[Product Review] Weinmann / Löwenstein Prisma 20A Auto CPAP

[Costas P]

Hello my friends!... 

As I've already promised in my first post in this forum, here is my review on Weinmann / Löwenstein Prisma 20A Auto CPAP. This machine is 100% "Made in Germany", as declared on its sticker, and in any documentation of it. It is a rather small footprint CPAP (main body, without humidifier). Its design, especially if seen sideways is 100% in accordance with its name: prisma (=prism). A simple design, with few lines, falling exactly in the "german spirit": simple timeless design, dark (almost black) color, with a big color touch screen in its front. Even by touching and "playing" with it, one can not but highly appreciate the "feel" of the firmly mounted plastics and their high quality, giving right away the impression, as Sleeprider quoted for prismaAQUA humidifier (in another review of mine) that: This equipment looks like it was built by and for people that drive BMWs and Mercedes. Indeed!...

My rating for this CPAP is :

Weinmann / Löwenstein Prisma 20A Auto CPAP

Quality of built: Superb!...

This CPAP is the main body of a fully expandable CPAP device desinged and built for patients (at their home treamtment) as well as for medical use too. This is achieved through its multiple "expansion" connectors, which can be used for sleep study medical centers, as well as for end-user (patient) apnea treatment - at home.

As seen from its left side, one can see the covered connectors for the humidifier unit (prismaAQUA):

Left side view: Humidifier connection - covered and exposed - in detail...

As far as the other (right) side of the CPAP main body is concearned, there are 3 ports, covered with 2 soft plastic cups. These 2 cups are covering:

1. On the upper part: a specially designed connector, which can accomodate 2 additional "modules". One communication "board" with: Bluetooth, Wifi and Ethernet port, allowing Prisma 20A to be connected in a CPAP network, for clinical use and, one board for connecting an oxymetry device, again for clinical use.
2. At the bottom of this side, also one can find two more connectors: a mini USB connector (for service use and maintainance) and an SD Card slot, where the user can "dock-in" the SD card (supplied by the manufacturer) for data recording and storage (using SD cards 256MB up to 8GB ver.2.0).

Right side: add on cards port, SD card, mini USB port.

You can notice the rectangular notches on which these special "boards" can be "plugged in", holding them firmly in the right position.

Turning the machine to its rear side, there is the air inlet with the appropriate air filter socket. We're all aware of the importance of this/these filter/s. This CPAP uses - as standard - a gray filter that needs periodacally cleaning / washing if needed, and also a white pollen filter. The pollen filter is not mandatory, but if used provides cleaner air for the user. This filter is disposable at the end of its usuable "life cycle".

Rear view: air inlet without / with  the standard (grey) filter installed.

At the bottom of the rear part of the device, one can see the power connector with a curved "shield" on top of it, as it can be seen in the photo above. Here, by the use of a special connector, the 92.5VA (!!!) Power Supply Unit (37V DC, 2.5A) is connected to the CPAP.
In my first post I was (by my mistake) reffering to this PSU as a 40VA, but in fact this was the CPAP power condumption.

Please note that this 92.5VA PSU is offered as standard equipment for this CPAP, meaning that one can initially buy only the main CPAP device and can install the humidifier (prismaAQUA) later on, without the need to replace the PSU with a bigger one - or with the obligation to by the CPAP initially with a humidifier and the corresponding PSU. Power needed to "feed" the main CPAP is 40VA so one can assume the extra 50VA are available for the humidifier, the heated hose and... perhaps a little more extra power available, as a reserve (if correctly designed a PSU must be able to offer a bit higher power than the one required by the device it's supposed to consume, for safety and... reliability reasons).

Needless to say that this PSU is supplying power for the heated hose too. This PSU is made by Skynet, a Taiwanesse PSU manufacturer claimming they make PSUs with an MTBF (Mean Time Between Failure) longer than 200.000 hours!...

Finally, lets go the front panel of the Weinmann / Löwenstein Prisma 20A Auto CPAP.

Very simple lines, one large 11.2 cm / 4.4" color touch screen, one power switch bellow this screen and... the outputs on its left side: on top, the molded air outlet and a bit lower the power connector for the heated hose.

A closer look on some... details!...
Air hose connector, power port for themal hose, main power switch.

The main (right) section of this CPAP is "devided" by a very elegant slim chrome plated line "running" from around the CPAP and providing it with an air of... elegance. Aesthetically it's an excellent combination with the chrome plated surroundings of the main power switch, giving the CPAP the "air" of a premim device. Indeed!... it is such a device.

When Weinmann / Löwenstein Prisma 20A Auto CPAP is set in stand-by mode it reminds a lot of a modern digital clock. The plastic from which is made of is giving the impression of a very fine and yet rigid equipment. Fine and silky in touch, and yet so strong, it looks like it can withstand almost anything!...If someone (unaware of CPAPs) sees it "lying" on a bedside table, might easily think it is a high tech gadget!...

The standard (gray) hose has a very "firm" toutch too, giving the sense that this will never bend more than what's really needed for the maximum comfort and safety of the patient!...


Ease of use: Outstanding!...

Except form the main power button (back light in green power logo), there are no other switches, buttons and regulators on this machine. Everything is shown on its large 11.2 cm / 4.4" colour touch screen display, and everything is controlled from this touch screen too!...

Selection of every function is easily done throught the use of green buttons. It's really simple: the grayed buttons are currently unavailable. Basic "keys" are 8: 3 on the left side of the screen (for the humidifier status and control) another 4 on the right side of it (like: Info, Home etc.) and 1 "button" at the central lower part of it, for setting the screen on / off during ECO mode.

Finally, the user can "wake up" the screen, which goes blank 30 secs after therapy starts, simply by dragging a finger over the central part of the screen (where the clock lies).

This is the stand-by screen of the Weinmann / Löwenstein Prisma 20A Auto CPAP :

showing current time, and a couple of touch switches available, like Info, Setup and Power Save. On top of it one can see the SD card "icon" which is blinking when updated by the recorded night data, or when changing something in the configuration of the device. Otherwise it remains steady green.


Settings:

Starting up the CPAP for the first time, the user has to enter some values, in the Time setting section, like:

Time Settings (summer / winter time period), hour : minutes, and hour format 12h/24h, plus Time Zone settings, for correct seasonal time changes.Also, the user can setup and use the embedded Alarm Clock (yes!... it's got one installed in there!...)


Of course there are other parameters too, that must be set by the doctor or the seller of the equipment, like Min. Max. air pressure (prescribed for the therapy by a doctor), AUTO CPAP / CPAP function, etc... which will be presented soon, in this post.

Other settings that can be selected by the user are:

Comfort (ramp) softSTART settings:
1. softSTART (ramp) on/off, and Level (0-3)
2. mask test pressure on/off and pressure level selection
3. softSTART starting pressure level (starting from 4cm H2O with 0.5cm H2O incrementation)
4. softSTART duration (up to 45 minutes)

Device settings about the: Display brightness, Leakage alert (on/off), Energy saving (on/off), and volume control for key tone, Alarm and Alarm Clock - not very loud to me...

Mask test pressure selection and... Accessories selection!...

Information:

A lot of information is available for the end-user of this CPAP. All one's got to do is touch the i button (info) an get the corresponding informatio . Of course the use of Left / Right Arrows is the way to switch menus, readings etc. This is very easy to be done even by a novice user. No expertise is needed to operate this machine, as a patient user friendly device.

As soon as the patient fits the mask and connects the hose to it, the CPAP automatically starts working (if configured to do so, else, the Power button must be used in order to start working).

A green mask icon appears right under the time and a two-way arrow shows inhalation / exhailation respectively.

If chosen, a "check mask for leakage" option (button) is available allowing the mask connected to operate at the selected testing pressure (10, 12, 14, 16, 18, 20 cm H2O) for 30 secs. Then it turns back to normal operation.

Now the mask icon is orange and if leakage is detected, an alarm can sound too - or not, according to the user setup on notifications.

Assuming now that therapy has started, the user can tap on the Info button and see a whole lot more information:

In the 3rd screen the information displayed is more detailed. It shows the current pressure of breathing (in/exhale) in cmH20, the status APAP / CPAP, hose diameter in mm, therapy settings pressure (min / max), softPAP level (0=none, 3=max) and the duration of therapy (in hours and minutes).

Also the ramp - softSTART button is available too in this screen, just in case a "releif" pressure is needed by the user. If softSTART is enabled then it shows the duration of this (up to 45 minutes), and if started, the remaining time of it.

Assuming therapy or softSTART has started the screen goes blanc, after 30 secs, allowing the patient to relax and go to sleep...

Each morning as soon as I wake up, I'm used to "swipping" my finger on the center of the blank screen, and wake up the screen too. It gives me the chance to take a glance at the current readings of my therapy, and at that point I'm disconnecting the hose from mask. The green mask icon becomes orange and the surrounding "leakage" symbol appears, and then the CPAP stops blowing air. Therapy is over.

A few seconds later a new screen appers. It's the Summary of the current night therapy. giving me at glance 3 main information items:
1. Usage time (hours, minutes)
2. Mask fit (leakage median in l/min)
3. Therapy quality (No of AHI/h)

A pretty neat feature of this very informative screen is that by using 3 green  check marks (3=max) the patient can have, at a glance, all the major information about the current night treatement. I find this screen very motivating too, and I think this gives me a complete idea of how things were during the night.

After all detailed data is recorded in the SD card, the user can simply touch the corresponding tab of either Mask Leakage median, and Therapy Quality in terms of AHIs/hour.

The duration of the detailed recording can be selected by the doctor or seller at 7 or 14 days segments. After that the detailed data is "combined" to the main body of data, and a new period is starting. During the current period the patient can select any of the 14 days recorded in detail and see all the above informations for each single date selected.


Conclusion:

I selected the Weinmann / Löwenstein Prisma 20A Auto CPAP after having tested for 7-8 days firstly Philips Respironics System One Auto CPAP 60 Series with Philips Respironics Pico nasal mask and after that I tested for another 7-8 days this Auto CPAP using ResMed Mirage FX (standard) nasal mask and then F&P Eson (large) nasal mask.

PR System One Auto 60 series and Pico was a bit noisy to me: mask was very noisy, it was "blowing" lots of air directly in front of my nose and it was really difficult for me to sleep at my side - towards my wife (she could catch a cold from the blown air to her).
But... the CPAP itself was a bit noisy too. With A-Flex enabled at 3, it was (sometimes) difficult for me to exhale, and it kept giving me the impression that I had to follow its operation and keep on breathing according to its function. This was pretty uncofortable to me!... Also, I didn't like the fact I was able to listen to its turbine changing reving speed from high to low and vice versa.
Above all, it was almost 25-30% more expensive (7+ years older) than the CPAP I finally chose, at the same configuration, plus I had to make my decision upon buying (or not) from the beginning the humidifier and the heated hose, since I needed another PSU for them. The standard PSU was 60VA and if I was going for the humidifier and the heated hose later I needed to buy a new PSU at 80VA, at an extra cost...

Last but not least, I learnt that this CPAP was an "old" model, so I asked about the availability of parts in case a service is needed and the answer was not conviencing at all: "We're oblidged to have parts for 4-5 years, but we do not really know their availability, since the machine is not really new. But of course, you can select DreamStation instead of 60 Series if you like. It's our brand new model!..." 

It was then, when I decided to take a second test using Weinmann / Löwenstein Prisma 20A Auto CPAP this time. When I learnt about Weinmann / Löwenstein being manufacturer of medical equipment, I thought I should give it a try!... I've been using for several years various appliances "Made in Germany" (washing machines, refrigirators, home and laboratory electrical appliances and... cars): all of them prooved to be very well built, with very few faults and lasted for many-many years of ( sometimes very demanding) operation.

The difference with PR was "day and night" to me: extremelly quiet operation, extremelly easy on my exhale, I'm feeling very comfortable breathing even at high pressures around 10-13 cm H2O, completelly silent turbine operation PLUS it is "Made in Germany" which was a kind of warranty to me, based on my previous experience as a consumer.

The whole machine looks and feels very well built, solid and is very easy to use (user friendly I would say), having zero mechanical controls, but only a big touch screen. I also like very much its expandability with features like add-on cards for medical use. This feature - in my opinion - indicates the high technological level of this CPAP.

The algorithms it is employing are very well acceptable by me, giving me excellent comfort of use and at the same time, working very well with my apnea issues, reducing my AHI 27/h (as shown in my night sleep study) down to 4 for the last 3 weeks I've been using it. I also like very much the quick information is giving me each morning I wake up and finish my therapy. I feel it gives me all the info I need to know for the night passed, which is - to me - except from informative also: motivating.

I strongly believe that this "interractive" relationship, through the data collected and presented to the patient, I become a better, more "involved" with my apnea issues and willing to make an effort for getting even more "compliant" to my therapy.
Weinmann / Löwenstein Prisma 20A Auto CPAP has 2 tools towards this goal: a very informative - at a glance - on screen summary of each night's treatment and the very well built, easy to use and powerfull in analysis Weinmann / Löwenstein prismaTS software which in my opinion should be accompanying this great CPAP, at least for users like us - in this forum - who are willing to monitor and learn more and more about our health status. There should be no obligation on behalf of the company to any of us, but they should give us the chance to use this great software, on our-own basis. Perhaps Weinmann / Löwenstein should give a second thought on this issue. Afterall, this would be a breakthrough in the CPAP market!

The Weinmann / Löwenstein Seller assured me that they have a contract for a 10-years availability of parts in case Prisma 20A Auto CPAP needs a service (provided by them) and a 2-year Warranty for complete device replacement in case of serious problem.
The complete configuration (CPAP, humidifier, thermal hose, mask) had a cost of 25-30% lower than the PR 60 Series, 50% less than PR DreamStation (of the same configuration) plus it's a new model, awarded in 2015 by the Red Dot Award as a Winner for Interface Design.

Using the ResMed Mirage FX nasal mask in the first 3-4 days of my trial with this CPAP did not go so well. The mask was leaking air, it was pushing my nose and I couldn't stand it. I even woke up a couple of night!... As soon as it was replaced by F&P Eson, the Weinmann / Löwenstein Prisma 20A Auto CPAP prooved all its virtues to me and drove me to the conclusion that THIS was the perfect combination for my therapy.

So, yes, for me Weinmann / Löwenstein Prisma 20A Auto CPAP is a great set of equipment and I would highly recommend it to anyone who would like a CPAP with properties and virtues described in this review. The reason I gave it such an extensive review is because I feel that very few people - members of this great forum - are aware of this great CPAP. So I hope that by reading this review, lots of people will have the chance to get to know to a really great CPAP, an equally great choise among the other well known and massivelly used equipment in this forum.

I hope I didn't get you too tired with this review. I sure hope you enjoyed reading it and perhaps you found something that really caught your interest!...

Finally, I promise to continue this review with the full setup - with the humidifier and the heated hose, in the near future, as soon as I start using them.

Thank you very much for reading this review!...


Costas

[Costas P]

My friends,

as I've mentioned in this review, Weinmann / Löwenstein Prisma 20A Auto CPAP can be connected to some expansion modules, which are tools in the hands of medical staff, working  in sleep study clinics. These modules can be attached on the right side of the Weinmann / Löwenstein Prisma 20A Auto CPAP main body.

The first module is the prismaCONNECT.

This module is connected using the upper, custom made, connector of the CPAP, and it offers 2 outputs: one Ethernet connector which allows the CPAP to be connected to a clinic monitoring network, allowing the specialized technicians to monitor and evaluate the apnea study of each patient, connected to each CPAP, and one custom made connector, designed to connect the CPAP with another module: prismaPSG which is a digital to analog I/O device.

Left: the upper (round) custom made connector for the prismaPSG and the lower Ethernet connector.

Right: the edges allowing the correct and firm attachment of prismaCONNECT on the prisma 20A Auto CPAP.

By revealing the rubber cover of the upper connector, the prismaCONNECT...


...is attached on the side of Weinmann / Löwenstein Prisma 20A Auto CPAP.

As you can notice, there's another rubber cover, on the upper of the prismaCONNECT, along with 3 notches, allowing the attachment of another module on it.


The second device that can be attached on the prismaCONNECT module is: prismaPSG.

This module is used to convert digital signals from the Prisma 20A Auto CPAP into analog data. The analog signals at
the output of the prismaCONNECT module can be transferred to prismaPSG via the corresponding cables. There are 8 analog channels available for lab use.

The prismaPSG module is used by specialist personnel in sleep clinics for diagnosis and titration purposes.

The 8 analog channels are used for: Respiratory flow, Leak flow, Degree of obstruction, Setpoint pressure, Actual pressure, Respiratory minute volume (RMV), Tidal volume and Respiratory frequency signals.


Costas

[DOOM_NX]

Hey Costas!

Great work you did there with the review! The Prisma looks a lot more advanced than the SOMNObalance I tried 3.5y ago. It looks like it includes every function of the S9 AutoSet and then some. The backlit LCD touchscreen is a huge improvement already! I really like that you can easily choose your mask fit pressure, the double filter design and the alarm that can go off at very high leak rate!

If only we could get our hands on the Weinmann software to read the high res data...

[Costas P]

Hi DOOM_NX !...



Thank you very much for your comments on my review!... I simply tried to present this CPAP in the best way I could, hoping that this might help some people that could have heard of it, but could not find any user comments or reviews on it. This is the situation in which I found myself, when I was looking for information about this CPAP. Thank God I was lucky to have this CPAP for a 7-8 days trial at home, before I finally make my decision.

I'm still hoping that Weinmann will make a decision and allow us have this great software prismaTS. This way we'll  be able to explore all the detailed data collected from this CPAP, about our apnea therapy.


Costas

[Kadenz]

Hello Costa, just read your great review in-depth review of this machine. Many thanks.

Just one question: how did the algorithm compare with the PR System One Auto that you also tried? Was your AHI lower, higher or about the same?

Kadenz