Respironics vs ResMed Differences

[cate1898]

Unless I'm misunderstanding everything I've read and the few videos on this subject. I'm assuming this based on ResMed's spike in pressure when it detects an apnea. Or perhaps I came to the wrong conclusion?

After all, I'm far from being really knowledgeable on this subject!

[archangle]

I know it's an old thread but I can't find an answer to a simple question that fits in here.
Is the ResMed algorithm really as much better as shown in this video?

NO!

I do slightly prefer ResMed, but the presentation you mention reads like biased ResMed ad copy.

The machines are hooked up to a breathing simulator, not a sleeping human.

In this simulation, increasing the pressure stops the apnea. The rapid pressure increase from the ResMed stops the problem.

Real humans may work differently. A too rapid pressure increase may disturb or wake the patient. A real patient may have a few apneas, and then stop even if you don't increase the pressure. A real patient may suffer from aerophagia (gas), extra leaks, and other problems as you increase the pressure, so the Philps machine might actually give better results.

Human beings are much more complex. What's best for one person may be wrong for another. Quite a bit in apnea and CPAP is trial and error, on top of a healthy dose of empirical science.

A simplistic analysis like this could also lead you to the conclusion that you should simply start with a higher pressure and prevent apneas to begin with. Which might actually be the correct answer for some patients, but causes problems for others.

The video isn't "wrong," but it's not the whole story by any means.

The ResMed vs. Philips contest has no clear winner. If I were buying one now, I'd avoid the DreamStation because we don't have a version of SleepyHead or Encore that works with it, and full data is a BIG thing to have if you have problems. The ResMed S9 and A10 are good, as is the PRS1 machine. More info in the Useful Links in my signature line at the bottom of the post.

[GPSMapNut]

Thanks Archangle for the very sensible answer. It helps to slowly build a picture as to which machine to choose - my APAP routine sleep study is next month, results in January.
At the moment, I'm thinking that; if they say to stay on CPAP, I'll get Philips Pro because of the simpler 12V option and better fit to my night table.
If the Dream Station will be available by the time of purchase (I'm in Canada), I will get it. Yes, data is very important but I'm confident that the SleepyHead will support it soon enough. After all, I'm not getting a machine for a month or two. I'm getting a machine that will serve me for a number of years.
If they say that an APAP is in order... if Dream Station is available, I'll get it on (possibly wrong) assumption that newer algorithms and technology are at least slightly better than the older ones. If it's no available, I'm still on the fence but leaning towards PR. After all, PR served me well for the last 11 years!
Oh darn, almost forgot. 12V is important but, I have to check which machine fits on the shelf in my travel trailer!

[GPSMapNut]

Well, I measured my shelf in the trailer and considered access - any of the machines I could be looking at will fit! In 11 years they did get smaller!
I also spent several hours looking at the various graphs attached to the posts on this board. You can call my conclusions simplistics. I call them " my impressions based on random samples of real life data".
Well, my impressions are; ResMed is quick to rise the pressure but slow to lower it.
Philips is slow to rise the pressure but quick to lower it.
Pick your poison...
Obviously, it's just an impression of one person and it's far from a clinical study.
If I end up with APSP, personally, since my AHI with a CPAP hovers around 1, I rather be treated with Philips approach. I do want to be treated with the minimum pressure that gives me restful sleep. I can always bump up the minimum set on APAP to get, at least, results as good as with CPAP.
For now; That's my story and I'm sticking with it. Tomorrow I may know better

[Gil]

Getting new machine after 10 years with Respironics. Did all the research and even the doctor tried to get to say with the Respironics machine. He kept saying the Respironics does not have a reset button with I have to a mitt is important. But I went with the ResMed air scene 10 her version. The changes I notice are, my AHI on the pr one ran from 1 to 4, on the ResMed it running point 8 to 1.4. The pressures the pr one ran constantly up and down were the ResMed seem to drift more gradual and stay high in general, but it does wake me up like the pr one did. I have come to the conclusion that the trouble sleeping was because of the constant changing on pressure on the pr one. I used to think it was from the high pressure but the ResMed keeps the pressure higher longer but I sleep so much better. Also the mask leaks are down greatly which I think is do to the EPA setting available on the ResMed machine. I am now getting the best sleep I have had in 10 years on the ResMed Airsense 10.

[archangle]

He kept saying the Respironics does not have a reset button with I have to a mitt is important.

I'm glad it's working out well for you.

What do you mean by "reset" button?

Another advantage of ResMed is that ResScan, the official data analysis program is light years ahead of Encore, the official program for Philips Respironics.

[vsheline]

I wonder, what's their [ResMed's] algorithm for lowering the pressure? I'm guessing that an APAP not only increases the pressure but also lowers it if the higher pressure is no longer necessary. Like, when a person moves from the back to the side, how long for each machine before it reacts to the lower pressure requirement?

Hi GPSMapNut,

Let's assume for sake of illustration that the pressure had previously been raised 4.0 cm H2O above the Min Pressure setting and that no additional signs of airway obstruction occur.

I believe ResMed Auto machines use an exponential decay with a 20 minute time constant, which would mean the pressure is gradually reduced back toward the Min Pressure Setting, with each adjustment large enough to return the pressure to the Min Pressure level in 20 minutes if the adjustments were of constant size and rate (but the adjustments are not constant - the size of the adjustment or the rate of adjustment gets smaller as the pressure returns closer to the Min Pressure level).

An "exponential rate of decay" is different than a constant rate of decay. An example of constant rate of decay would be to reduce the pressure by 0.2 cm H2O every minute for 20 minutes, and after 20 minutes the pressure would have been reduced by all 4.0 cm H2O, and the pressure would be back at the Min Pressure level. That is not what ResMed does.

Exponential rate of decay makes ever-slightly-smaller adjustments as the pressure drops toward the Min Pressure level. For example, after multiple ever-slightly-smaller adjustments have succeeded in dropping the pressure to 2.0 cm H2O above the Min Pressure level, the rate of decrease would be 0.1 cm H2O per minute, which is again one twentieth of the present difference above the Min Pressure level.

After one time constant (20 minutes) around 37% of the initial 4.0 cm H2O pressure difference would still be left. After two time constants (40 minutes) around 13.5% of the initial 4.0 cm H2O pressure difference would still be left. After three time constants (60 minutes) around 5% would still be left.

[vsheline]

I went with the ResMed air scene 10 her version. ... I am now getting the best sleep I have had in 10 years on the ResMed Airsense 10.

Hi Gil, welcome to Apnea Board.

Yes, I think many men (if given test trial) would prefer the S10 AutoSet For Her version, which offers the standard AutoSet therapy mode, the less-aggressive AutoSet For Her therapy mode, or fixed-pressure CPAP therapy mode to choose from.

Three machines in one. Same price as the standard AutoSet.

By the way, your profile lists your pressure range as 3-10. If it is at all uncomfortable starting at low pressure, I would suggest raising the Min Pressure setting (and the Start Pressure setting also, if you use the Ramp function).

[Gil]

He kept saying the Respironics does not have a reset button with I have to a mitt is important.

I'm glad it's working out well for you.

What do you mean by "reset" button?

Another advantage of ResMed is that ResScan, the official data analysis program is light years ahead of Encore, the official program for Philips Respironics.

---

He kept saying the Respironics does not have a reset button with I have to a mitt is important.

I'm glad it's working out well for you.

What do you mean by "reset" button?

Another advantage of ResMed is that ResScan, the official data analysis program is light years ahead of Encore, the official program for Philips Respironics.

I'm sorry I should have been more clear what I am calling the reset button is actually a ramp button when pushed it takes the machine back to zero and starts the ramp function all over again

[archangle]

I'm sorry I should have been more clear what I am calling the reset button is actually a ramp button when pushed it takes the machine back to zero and starts the ramp function all over again

Just turn the machine off and on, and the ramp starts over.

BTW, AHI readings tend to vary between machines, even with the same setting. This may be actual differences in how well the treatment works, or it may be differences in the way the machine measures apnea events. Sometimes, events are on the borderline as to whether you should count them or not, and the machines may interpret the results differently.