auto M Series for the last 5 years. It is time for a new machine. My levels are 20/16. I am looking at both the ResMed VPAP S and the Resmed VPAP Auto. Would also consider the System One. Can anyone help me with suggestions to which might be the better machine?
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#2
I would stick with Respironcis as serve you well for the last 5 years but upgrade to System One
PRS1 machines are cheaper than Resmed S9 machines

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#3
what zonk said. I am accustomed to ResMed and so I wouldn't change for that reason and the fact that I have 2 humidifiers that I wouldn't have to buy. If the current brand you have used for the past 5 years worked well for you and you are satisfied with how you feel, sleep, machine performance, etc., I wouldn't change. Both brands are reliable and many members of this forum use one or the other and seem satisfied with them.
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#4
Hi bob72601,
WELCOME! to the forum.!
I echo what has been said so far.
Best of luck to you.
trish6hundred
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#5
Thank you for your input. I think I will go with the ResMed VPAP-S. Medicare is paying for it, so not too worried about the price.
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#6
(12-26-2013, 09:10 PM)bob72601 Wrote: Thank you for your input. I think I will go with the ResMed VPAP-S. Medicare is paying for it, so not too worried about the price.

Hi bob72601,

On the S9 VPAP-S, the EPAP pressure is a manually-adjusted pressure setting. It is NOT an Auto machine like your Respironics BiPap Auto.

I would advise you to get the S9 VPAP Auto over the S9 VPAP-S. Even if you choose to not use the Auto feature nightly, it is very valuable to be able to turn on the Auto feature at least once in a while (and whenever you are having problems or are sick or have changes in medications) to verify what your pressure needs are. Or, simply leave it in Auto mode all the time, like most people do who have an Auto model. An Auto machine will allow you to see a report of your treatment results which is like seeing results of a mini titration study every night, which can be very helpful in monitoring the success of your treatment.

ResMed says on their web site that the S9 VPAP Auto is their "optimal" machine for treating Obstructive Sleep Apnea. It has three modes. It can be set to operate exactly like a fixed-pressure S9 Elite, or exactly like an S9 VPAP-S, or it can be set to operate in S9 VPAP Auto mode. So it is like getting three machines in one.

Or, the "Phillips Respironics System One BiPAP Auto with heated humidifier and heated hose" is similarly capable as the S9 VPAP Auto and is the successor machine to the one which has served you for the past 5 yrs.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#7
Hi Vaughn
Can S9 VPAP Auto operate like an AutoSet also if there is another bilevel machine can function like autoPAP
Thanks
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#8
(12-27-2013, 03:15 AM)zonk Wrote: Hi Vaughn
Can S9 VPAP Auto operate like an AutoSet also if there is another bilevel machine can function like autoPAP
Thanks

Yes, although there is not a mode which is exactly like the AutoSet, if the Pressure Support is set to 3 (or less), then the VPAP Auto (when in Auto mode) will be much like an AutoSet with a few more bells and whistles. (A few more things are adjustable, like how quickly it triggers from the lower EPAP pressure to the higher IPAP pressure when we start to inhale, and how quickly it cycles back to the lower EPAP pressure again when we start to exhale.)

In brief, if an S9 AutoSet is set for:
Minimum Pressure = 10
Maximum Pressure = 16
EPR = 3

then the equivalent pressure settings on the S9 VPAP Auto would be:
Min EPAP = 10 - 3 = 7
Max IPAP = 16
Pressure Support = 3

Similarly, the PRS1 BiPAP Auto can be set to operate much like a PRS1 REMstar Auto.

But unlike EPR which is equivalent to Pressure Support, Flex is NOT equivalent to Pressure Support, so on the PRS1 BiPAP machines the Pressure Support and Bi-Flex are separately and simultaneously settable.

Also, the PRS1 BiPAP Auto has a neat feature which the S9 VPAP Auto does not have, which is that the PRS1 BiPAP Auto can intelligently (but very slowly) auto-adjust Pressure Support within a min-max range while seeking to minimize Flow Limitation.

If a PRS1 REMstar Auto is set for:
Minimum Pressure = 10
Maximum Pressure = 16
A-Flex = 3

then I think the equivalent pressure settings on the PRS1 BiPAP Auto would be:
Min EPAP = 10
Max IPAP = 16
Minimum Pressure Support = 0
Maximum Pressure Support = 0
Bi-Flex = 3
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#9
I had to ask, was on mind for a while
Thanks Vaughn

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#10
bob72601,

Here's my two cents: The Auto algorithm on the System One BiPAP Auto is essentially the same algorithm that your BiPap Auto M Series uses with a few refinements, including the ability to distinguish between CAs and OAs. The S9 VPAP Auto's algorithm has some differences.

1) On the System One, the IPAP and EPAP vary independently of each other unless one of the following happens:
  • IPAP = EPAP + min PS and EPAP needs to be increased. In this case, both IPAP and EPAP will be increased.
    IPAP = EPAP + max PS and IPAP needs to be increased. In this case, both IPAP and EPAP will be increased.
    IPAP = EPAP + min PS and IPAP can be decreased. In this case both IPAP and EPAP will be decreased.
    IPAP = EPAP + max PS and EPAP can be decreased. In this case both IPAP and EPAP will be decreased.
But on the Resmed S9 VPAP Auto, the IPAP and EPAP are not allowed to vary independently of each other. In other words, IPAP and EPAP are always increased and decreased together and by the exact same amount. The difference between IPAP and EPAP remains constant on the S9 VPAP, whereas it can vary on the System One BiPAP Auto.

2) The System One will increase IPAP (only) for clusters of Hs, FL, and RERAs. The System One will increase EPAP (only) for clusters of OAs and snoring. The Resmed S9 will increase both IPAP and EPAP for clusters of Hs, OAs, FL, and snoring. (The S9 does not try to score RERAs). In use, this difference typically means that the average, median, and 95% EPAP pressures are more likely to be lower on the System One than on the Resmed S9 when you use the same min EPAP and max IPAP settings.

3) The System One BiPAP Auto has Bi-Flex, which offers a small (variable) decrease in EPAP pressure at the beginning of every exhalation. In other words, when Bi-Flex is turned on, at the beginning of each exhalation, the pressure can drop a bit below the EPAP setting as a form of additional exhalation relief beyond that provided by dropping the pressure from IPAP to EPAP. The S9 VPAP Auto does not have any additional exhalation relief beyond the drop from IPAP to EPAP. If you are currently using the Flex system on your M-Series BiPAP Auto and you like the way it feels, this could be a potential issue when switching to a Resmed S9 VPAP.
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