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Respironics vs ResMed Differences
#11
Another thing with the Resmed Autoset 10 is that it doesn't always have the cellular. Here in Oz I just received one a little while ago and it appears to have no cellular. Whilst my original ResSleep loaner was connected (cellular), my new owned one has nada. I don't even see the screen icon of a turned-off (airplane mode) radio.
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#12
Having used both Resmed and Respironics, I can say from the user side, there is little to no real difference in quality or feel - both are quiet, both give good treatment, there is a small bit of difference in how the EPR and Flex feels (respectively) but not enough to make one a fan of one over the other, and ultimately, if you have the choice of both then flip a coin - if you go for Resmed, I would suggest the "for Her" model if they will give it, as it has slightly more detailed reporting, closer to the detailed reporting of the Respironics. The tanks of the Respironics are easier to clean in the dishwasher, and to fill, but there is a bit of a small risk of "tank Echo" compared to the Resmed S9, although I cannot speak for the A10, which, like the Respironics machines, now has an exposed tank (the enclosed tank of the S9 acted to muffle the sound of it more).

I find that I am perfectly happy with both manufacturers. Whichever is cheaper with all the bells and whistles is the one you want, ultimately (heated hose, correct power brick, etc - caution, for the Respironics, you HAVE to request the heated system from the get-go - they sell, for almost no price difference, two completely different humidifiers, one for heated hose systems, one for unheated systems, both with different power requirements). One other thing, a small thing - the Respironics has a double filtration system, and external sponge filter to catch large particles and a second filter inside that for fine particles, for the Resmed you have a large particle filter and any fine particle filters you may wish are third party and inserted further into the device. This is only an issue if your environment is high on fine dust. If you can take a nasal pillow, the Resmed P10 is very nice to use, and fits all systems of all manufacturers. For Full Face Masks, I will defer to others on the board.

Off-topic, I was also a Unix guy way back (actually go further back than that - I started out programming PDP 8Ls on teletypes and card punches), still have my beloved SGI Indy and SGI O2 doing some work for me (with the SW1600 wide screen monitors) and Sun Spark 5 running my internal server (I keep all my med library backed up on it for research and home use, teh SGIs for molecular and medical imaging and simulation - still the best in biz for that), but these days mostly using a Sony Vaio Pro 13 (alas, poor VAIO, I knew thee well) for personal work use and an Acer desktop at home with an LG Ultrawide 34" screen. The hospital forces us to use an antiquated proprietary system for all record keeping on desktops that are a good 15 years old on old 15" tube monitors (and a few equally old 15" LCDs), but I have been working to convince them to move to tablets (I have been pushing for Sony Xperia Tablets as the lightest and best to use on rounds, but there is a strong iPad contingent here - not a great fan and it would require a complete rewrite of the current record keeping software, whereas the Sony tablet would not and the Xperia 4 will be the lightest and fastest tablet out when it comes in a few months, and has the best screen for viewing x-rays and the like). While the M$ Surface Pro would be the best from a software perspective, it is also the heaviest, so out for rounds and the like but not as desktops (I tried to convince them to replace all our current desktops with VAIO Tap 21s when they were available, some 20 times more powerful than our current desktops, and of course, light and portable enough to move from office to office without a problem, even have them on Crash Carts and other carts - something that would have lasted a good 5 - 10 years - who could have guessed Sony would sell off the computer division? A huge mistake IMHO). Samsung Notes are also in the running. Right now it is down to politics and religion as to what will be the ultimate choice, and my guess it will be decided based on the kickbacks no matter what we working doctors and nurses think is best for OUR needs. <grumble>
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#13
Thanks Doc that great info from first hand experience.
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#14
Thanks so much for taking the time to write that thorough response, Vaughn. Based on your several prior posts about the differences in Bilevels re: variable or not PS, I’d already decided to choose my sleep doc’s recommended Respironics (DS760TS) over the AutoV if my results justify bilevel. Thank you for those posts, as well.

Doc, thanks so much for the considerable informed user perspective. Your thoughts and feelings echo my sleep doctor’s—both are good—toss a coin. Good info on the dishwasher (extra cost on ResMed), tank echo, and filters. I’m not too concerned about CPAP noise because for years we’ve used a Marsona sound machine with “Waterfall” cranked up at night. I’ll have to remember to take it to my sleep study, LOL. I’ll definitely insist on a “TS” suffix for the heated tube.

I’m down to deciding between the DS560TS and the ResMed AirSense 10 AutoSet (my doctor only prescribes automatics) in the event a bilevel isn’t justified. There are things I like better about the ResMed, but I’m leaning toward the Respironics, especially since the doctor prefers its more conservative algorithm. I’ve seen the YouTube video demonstrating the ResMed responds faster and more effectively, but besides questioning whether it was contrived, I balance it against reports of the ResMed rising very quickly (which could awaken one) and hanging there. The native 12 volt DC and privacy of the Respironics are nice, but not deal-breaker gotta haves.

OT again, most of my (really my staff’s) Unix support work was Sun with a little SGI. Last were some Sparc 20s with an Indy and an O2 also. Past the turn of the millennium, Windows prevailed in commercial science and engineering software, with Linux grabbing the Open Source side of it. Memories! They look a little heavy but I think my doctors here use the Panasonic Toughbook convertible tablets.

Thanks so much to all who’ve contributed to this decision! I feel pretty comfortable about being able to effectively use whatever auto shakes out. I’d like to try the ResMed P10 nasal pillows, but wear an extra-large 7-3/4 to 7-7/8 hat/helmet size. I may just need to stick with something like a Swift FX to avoid “piggy nose.”

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#15
I'm not sure if anyone mentioned it but I believe the Respironics has a "Ramp Reset" button on top whereas the Resmed does not.
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#16
iSnore,

Both are good machines, and you will be happy with either - one caveat I have against Resmed is the damned LDC screen stays lit all night, whereas the Respironics doesn't. I don't know if they have fixed that in the most recent iterations of the A10.

My current machine is a variant of the DS560TS and I am very content with it, but as I said, they are all about equal now. The video you mentioned is definitely slanted in favour of the Resmed machines, alas, and again, the algorithms used to fix the pressures are basically different philosophies of how to find where it is, one using a sort of continuous hunt and peck system that allows for considerable variance against the real needs of the patient (the PRS600) and one which sort of gradually rises to find the right level, but doesn't drop back so easily once there (the A10) - in practice, both work as well in almost every case, with only a few being exceptions - if you have a very variable pressure need over the night the PRS would be your better choice but if you have simple OSA where the pressure needs remain mostly constant once deep into the sleep cycle, then the A10 can shine as well. On the S9, the precursor to the A10, there were complaints here in Switzerland about the motor noise (a sort of high whine that I sometimes noticed as well on the outbreath) but I think the A10 addressed that issue. Also, signal13 is correct that the PRS has a Ramp reset button, which I have had occasion to use.

I discounted the Toughbook tablets due to weight - no one wants to lug something that size around. Heck, my VAIO Pro 13 is lighter than that - it is also lighter than the last generation of iPads. And that is a full fledged laptop (which I am using right now to write this). Even with a cover, the Xperia tablets remain the lightest of the lot, and the Triluminous display is excellent for viewing radiography images. But the Samsung has a stylus holder, and that is also a plus. A representative from M$ is coming over with a preview machine for the Surface Pro 4 11, 13 and 14 for us to try out - if it meets our requirements, who knows? Maybe the evil empire will win over a massive governmental institution like us. Again, the final decision will be out of our hands - we can only recommend and campaign for what is really useful to us rather than what bean counters think we should have. Never needed any of this in my younger days - charts were perfectly fine for us back then.....
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#17
Just for notes, my Resmed display goes dark after about 5s after auto start up. In sleepyhead I can see the rise and fall of the pressure during the night. And it is quieter than the dog.

Doc: If your work goes all techy, have you guys thought about contingency during a power or server failure? Keep a stash of backup clipboards, paper and pens handy just in case?


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#18
Thanks, signal13. As Doc points out, you're correct about the Ramp button. The ResMed instead has a home button.

Doc, thanks for pointing out the advantages of the algorithms. I go beyond, "it is what it is" to trying to find things to enjoy about whatever tool I wind up with... maybe a glass half-full mindset. IIRC, the A10s have LCD backlight timeout now.

I carried a company-provided iPad 1/3G and an iPad Retina/4G for nearly three years. With ssh and rdp, they let me do the remote admin I need. I really liked them. Then they outlawed jailbreaking and insisted on their mobile device management software that could spy on me/track me, so I replaced the iPad with a MacBook Air and a 4G/LTE mi-fi. They're a little bulkier, but imminently more useful.
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#19
(04-16-2015, 11:52 AM)trailrider Wrote: Just for notes, my Resmed display goes dark after about 5s after auto start up. In sleepyhead I can see the rise and fall of the pressure during the night. And it is quieter than the dog.

Doc: If your work goes all techy, have you guys thought about contingency during a power or server failure? Keep a stash of backup clipboards, paper and pens handy just in case?

Good to know they fixed that - it was a real pain with the S9.

The hospital has back-ups of backups of everything - power generators, servers (ancient though they be to run the ancient software we use - I went down there one day and expected to see Bulls lining the walls - it wasn't that bad, but it looks like a server room from the late '90's).

We still do a lot on paper, but the government is pushing to move everything to a paperless system, and one where all the hospitals and doctors throughout Switzerland can communicate with each other easily and share files as needed. This is a real problem, since most hospitals here run proprietary systems and no one can agree on a universal records keeping system, and each Kanton (state) has their own ideas on what should be run. In house anything can be called up, all radiograms are now automatically digitised, even if they are first generated on film (which is becoming rarer outside of x-rays, and even there), all dosage orders are now done electronically as well as written so there is a constant immediately accessible record of pretty much everything, which keeps the bean counters and the insurance companies very happy indeed. But the system was built around interfaces and database languages that are no longer current, and not easily movable to something a bit more modern (and a bit more GNU), so lots of hurdles still to be overcome.

Out of house, the system is not accessible except by authorised doctors who have privileges at the hospital, and only certain staff (I can access certain areas from home via a VPN, but not all areas - patient records have to specifically unlocked individually by me from my office before I can access them from home). Remote consults with other physicians in other hospitals pretty much does not yet work at all. That is something I want to rectify, first with the other big hospitals in Switzerland then with the private hospitals, then with specialists and finally GPs..... And then make it work with major centres in other countries.

For what it is worth, we keep both written records and electronic - I have to enter everything twice, once on my paper charts and once on the computer screen, which ever is handy. Prescriptions are entered into the computer system and it generates a paper copy for me to sign and stamp (yep, we stamp our Rxs, otherwise it ain't legal) which is then given either to the patient if they are to fill it, or to the duty nurse if they are to carry it out. Once they do it, they have to enter into the computer that they did it. All very controlled.
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#20
(04-16-2015, 11:52 AM)iSnore Wrote: Thanks, signal13. As Doc points out, you're correct about the Ramp button. The ResMed instead has a home button.

Doc, thanks for pointing out the advantages of the algorithms. I go beyond, "it is what it is" to trying to find things to enjoy about whatever tool I wind up with... maybe a glass half-full mindset. IIRC, the A10s have LCD backlight timeout now.

I carried a company-provided iPad 1/3G and an iPad Retina/4G for nearly three years. With ssh and rdp, they let me do the remote admin I need. I really liked them. Then they outlawed jailbreaking and insisted on their mobile device management software that could spy on me/track me, so I replaced the iPad with a MacBook Air and a 4G/LTE mi-fi. They're a little bulkier, but imminently more useful.

It is excellent to go beyond the "it is what it is" - your are making a major change in your life, and knowing what it is and how it works is vital - one thing I never tell a patient is "shut up and do what I say, don't ask" - they have a better chance of getting better when they fully understand, as much as they can, what is happening and what the treatment entails. Believe it or not, it aids the placebo effect of treatment, and there is always a certain amount of that in any treatment. The more the mind is ready to work to get better, the more the body responds positively. In CPAP therapy that would be the ability to accept and adjust to wearing a mask and having air forced into you all night.

I take my VAIO Pro 13 to the office, even though it is my private one, and carry it to my consults. I don't take it on rounds, mostly because it is no use there, but I do bring it into most meetings and my teaching classes. I have never cottoned to the bulky old pizza boxes they forced on us in the offices.

One of my mates has a jail-broken iPad retina display with tons of medical software he nicked from a rotation in the US (the Mayo, I think), but it is more for show - I can do most of the same stuff he uses the iPad for faster and better with my own eyes and mind and a good probing finger or two.

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