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Newbie from Greece
#41
just a word of warning if you decide against the prisma and choose a ResMed-Device:
take the FOR HER! - in the european firmware for the resmeds only the for her can track RERAs and has the For Her Mode (the For Her has everything the "normal" Autoset has PLUS the For-Her-Mode AND the RERA-scoring)

ETA for SH to be able to read the Prisma-Line is .... well ... don't get your hopes up - summer looks like an overestimation (might get cold again outside before that really happens^^)

maybe they are more "forthcoming" if you explain to them that a machine whithout the software is absolutely no option for you! (you might want to emphasize that you don't want any support for the software from them - other than a woking initial installation and maybe a way of reinstalling (at their office!?) it in case you change your computer / it melts down or whatever^^)

I really can understand, that the manufacturers are not that keen to give the software away, because they don't want ganny and grandpa calling them and asking about the computer-troubles they experience^^ (and of course they believe it only comes from that very software - 99% of all pc-related problems are sitting in front of the screen^^[period])


----

For what it's worth I give you my few cents anyway:

I'm not that long into CPAP (a little over half a year). I'm totally biased towards Heinen + Löwenstein / Weinmann as I do have the SomnoBalance (different line from H+L - let's call it the "little brother"). I never had the chance to try a different machine and I do love mine^^ (I would take the prisma at first chance^^)
I do believe that I have some pretty extensive knowledge about my machine and the way it reacts or regulates. (and for that matter how the H+L-Algorithms "function")

so, please keep that in mind regarding the following:

The Prisma 20A seems to be pretty awesome.
One main-disadvantage compared to the ResMed is: the climate-tube has no "auto-control" ... you can change the temperature by hand, but (If I remember correctly) there is no such thing as "automatic".

compared to resmed the algorithms to respond to events are totally different. Resmed mainly reacts to flowlimitations. H+L reacts to obstructions - and to be precise: they react to the "epochs". (in the graphs you showed us the "obstruction-graph" is the closest thing H+L has to offer compared to the "flowlimitations" on resmed)
Resmed raises the pressure pretty fast on flowlimitations - H+L reacts just a bit to epochs of flowlimitation (and mainly just to the first - not to each and every epoch^^).
H+L reacts in about the same speed and range to obstructive epochs as resmed does to flowlimitations.
(so speaking in terms of plain AHI the resmed-devices would produce a (slightly) lower AHI ... if your device is fine-tuned very well you will not really get a difference!)

H+L reduces the pressure slower than resmed does (after the events are over).

the softPAP is comparable to the resmed - but not the same - softpap gets deactivated during (some) events. (+ H+L has the inhalation assistance where it raises the IPAP 1cmH20 and lowers the EPAP 2cmH20 - giving you a "PS" of about 3cmH20)

H+L does make a difference between Hypopneas - H+L knows obstructive and "central" Hypopneas. (resmed only knows hypopnea and they don't score a length for that - for RERAs resmed does not score a length as well)
Besides that H+L does score "artefacts". They say that's a falsification of the signals - like when you cough, speak, change your position. (I totally love the artefacts^^)
for scoring RERAs they are very ambitious  Laugh-a-lot  ... if you look closely enough some of them turn out to be just artefacts. (but that is a good thing and with that the algorithm leans a bit more towards resmed's behavior)

if you are in the lower pressure range (with your 7 you should be above that range) the H+L devices tend to misinterpret obstructive events as centrals (only in the lower pressure-range of the device!). I don't want to say that H+L is worse than resmed or resmed is better, as resmed reacts mainly to flowlimitations and with that they don't really get to that very situation. In the end they both might be or are equally bad or good in detecting centrals.
It's really no big deal - if you notice central-events while on the lower pressure end just raise the pressure and see if they vanish (or become obstructive ones) (if you are really interested on that matter you can read up here: http://www.apneaboard.com/forums/Thread-...ssifies-it )

In terms of "interpreting" the data:
H+L scores epochs. Straight from their manuals: (this is taken from Weinmann-Support - the software which came before PrismaTS and the prisma-series)
Quote:Epoch
An epoch is a period lasting approx. 2 minutes. Within this epoch, the therapy device collects obstructive events and evaluates them. Depending on the degree of severity of the obstructions found, an epoch is classified as an
- epoch with severe obstructions
- epoch with mild obstructions
- epoch with flow limitations
- epoch with snoring
An epoch event is saved if the mean value of the event index during the epoch is greater than its threshold value or if oH, oA or RERA occur. The events threshold value is pressure-dependent.

This makes it very easy to identify the "interesting" parts in your data. (if there is no epoch scored it is uninteresting^^)


-----

I'm only telling you this because I have never read a first-hand direct comparison between the Prisma and Resmed-devices. Overall I don't read that much at all from Prisma-Users. (I come from germany where H+L comes from as well - so I know the german board^^)
[to be completely honest in germany there is some talk against the prisma - but that comes from people who had a resmed-device and are now about to get a H+L-device ... we have a completely different health-insurance system - we cannot really choose what machine we get - so that does not say anything about resmed or H+L]
If we are honest this can have 2 reasons: 1st Prisma works very well ... noone has a problem with it - or (more likely in my eyes)
2nd: noone has access to PrismaTS and therefore doesn't know how they are doing or what to do^^

As mentioned before my own experience comes mainly from the SomnoBalance (same manufacturer - the line that came before the prisma. the somnoBalance is not the "old version" - it still gets manufactured and is up-to-date and totally comparable to the resmed-devices! if we take the comparison from SleepRider (I hope I got you right this time) think of them as the mercedes and the VW^^)
All I said comes from looking at the data from other people and generalizing from my SomnoBalance (but I have looked at the data from quite some Prisma-Users. So in my not so humble opinion I think I can say the aforementioned.)
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#42
(04-28-2017, 05:37 AM)TBMx Wrote: ...
so, please keep that in mind regarding the following:

The Prisma 20A seems to be pretty awesome.
One main-disadvantage compared to the ResMed is: the climate-tube has no "auto-control" ... you can change the temperature by hand, but (If I remember correctly) there is no such thing as "automatic".
...

I was alerted by this, so I asked the Weilnmann seller from which I bought my equipment about this. The answer was straight foreward:

By adjusting the humidifier level, the user really adjusts the amount of the humidity that will be "inserted" in the air he/she is breathing. Prisma 20A has a built-in room temperature sensor, reading the temperature of the environment in which it is operating, so as to automatically adjust the amount of heat it needs to apply to the water, in order to keep up with the humity level which is set by the user. So, at a hypothetical setting of 4 (for humidity), the heat produced by the resistor inside the prismaAQUA humidifier differs each time, depending on the temperature of the room in which  it is set in operation.

I think, if this is true, that this means auto humidification level control, or not?...

Thinking about this auto humidification level control, a question crossed my mind:

Is this auto function applicable only when the heated tubing is connected to Prisma 20A, or even with the simple one?

I will ask my Weinmann seller, and I will let you know. Of course, I will test it for myself, as soon as my heated tubing is delivered to me.


Costas
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#43
If that's all that alerted you, I'm relieved Dielaughing

the heated hose is to prevent rainout in the tube. (really - it's not so much about making you feel comfortable^^)

As far as I understand the ResMed-Setting, it regulates itself the humidifier and the heated hose so that you get a relative humidity of sth. around 75%.

H+L has a setting for the temperature in the heated hose - that's one thing. One totally different thing for them is the setting of the humidifier. ... if you set the temperature in the hose to - let's say 30° - in your room you have 10°. your humidifier works based on the 10° - the heated hose heats the air more - the relative humidity drops.

NO BIG DEAL! - you find the right setting - I was simply pointing out: resmed has a "oh please for christs sake - decide the settings yourself" option. H+L has not! (regarding the heated hose (in combination withe the humidifier - but who would use the heated hose without it?)! - not the humidifier!)
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#44
(04-29-2017, 04:07 PM)TBMx Wrote: If that's all that alerted you, I'm relieved  Dielaughing

Well, I assume that as soon as I reach your point of knowledge, I will be able to understand better all the very interesting - but not fully understandable to me, for the moment - things you're writting in your post.

After all... I'm just a newbie in this story!... but I promise: I learn fast, by studying things that come to my interest!...  Bigwink
 

Costas
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#45
I have no doubt in that^^

If you don't get PrismaTS and decide to keep it anyway, bring them to the point where they agree at least to the following:
they send you the XL-sleepreport (or the most detailied one PrismaTS can produce) at least every 2 weeks if you email them your therapy.pdat (or bring over the sd-card) for the first 3 to 4 months. (4 months really should be enough^^)
(they can import that file alone - the sd-card is not really needed - don't let them fool you by demanding you have to bring in the sd-card)

AND: that they set your machine to store the maximum of detailed data (I believe it's 14 days ... I only say this because they also have a setting for storing only the last day in detailed data^^)

that way you will be able to control your therapy - and believe me: you want to! (really! --- you might not want to change something the first week ... but after 1 or 2 months in you really want better results^^)
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#46
(04-29-2017, 04:49 PM)TBMx Wrote: I have no doubt in that^^

If you don't get PrismaTS and decide to keep it anyway, bring them to the point where they agree at least to the following:
they send you the XL-sleepreport (or the most detailied one PrismaTS can produce) at least every 2 weeks if you email them your therapy.pdat (or bring over the sd-card) for the first 3 to 4 months. (4 months really should be enough^^)
(they can import that file alone - the sd-card is not really needed - don't let them fool you by demanding you have to bring in the sd-card)

AND: that they set your machine to store the maximum of detailed data (I believe it's 14 days ... I only say this because they also have a setting for storing only the last day in detailed data^^)

that way you will be able to control your therapy - and believe me: you want to! (really! --- you might not want to change something the first week ... but after 1 or 2 months in you really want better results^^)

Thank you very much for all you detailed help on this. As I have seen through the setup of my Prisma 20A Auto CPAP, the storage setting for detailed data is currently set at 14 days.

As far as the "deal", I'm still waitting for the Seller's reply upon my request for the prismaST software. I intend to use all the "steps" you advised me to follow in this negotiation. I hope that, finally, they will accept to issue me a prismaST software.

Of course, I will keep you posted on all this.

Thanks again!

Costas
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#47
Hello my friends!

As I have promised I'm "collecting data" (= my personal experience) on my currently obtained Prisma 20A Auto CPAP. I have more than 2 weeks "experience" on it, and I'm planning to post a detailed presentation of it at the end of the 3rd week.

Hopefully, by then, I will have received the heated tubing too, so as to offer you a complete presentation of it, with comments and photos.

I really appreciate your interest - and comments - on my posts, and I promise to keep posting... hopefully interesting information about this new CPAP (to this forum). The most "interesting" (to me) comment, came from Sleeprider who wrote: "...This equipment looks like it was built by and for people that drive BMWs and Mercedes.  It appears very well built...". Indeed!...


Thanks

Costas
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#48
My friends,

As I've already promised, I wrote a full review for the Weinmann / Löwenstein Prisma 20A Auto CPAP in the corresponding section of this great forum!...

In case you're interested, you can read it using the following link:

http://www.apneaboard.com/forums/Thread-...-Auto-CPAP


Thanks

Costas
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#49
Hi everyone!...

Well... it's been 43 days since I've "officially" started my apnea therapy. By "officially" I mean by using my own CPAP, Weinmann Prisma 20A Auto CPAP.

Today, I deciced to check my therapy progress, so I copied (from the SD card) my therapy file and e-mailed it to my CPAP seller, asking him to send me some screen shots of my therapy and also send it to my doctor for his evaluation.

Please find followng the screenshots I received, for the period I've been using my CPAP. Needless to say that I would appreciate very much your comments on the progress of my treatment, from all of you people - members of this forum with high expertise in this field.

[Image: A6Vx1Jt.jpg]
Oveall view of my therapy

A more analytical view of the above, follows in the next 3 screenshots:

[Image: 5WeInXP.jpg]

[Image: b1rzmVc.jpg]

[Image: sYjR6TB.jpg]

Then comes a screenshot with a "bar graph" summary of this period:

[Image: Sadi1ko.jpg]

and a detailed analysis of my last night. Of course all nights are available in full detail analysis...

[Image: KNsMt87.jpg]

What's your opinion on the progress of my therapy?

As I've noticed, during the days I was really worked-out, my night sleep was not good too, more AHIs, snoring etc. Still, I don't know if this is a result of perhaps opening my mouth during my sleep or anything else. Overall I have the sense that I'm sleeping well, waking-up well and in general I can have a "full power" day without any problems.

So please, comment on these, I would really like to read your opinion based on the above.   Unsure


Costas
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#50
The posted report tends to reinforce our past suggestions, but I was surprised a bit by the number of cAHI and find it significant.  It appears from the chart it is not just of the detailed day of 1/6/2017, but all through the month of May.

This suggests to me that the setting I would seek is:
(A) one that makes exhale pressure remain above 9 (but better at 10), [to ward off obstructions] and
(B) one that reduces the difference between inhale pressure and exhale pressure, [to minimize occurrences of clear airway events logged as cAHI] and
{C) one that limits the highest inhale pressure to what seems likely to resolve most obstructive hypopnea and flow limitations.

I would set min pressure to 11 cm (with APAP mode) or 9 cm (if you switched to CPAP mode) to resolve (A) above,
I would set softPAP to lowest setting (partly to resolve (B) above), and consider changing to CPAP mode to more fully resolve (B) above.
I would set max pressure to 13 cm (with APAP mode) or 12 cm (if you switched to CPAP mode) to resolve {C) above,
Finally, I would set softSTART pressure to 9 cm.
[and evaluate after 4 to 7 days]

Good luck with best sleep possible.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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