DreamStation 2 vs ResMed?

[dk2011]

I know this has probably been posted a bunch, but I'd like to ask and get a fresh perspective.  If you were getting new machine today, considering the recall of Philips DreamStation, would you buy a DreamStation 2 or buy a new ResMed machine?  And why?  What are the pros and cons?  How is quality control with both companies?  I don't want any issues, and I always uses hoses and masks that are actually from the same manufacturer as the machine for consistency purposes.  Thank you in advance.

[bossfan50]

I used this answer in another thread when someone was asking a similar question.

Since I started CPAP I used a Respironics System One.  Almost always had a AHI over 5 because of an excessive amount of hypopnea events.  About two weeks ago I got a new machine.  I asked my doctor to prescribe a Resmed Aircurve ASV (I have complex apnea so I need an ASV).  My DME gave me a Dreamstation because someone at my DME said that the Resmed could not be set for the min/max pressures that the doctor ordered.  I spoke with someone at my DME who agreed that was a mistake and that the Resmed could be set for the pressure range ordered. So the DME authorized a swap of the Dreamstation for a Resmed Aircurve 10 ASV.

I've used the Resmed for 4 days.  AHI is much lower, always under 3.0 instead of the usual over 5.0 that I've always had with Respironics.  On another board I was told that this is because the Resmed seems to better recognize when there is a flow limitation that is about to cause a hypopnea and treats it.  Respironics usually flagged 20-50 hypopneas.  Resmed flags much less hypopneas.   I also think that the Resmed responds better to my own breathing pattern and the therapy is more comfortable.  This is a long answer to your question but Resmed all the way.  I speak from very recent experience.

Also it sounds like the Oscar team will not be able to decode the Dreamstation 2 data to be able to download into Oscar so if you want Oscar support then you have to get Resmed.

[racprops]

So here we are...

"Philips has determined that as a company we must encrypt data for privacy and security reasons. This statement means they intend to deny patients access to detailed data.

And Many sleep apnea patients need someone to pay attention to their data, but we all know just how rare your doctor is! For the rest of us none of the professionals who are being paid to treat us are going to look at our data -- I am abundantly aware of the fact that if I don't look at my data then no one is going to look at my data.

Is it possible that PR is simply unaware that when they oh so carefully curate and protect this data, that virtually the only people who are willing to look at it are the patients -- the exact people that they are "protecting" the data from!"

I just tested a ResMed Air Curve 10 ASV and one reason I am returning it is the LACK OF DATA.

It only reported my obstruction apneas and UNCLASSIFIED APNEAS  what the heck???

Only tree to four reports VS my Dreamstation displays 7 reports.

So I feel ResMed is also lacking full reports, is there any way to open the information up?? To get more reports out of a ResMed system??


Rich

ResMed's report
[attachment=33142]

Dreamstation Report
[attachment=33143]

This said it all:

"It's so ironic that the medical device that's temporarily curing us of an ailment (sleep apnea) could be afflicting us over time with a more severe life-threatening ailment (cancer, etc.) - and in such a gradual way that would never point the figure at the root cause (deteriorating foam containing a proven cancer-causing chemical).  Philips recalled device users, at least in the U.S., will ultimately demand to know to what degree their use of their recalled Philips medical device contributed towards any current (or future) medical condition."

[dk2011]

Thank @bossfan50.

What is the general consensus on this board about the recall? It says I should stop using my DreamStation. So are people just not using their CPAP right now? Or what? I haven’t had time to read this board much lately since I’ve been so busy at work.

[racprops]

"In case you're interested, comparing the 2 charts racprops posted, the ResMed reports events it encountered. If it didn't encounter a certain event, there's no events to report. The Philips maybe is doing the same, but I know for certain the ResMed acts this way."

I noticed that on another night it added a forth report.

So are you saying it will only report events IF it sees them??

 Phillips shows all the idems it WILL report even if there is nothing to report, it show the band either way as in my report I had no clear air (centrals) and no Periodic Breathing etc.





His ResMed comparison has some other differences. The ResMed Min EPAP pressure was 10, Respironics min EPAP 12. ResMed AHI 0 Respironics AHI .39

I found the ResMed seemed to not drop the low pressure as much or as well does the DS, so had lowered it to see if i ould improve it, it did not work.

The higher pressure seem to be my best settings on the DS.

I have found often when I make a switch to a different machine I often have lower readouts...

A good night on Phillips
[attachment=33144]

2nd night on ResMed
[attachment=33145]


"ResMed didn't allow Hypopnea or Obstructive but Respironics did have a bit of both."

As I have always had Hypopneas I do not understand what your saying: Are you saying Hypopneas DO not happen on Resmed machine as they do because on the second night it did indeed report Hypopneas...

And both nights it reported on UNCLASSIFIED APNEAS....what are they??

As I do have clear air (Phillips for Centrals) I would rather see them reported as such. 

Or is UNCLASSIFIED APNEAS ResMed for Centrals??

Rich

[racprops]

OK I will post this here, and I AM LOOKING for feedback, as this is as I understand things at this point, OK?

My review of a ResMed Air Curve 10 ASV VS a Phillps Dreamstation BiPAPAutosv.

I have been a long time user of Phillips Sleep Apnea machines.

Due to the recall because of problems with sound control foam millions of Phillips sleep machines users have been scared by these reports and recall and looked to the other major machine maker ResMed.

I too was very upset over this and ordered a ResMed ASV machine.  Then I learned ResMed has some foam within their systems. They claim it is not the same but I feel I want NO Foam of any kind in my sleep machines. Old saying: Fool me once shame on you, fool me twice shame on me.

This is a Resmed Fan

[attachment=33146]

So I called to cancel my order.

But they were unable to stop the delivery so it came Saturday. UPS did the standard drop and run delivery and I was unable to catch the driver as he was long gone by the time I found it on my door step.

This is a “refurbished” used machine. That means they clean it, replace the water tank, hose, and filter with new parts. It came with a 10 free trial, return it by 10 days for a full refund. And a 6 month warranty.

Also as the payment has gone through plus it is Saturday so I decided to go ahead and try the machine. So the seller failed to do two things he said he would do, stop the delivery and recall it and to issue a refund.

First night I found a number of problems!!

Fan is noisy; it is a low level howl, which changes per intake or exhale breathe. It is border line loud. This needs to be replaced. It should have been replaced before shipping. Much less guilt for using it.

Second I started the humidifier at setting one. There is 8 setting VS 5 on Dreamstation.

It used NO Water. On my second sleep cycle I turned it up to 4, still very little water use.

Apron waking I felt the water tank and it was still COLD.  I feared this heating plate might be burned out, But it will warm on the prewarming, so the heating plate seems to work.

As this is my only use of a ResMed machine I do not know if this normal, seems not, but these machines do claim to specially control their humidifiers so that could be part the problem, and the seller failed to provide the special hose for part of the feature.

Third try at the highest setting barely warm. All my Phillips machines ran hotter.

Next is a problem how it works. After a couple of nights I switched back to the Dreamstation ASV last night and felt another feature I really like with Phillips: breathing reaction time.

This IS a feature of Phillips where there is an adjustment for how fast the machine reacts to your breathing, as you switch from inhaling to exhaling.

I use a setting of T1, this cause the reaction time to be so fast it feels like my own breathing, it is not notable when it follows my own breathing, I cannot feel it as it changes in an instant.

There are times when I cannot tell if I am choosing to inhale or exhale myself or if the machine is in control, but if I think it is controlling me I just hold my breath and it IS me.

The ResMed does not have this adjustment and is not as fast; it takes a split second to switch from input to output, I was having to push a little to get it to switch. There is a slight delay in this change that at first I did not like.

I also noticed that even set to below my Dreamstation settings of exhale at 12 running 10 and my inhale it 18, the low in the ResMed seems to be higher as I feel more pressure than my Dreamstation in action.

Last test night, it does as I thought, does not drop exhale pressure all the way, I feel slightly suffocated as there is resistance to my exhaling even at 10 setting.

And the high does not seem as strong.

Plus as madding the breathing rate is a curve, it starts low and then rises to full pressure.

Lastly I ran into the runaway cycle…it started going up in volume and pressure.

All of this was so bad I could not stand it so I cut tonight’s test short and went back on the Dreamstation.

There are a lot less settings. For dummies this can be good with fewer things to get wrong and mess things up. And I may very well have had some problems in the past due to a lack of full knowledge of each setting and its interaction with other settings.

On the other hand I can make finer settings tuning the Phillips machine.

The reports: DUMBED DOWN….four reactions are reported…ONLY four VS seven for Phillips.

I much prefer to see the more detailed reports of the Phillips systems. Again it is better to see what problems I am having so I can tune the system better.

All in all I prefer the Phillips Dreamstation I over the ResMed Aid Curve 10.

[racprops]

I am very interested in this:

"I've used the Resmed for 4 days.  AHI is much lower, always under 3.0 instead of the usual over 5.0 that I've always had with Respironics.  On another board I was told that this is because the Resmed seems to better recognize when there is a flow limitation that is about to cause a hypopnea and treats it.  Respironics usually flagged 20-50 hypopneas."

I believe you were not set for the correct pressures to clear Centrals and Hypopnea you need a higher inhale pressure as I treat my self I follow the instructions lower my Apneas very well.

Phillips
[attachment=33147]
Phillips
[attachment=33148]
Resmed
[attachment=33149]

[Dog Slobber]

You are finding fault with your ResMed, when in fact the behaviour is within OSCAR.

For most, perhaps all of the Event Flags, OSCAR will not report the field, for a new device until it has experienced its first event.

This is why you did not see the Large Leak on Jan 19th, but then it appeared on Jan 20th. 

Other data that you claim is missing, is not. It's just presented differently, sometimes as a trace diagram, other times it's named differently, sometimes their measurements/criteria is slightly different.

• PB (Periodic Breathing) is presented  as CSR (Cheyne Stokes Respiration), though they aren't exactly the same
  
• Large Leak Events appear on both, as does a Leak Trace, though ResMed only reports excess Leak while Respironics reports Excess + Estimated Vented
  
• Central Apneas appear on both
  
• Obstructive Apneas appear on both
  
• Hyponeas appear on both
  
• UA appear on both
  
• FL (Flow Limitations) appear as an event Flag on Respironics, but a trace diagram on ResMed
  
• VS appear as a Snore Trace Diagram 
  
• VS2 has no equivalent on ResMed. I would love to see an explanation about what exactly VS2 is, how it differs from VS. As far as I'm concerned it's excess vibration that results in too much noise on the Event Flag and Pressure traces
  
• RE (RERAs - Respiratory Event Related Arousals) are reported as events on some ResMeds (not the BiLevels) and isn't reported on Respironics
  

About UA being ResMed for Centrals, that's *kinda* true, but not quite (but only for the ASV).

ResMeds (all but the ASV) use a very reliable FOT technology to differentiate between Obstructive and Centrals, but the ASV only flags OAs and UAs. OAs are clearly Obstructive but UAs may be unknown, central or mixed. To properly use FOT to determine OA or CA takes time. ResMed immediately increases pressure upon detecting breathing has stopped, that's the nature of ventilators. The increased pressure is not compatible with FOT.

There are some other differences, but I think I've outlined the majority of your questions or inaccurate reporting differences.

[Crimson Nape]

racprops -All your charts show the same username. Since each brand reports differently, did you create a new profile for your Resmed? If not, you may want to try it.

[racprops]

Thanks Dog Slobber,

As my old records for my Phillips systems all contained the reports so with them I guess Oscar found complete events to load so I have not seen that behavior in Oscar.

SO if I understand you, Oscar and Resmed will show all the events as the happen, and I take it they will then become a perment part of the reports?

OK Good to know.

Now about the other details, I have a full copy of the ResMed and Phillips Clinician Manuals and found a lot that is not there that is in the Phillips.

Rich