Machine choices

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One of the most important factors in successful treatment of sleep apnea is getting the correct CPAP machine.

Good vs. Bad Machines - Don't Get Taken

Good CPAP machines will record every breath you take during the night and attempt to detect apneas and tell you how your treatment is working. Unfortunately, the manufacturers still make "brick" CPAP machines that only record the hours you use the machine, but don't record data on how your therapy is working. Having data can allow the patient and his doctor understand problems and target those problems with changes in therapy pressure or even show the need for a different type of machine. Data avoids the need for repeat sleep studies to diagnose and treat problems, and to fine-tune CPAP or bilevel (BPAP) therapy.

Many DME's (Durable Medical Equipment provider / CPAP salesmen) will try to sell you a brick CPAP because they make a higher profit with a brick machine. Do NOT trust your DME. Many will claim a brick does record data when in fact it only records "compliance" data, i.e. the time you use it.

Don't trust your doctor to make sure you get the right machine, either. Many doctors have a spectacular ignorance about CPAP machines. Often wrong, but never uncertain. They also tend to put WAY too much faith in the DME.

This page is a consensus of Wiki Editor opinions on what machine to get.

Remember that even a dataless CPAP machine is a marvellous, life saving device. It's just that a fully data capable CPAP machine is a much more wonderful device that will save many more lives if used properly.

CPAP Machines

Auto vs Manual CPAP vs Bilevel vs ASV machines

CPAP machines typically come as one of four basic types:

  • Manual or fixed pressure machines. The are the most basic form of CPAP. You (or your medical adviser) will set a single pressure and the machine will maintain it all night long. Some doctors and respiratory technicians prefer this type of machine, but in general we don't recommend it - an automatic machine is better for a number of reasons.
  • Automatic machines, also known as auto-setting, auto-titrating or APAP. With these machines, you can set an upper and lower limit for the pressure, and the machine will automatically adjust the pressure between these extremes. The machine can sense apneas, hypnopeas and "precursors" such as snoring and increase the pressure as necessary to head off any further apneas. APAP machines generally run close to the lower limit, raising the pressure when necessary then lowering it again later. APAP machines can accommodate changes in your breathing, position in bed (eg supine or not) and general health changes as you age. APAP machines can also be set to run in fixed-pressure CPAP mode if desired.
  • Bilevel machines are identified by names such as Bipap, VPAP, AirCurve etc. These are typically more sophisticated and are used to treat apnea that requires high pressures or other respiratory conditions.
  • Adaptive servo ventilators (ASV) are even more sophisticated and are used to treat central apnea, Cheyne-Stokes respiration and other conditions. ASV machine are typically much more expensive than CPAP or APAP and are only recommended for special cases.

In addition to these standard types, many manufacturers have "travel" machines. These include Transcend, DreamStation Go, and Resmed Airmini. While offering some convenience, most of these machines do not provide the full range of features as found in the bedside models. This wiki article does not go into depth on travel machines, but there are many discussions in the Apnea Board Main Forum

Makes and Models

The CPAP market is dominated by two players: Resmed and Philips Respironics. These companies make some excellent machines as well as a few to be avoided. Their research and development seems to be well in advance of other makers. The majority of members on apnea forums such as Apnea Board are familiar with one or other of these brands, making it easy to get support and advice from fellow users. Most (but not all) of these machines are supported by Oscar software.

There are a number of second string manufacturers including Fisher & Paykel, Devilbis and Weinemann. While these companies make good machines they are not as widely known and in some cases support software is either not available or not very useful.

Newly arriving on the market is a range of Chinese machines such as Apex, BMC, Luna and others. While they may be excellent machines, apnea community support is lacking and software support may not exist.

Be careful - it's easy to be confused by the names of the machines. For example a Resmed S9 Escape Auto is a totally different machine from an S9 Autoset. A BMC RESmart is not the same as a Resmed. Note also that many machines have different names and model numbers in different countries. Make absolutely certain you have the exact model you want - double check on the Apnea Board forum if you're not sure.

Software

To get the best possible results from your machine it's necessary to see in detail what's happening during your sleep. Most major manufacturers have a simple web-based software which provides some basic data, such as the hours used and AHI. Examples are Resmed MyAir and Philips Respironics DreamMapper. Much more detailed data can be viewed using the manufacturer's professional software (eg Resmed ResScan and Philips Encore). Generally speaking these professional software packages are complex and difficult to use.

The preferred software is OSCAR (Open Source CPAP Analysis Reporter), which is a derivative of the SleeyHead program. This supports a wide range of machines, is relatively easy to use, and generates charts and tables to allow you to see exactly what happened on a breath-by-breath basis. We recommend machines that are supported by Oscar, as they will have the most complete support for user-friendly analytical software. Link to OSCAR Software

Recommended Models

The following is a list of recommended and non-recommended machines. In general autosetting machines with full data capability are recommended, while fixed pressure CPAPs with full data are considered acceptable and machines with limited or no data capability are not recommended.

Note that many machines are sold world-wide and may be called different names in different markets. The model numbers will likely also be different for the same machine sold in different countries.

Philips Respironics Dreamstation Series

The DreamStaton was introduced in 2015 and replaced the System One series.

  • Recommended (Full data capability and automatic pressure)
    • Dreamstation Auto (DSx500)
    • Dreamstation BiPAP Pro (DSx600)
    • Dreamstation BiPAP Auto (DSx700)
    • Dreamstation BiPAP AutoSV (DSx900)
    • Dreamstation BiPAP S/T (DSx1030)
  • Acceptable (Full data capability and fixed pressure)
    • Dreamstation CPAP Pro (DSx400)
  • Not recommended (Compliance-only data capability)
    • Dreamstation CPAP (DSx200)

Philips Respironics System One (PRS1) 50 and 60 Series

  • Recommended (Full data capability and automatic pressure)
    • Auto CPAP (DS550 DS560)
    • BiPAP Pro (DS650, DS660)
    • BiPAP Auto (DS750, DS760)
    • BiPAP Auto SV (DS950, DS960)
    • BiPAP ST (DS1050, DS1060)
  • Acceptable (Full data capability and fixed pressure)
    • CPAP Pro (DS450, DS460) (Fixed pressure)
  • Not recommended (Limited or no data capability)
    • CPAP Plus (DS250, DS260) (Fixed pressure "brick")

Note, all Philips CPAP machines also use the trade name REMSTAR, including legacy machines such as the M-Series and earlier models. None of the machines prior to the PRS1 series are supported, because they are not equipped with SD card slots.

Resmed Airsense 10 and Aircurve 10

  • Recommended (Full data capability and automatic pressure)
    • Airsense 10 Autoset and AutoSet for Her
    • Aircurve 10 S (Lumis 100 VPAP S)
    • Aircurve 10 ST (Lumis 150 VPAP ST)
    • Aircurve 10 ST-A (Lumis 150 VPAP ST-A)
    • Aircurve 10 VAuto
    • Aircurve 10 ASV (PaceWave CS)
  • Acceptable
    • Airsense 10 Elite
  • Not recommended (Limited or no data capability)
    • AirStart (all models)
    • Airsense 10 CPAP
    • AirMini

Resmed S9 Series

  • Recommended (Full data capability and automatic pressure)
    • Autoset and Autoset for Her
    • VPAP S
    • VPAP Auto
    • VPAP ST
    • VPAP Adapt (AutoSet CS)
    • VPAP ST-A iVAPS
  • Acceptable (Full data capability and fixed pressure)
    • Elite
  • Not recommended (Limited or no data capability)
    • CPAP SE (Limited or no detailed data)
    • Escape CPAP (Limited or no detailed data)
    • Escape Auto (Limited or no detailed data)

Resmed S8 and earlier series

  • These machines are obsolete, not supported by OSCAR and are not recommended.

Devilbiss

  • Acceptable
    • DV54 Auto Note: does not provide the very important Flow Rate chart
    • DV64 CPAP
    • DV64 Auto

Note: Devilbis DV64 machines are supported by OSCAR v1.0.0, however the support for this model is incomplete, and needs further development and quality assurance.

Fisher & Paykel

  • Icon
  • Icon+

Some of these machines are supported by OSCAR.

Lowenstein / Weinmann

  • Prisma series including CPAP, APAP, bilevel and ASV.

Some of these machines are supported by Oscar. The manufacturer's software prismaTS provides a reasonably good alternative.