(12-15-2014, 07:28 PM)magictrkaz Wrote: I didn't have issues with the S9, I just hate to get a new machine that no longer has parts to support it in a few years because they are trying to switch everyone to the 10 (but maybe this will get me a new machine in a few years)...
Hi magictrkaz, welcome to the forum!
If I were looking to buy a new ASV unit, I would try searching the internet to see if I could find comments from several patients or researchers who have used (or monitored patients who have used) both an S9 ASV and the new A10 ASV. But, because the AirCurve 10 ASV is so new, I doubt that any comparisons like that exist yet.
As of now, personally, I would probably go with the new A10 unit.
Regarding, "I would think it would be beneficial to get the new one since likely support for the S9 will go away eventually, but I have seen some issues with the humidifier and pressures being off."
On the A10 Series, I do not believe the therapy pressure is "off" in the sense of being inaccurate; instead, my assumption is the A10 units may be more sensitive to Flow Limitation (causing the machine to raise the pressure faster and higher), perhaps because new sensors may have been used which are more sensitive, or perhaps because of improved calibration or something like that. ResMed has said that the Enhanced AutoSet Algorithm itself (introduced in the S9 AutoSet) has not been changed in the standard A10 AutoSet model.
I am not sure how widespread are the issues with the A10 humidifier which some users have reported. I've heard that using the washable tub may improve things, but I'm not sure. On balance, I don't see this as widespread enough or serious enough to be a reason to avoid the A10 series. And at some point a slightly redesigned tub or a software upgrade may address the issue.
As you probably know, and unlike with the A10 series, the S9 series cannot receive software upgrades in the field, over the air. Nor, for example, can a DME provider install software updates on the S9 series. In that regard (software updates), there has never been support for the S9 series, other than the ability to return a malfunctioning unit for hardware repair/replacement if the unit is still under warrantee.
Both the S9 and A10 have only a two year warrantee. So your concern about the future availability of repair parts is a significant one for repairs which may be needed after the two year warrantee is over.
At some point ResMed may simply decline to repair S9 units (no matter how much you may be willing to pay), if replacement parts are no longer available. This will not be an issue during the two year warrantee period because ResMed has the option to simply replace the S9 unit with the equivalent A10 unit.
If you call up ResMed Customer Service and ask whether there is any guarantee that repair parts will be available for at least 5 yrs for all S9 models (which are continuing to be sold as new), it is my guess is the answer would be "No, we recommend purchasing the AirCurve 10 model."
My own S9 VPAP Adapt unit is an early model, manufactured earlier than November 2012, which includes the "ASV" treatment mode but not the new "ASVauto" treatment mode. On my S9 VPAP Adapt model, EPAP (the pressure during exhalation) is fixed (manually adjustable). S9 VPAP Adapt units manufactured more recently include the ASVauto therapy mode which (in addition to quickly adjusting Pressure Support to counteract obstructive and central apneas and hypopneas which are in progress, which the earlier "ASV" therapy mode does also) adjusts EPAP slowly in the background, like the AutoSet units do, to raise EPAP to avoid obstructive events. By the way, Pressure Support is merely the name for the amount by which the pressure is boosted during IPAP (the pressure during inhalation). EPAP + Pressure Support = IPAP
Anyway, if the S9 series had allowed software downloads (like the A10 series will allow), perhaps my machine could have been automatically updated to include the new ASVauto therapy mode when it came out. In any case, I think the ability of the A10 series to receive software downloads over the air may prove helpful in future.
You do have the Clinician set-up manual for your present machine, right?
If your present machine reports these numbers, what numbers does the machine report for the 95% (95 percentile) pressure, Max pressure, Obstructive Apnea Index (OAI), Central Apnea Index (CAI), Hypopnea Index (HI) and total Apnea Hypopnea Index (AHI)? (If your present model is the S9 Escape Auto, it does not detect whether the apneas are obstructive or central in type and reports very little data, unfortunately, much unlike the S9 AutoSet.)
I think you will need to download ResScan to view the data on the new unit, whether it is an S9 or an A10. It will be important to see the detailed data to see what is going on, so as to be able to fine tune your therapy and address any problems which arise, such as aerophagia (air swallowing) and excessive leak and other issues caused by higher pressures, which are common with ASV therapy. (Also, it would be a good idea to use ResScan now, to view the data from your present machine.)
New ASV models automatically adjust EPAP (the pressure during exhalation) to provide about the same EPAP pressure as an APAP machine (like your present S9 Auto) will provide in order to treat/prevent obstructive apneas and Flow Limitation and Snore. Additionally, ASV machines will automatically vary "Pressure Support" such that IPAP (the pressure during inhalation) will usually automatically vary up to perhaps 10 cm H2O higher in pressure than the EPAP pressure in order to do for us all the work of breathing when we are in the middle of a central event.
Thus, with ASV treatment the IPAP pressure can get a whole lot higher than on the standard APAP machines, and the higher pressures can require tighter mask straps and use of a Full Face Mask (above 20 cm H2O of pressure, if using a nasal mask type, air tends to blow right past the lips, even if the jaw is closed) and use of mask liners to stop leaking (or at least to quiet it down and make it untroublesome).