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New Machine
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bob72601 Offline

Members

Posts: 8
Joined: Dec 2013

Machine: Respironics BiPap Auto M Series
Mask Type: Full face mask
Mask Make & Model: Fisher&Paykel FlexiFit 432
Humidifier: REspironics M Series
CPAP Pressure: BiPap 20/16
CPAP Software: Not using software

Other Comments: Been BiPappin' since 2008.

Sex: Male
Location: Harrison, Arkansas

Post: #1
New Machine
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?
12-26-2013 06:38 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: New Machine
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
12-26-2013 08:43 PM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #3
RE: New Machine
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.
(This post was last modified: 12-26-2013 09:08 PM by me50.)
12-26-2013 08:53 PM
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trish6hundred Offline

Advisory Members

Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: New Machine
Hi bob72601,
WELCOME! to the forum.!
I echo what has been said so far.
Best of luck to you.

trish6hundred
12-26-2013 09:02 PM
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bob72601 Offline

Members

Posts: 8
Joined: Dec 2013

Machine: Respironics BiPap Auto M Series
Mask Type: Full face mask
Mask Make & Model: Fisher&Paykel FlexiFit 432
Humidifier: REspironics M Series
CPAP Pressure: BiPap 20/16
CPAP Software: Not using software

Other Comments: Been BiPappin' since 2008.

Sex: Male
Location: Harrison, Arkansas

Post: #5
RE: New Machine
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.
12-26-2013 09:10 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #6
RE: New Machine
(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.
(This post was last modified: 12-27-2013 03:20 AM by vsheline.)
12-27-2013 02:47 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #7
RE: New Machine
Hi Vaughn
Can S9 VPAP Auto operate like an AutoSet also if there is another bilevel machine can function like autoPAP
Thanks
12-27-2013 03:15 AM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #8
RE: New Machine
(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.
(This post was last modified: 12-27-2013 05:08 AM by vsheline.)
12-27-2013 03:39 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: New Machine
I had to ask, was on mind for a while
Thanks Vaughn
12-27-2013 04:07 AM
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robysue Offline
Wiki Editor
Advisory Members

Posts: 1,245
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #10
RE: New Machine
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.
(This post was last modified: 12-27-2013 09:57 AM by robysue.)
12-27-2013 09:56 AM
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