Advice re purchasing a new CPAP machine..models and foam...

[cate1898]

So I just found out this weekend that I've qualified for a new machine after just over 8 years on my Airsense 10 elite.  Not sure what all my choices will be but I seem to remember the nurse mentioning Airsense 10 and 11 and alluded to other makes/models to choose from.  I have NO insurance, so based on whatever the Ontario government currently pays, she mentioned I will probably have to pay out of pocket between $300 to $900 ++ depending on which machine I choose.

Now having had 2x Philips "Foam Recalled machines"-a DS Go and a PR1-560 (the latter of which has yet to be remediated)I probably for financial reasons may choose either an Airsense 10 or possibly if it's an option, a Dreamstation 1.  I just want to make sure that they wouldn't/couldn't sell me a machine with the foam problem, namely concerned if I choose a Dreamstation 1.  Is there any reason to worry about this?  

I have seen a number of YT videos discussing the Airsense 11 and it's host of issues from louder noise than the A10 to problems removing and filling the water chamber for way more money, so not going to choose the Airsense 11, not to mention it's one of the machines that will cost me $900++ to do so.  

Also she mentioned CPAP machines don't have SD cards anymore and that all data is done automatically???  What's this?  Do I still have the option of sticking an SD card in to look at Oscar should I wish to?

Any helpful advice or thoughts about this?  Thanks in advance,

Cate

[PeaceLoveAndPizza]

My opinion in preferred order…

1. ResMed AirCurve 10 Vauto
2. ResMed Airsense 10 Autoset
3. ResMed AirCurve 11 Vauto
4. ResMed AirSense 11 Autoset

Nothing from Philips. Fisher and Paykel machines are very good, but we have more experience with ResMed.

The Vauto will act as a bilevel APAP, static bilevel (S mode), or CPAP. It should serve well for many years.

The 10 series is the workhorse of the ResMed stables. The 11 is the new entry which should be fine, but reports are it is a bit nosier than the 10.

[chronic]

My advice, suggestion really. Resmed airsense 10 auto. Make sure it uses an sd card, they do and do a lot more research.

[Deborah K.]

If you will post a recent Oscar chart we will be able to tell you whether you need a ResMed AirSense 10 AutoSet or a ResMed AirCurve 10 Vauto, especially since you will be paying out of pocket.  If money is no issue I would get the Vauto, but if it is, it's worth learning if you need it.

On the card-to-cloud issue, my understanding is that you can use Oscar with either type of machine and that the card-to-cloud is generally cheaper.

[Sleeprider]

Hi Cate. Welcome back. The Resmed Airsense 10 and 11 machines all have SD card capability, and while you're familiar with the Airsense 10 Elite, the 10 or 11 series Autosets are both great devices. I don't think the 11 is known for significantly more noise, although it has a smaller format and motor, it is well made and should provide a familiar pressure response. Certainly better than the Philips machines. I would not worry too much about the details. If your out of pocket costs are correct, I would suggest looking at some of the U.S. suppliers and inquiring about the Airsense 10 Autoset which are selling for as little as $499 USD. Even accounting for shipping and customs, you might find a deal.

[juniper]

I agree with sleeprider. If you like the 10, there's no sense in paying extra for the 11. Personally, I have an 11 that my insurance picked out for me, and think it's fine.

[Phaleronic]

The remediated DS1s are just fine and actually I prefer them over the resmed offerings (I've used both brands)-if I had to go with Resmed I'd choose the S10 though.

[cate1898]

Thanks for all the replies. My appt with my DME is this morning so I have no time to post Oscar info. Based on past info, my original sleep Doc (now retired) said I didn't even qualify for an auto machine. I'm hoping they have phased out the CPAP and Elite versions by now as looking at some online retailers it appears that there are mostly auto machines out there. It's crazy knowing it's just a software thing and that the machines are in essence the exact same machines hardware-wise.

I also saw some YT's of a well-known Aussie fellow who posts CPAP reviews and he talked about the replacement foam that went into the remediated machines (aka my Dreamstation Go which I paid a ton for out of pocket) were 'fixed' by subbing in some sort of silicone which apparently is off-gassing formaldehyde when the machines heat up. Sounds like I'll be staying well away from Philips. (just have to decide to do with my $1200 DSG remediated brick)

So based on your responses, and watching a bunch of YT reviews of lots of different machines, it looks like I may very well go with the Airsense 10 once again and hope they allow me to purchase an auto (our rules/laws here in Ontario are truly crazy - back in 2015 I was not ALLOWED to pay to purchase an auto machine unless paying the whole thing out of pocket. If I wanted the Ontario govt subsidy of about $1000, I was forced to buy a straight CPAP machine and so opted for the S10 Elite which at least allowed me to insert an SD card and see my results.)

Thanks everyone for taking the time to give me your insight!

[cate1898]

I've also been looking at other manufacturers that are maybe not as common here in North America. Not sure if I will have these as possible options for me.

Thoughts on F & P Icon vs Sleepstyle, and I've heard great things about the Lowenstein 20A machines.

I have my new machine consult in about 3 hours if anyone has the time and knowledge about these machines...would really appreciate hearing!

[WisNaeMe]

Might be a bit late, but hopefully you've got a bit of time still to decide.

I would follow the herd and purchase a ResMed - there is much more support available here on Apnea Board and elsewhere for their machines - there’s safety in numbers! Buying one of the more exotic brands offers that much less support from both fellow pappers and the medical profession …and could be pricier! Prioritise getting the support you need, over the bells and whistles of a PAP machine fashion parade.

Should you go ResMed, then the AirCurve, would offer you a bit more flex and headroom over the AirSense, should it emerge that you have slightly more complex apnea management needs (e.g. needing more Pressure Support).

ResMed machines are more widely supported regards third-party integration / development (e.g. apps for phones, apps OSCAR or SleepHQ, oximetry, etc..). People design for them, knowing the size of installed user base.

In IT procurement circles there is the adage - Market Share wins out - ALWAYS! That the smaller (or even not so small) companies, disappear or become quite niche (see …rise of Microsoft). This Seems to be happening in PAP World too, with a number of well-known manufacturers pulling out of the marketplace this year.

I would look to purchase from the US. I did this a couple of weeks ago. Imported a new AirCurve 10 Vauto into UK - total cost incl. shipping 810 GBP (1,393 CAD) - plus 110 GBP duty/tax (reclaimable). Painless process, very fast deliver and no prescription required outside US. Supplier was CPAP Specials. I’ve noticed their prices have increased a fair bit since I got mine, but the pricing differences between both AirSense/AirCurve and 10/11 models, seems negligible …and given the life of a machine, it may be worth paying the premium to get the flexibility of the bi-level version. They currently list AirSense 10 (new!) at around 1,265 CAD.

Machine was described to me as Card-to-Cloud, though it actually appears to have a modem and picks up ResMed’s wireless carrier in UK. Don’t really need this function so not looked too closely at it - think it might be a case of persuading ResMed to allow machine to be registered in different market area (Americas vs Europe).

Note: I was formerly a Lowenstein PrismaSmart user (bought due to limited machine choice - chip shortages, Covid and Philips Foamgate. In hindsight, getting a ResMed AirSense 10 would have go me sorted out quicker!