RE: Newbie from Greece
just a word of warning if you decide against the prisma and choose a ResMed-Device:
take the FOR HER! - in the european firmware for the resmeds only the for her can track RERAs and has the For Her Mode (the For Her has everything the "normal" Autoset has PLUS the For-Her-Mode AND the RERA-scoring)
ETA for SH to be able to read the Prisma-Line is .... well ... don't get your hopes up - summer looks like an overestimation (might get cold again outside before that really happens^^)
maybe they are more "forthcoming" if you explain to them that a machine whithout the software is absolutely no option for you! (you might want to emphasize that you don't want any support for the software from them - other than a woking initial installation and maybe a way of reinstalling (at their office!?) it in case you change your computer / it melts down or whatever^^)
I really can understand, that the manufacturers are not that keen to give the software away, because they don't want ganny and grandpa calling them and asking about the computer-troubles they experience^^ (and of course they believe it only comes from that very software - 99% of all pc-related problems are sitting in front of the screen^^[period])
----
For what it's worth I give you my few cents anyway:
I'm not that long into CPAP (a little over half a year). I'm totally biased towards Heinen + Löwenstein / Weinmann as I do have the SomnoBalance (different line from H+L - let's call it the "little brother"). I never had the chance to try a different machine and I do love mine^^ (I would take the prisma at first chance^^)
I do believe that I have some pretty extensive knowledge about my machine and the way it reacts or regulates. (and for that matter how the H+L-Algorithms "function")
so, please keep that in mind regarding the following:
The Prisma 20A seems to be pretty awesome.
One main-disadvantage compared to the ResMed is: the climate-tube has no "auto-control" ... you can change the temperature by hand, but (If I remember correctly) there is no such thing as "automatic".
compared to resmed the algorithms to respond to events are totally different. Resmed mainly reacts to flowlimitations. H+L reacts to obstructions - and to be precise: they react to the "epochs". (in the graphs you showed us the "obstruction-graph" is the closest thing H+L has to offer compared to the "flowlimitations" on resmed)
Resmed raises the pressure pretty fast on flowlimitations - H+L reacts just a bit to epochs of flowlimitation (and mainly just to the first - not to each and every epoch^^).
H+L reacts in about the same speed and range to obstructive epochs as resmed does to flowlimitations.
(so speaking in terms of plain AHI the resmed-devices would produce a (slightly) lower AHI ... if your device is fine-tuned very well you will not really get a difference!)
H+L reduces the pressure slower than resmed does (after the events are over).
the softPAP is comparable to the resmed - but not the same - softpap gets deactivated during (some) events. (+ H+L has the inhalation assistance where it raises the IPAP 1cmH20 and lowers the EPAP 2cmH20 - giving you a "PS" of about 3cmH20)
H+L does make a difference between Hypopneas - H+L knows obstructive and "central" Hypopneas. (resmed only knows hypopnea and they don't score a length for that - for RERAs resmed does not score a length as well)
Besides that H+L does score "artefacts". They say that's a falsification of the signals - like when you cough, speak, change your position. (I totally love the artefacts^^)
for scoring RERAs they are very ambitious
... if you look closely enough some of them turn out to be just artefacts. (but that is a good thing and with that the algorithm leans a bit more towards resmed's behavior)
if you are in the lower pressure range (with your 7 you should be above that range) the H+L devices tend to misinterpret obstructive events as centrals (only in the lower pressure-range of the device!). I don't want to say that H+L is worse than resmed or resmed is better, as resmed reacts mainly to flowlimitations and with that they don't really get to that very situation. In the end they both might be or are equally bad or good in detecting centrals.
It's really no big deal - if you notice central-events while on the lower pressure end just raise the pressure and see if they vanish (or become obstructive ones) (if you are really interested on that matter you can read up here: http://www.apneaboard.com/forums/Thread-...ssifies-it )
In terms of "interpreting" the data:
H+L scores epochs. Straight from their manuals: (this is taken from Weinmann-Support - the software which came before PrismaTS and the prisma-series)
This makes it very easy to identify the "interesting" parts in your data. (if there is no epoch scored it is uninteresting^^)
-----
I'm only telling you this because I have never read a first-hand direct comparison between the Prisma and Resmed-devices. Overall I don't read that much at all from Prisma-Users. (I come from germany where H+L comes from as well - so I know the german board^^)
[to be completely honest in germany there is some talk against the prisma - but that comes from people who had a resmed-device and are now about to get a H+L-device ... we have a completely different health-insurance system - we cannot really choose what machine we get - so that does not say anything about resmed or H+L]
If we are honest this can have 2 reasons: 1st Prisma works very well ... noone has a problem with it - or (more likely in my eyes)
2nd: noone has access to PrismaTS and therefore doesn't know how they are doing or what to do^^
As mentioned before my own experience comes mainly from the SomnoBalance (same manufacturer - the line that came before the prisma. the somnoBalance is not the "old version" - it still gets manufactured and is up-to-date and totally comparable to the resmed-devices! if we take the comparison from SleepRider (I hope I got you right this time) think of them as the mercedes and the VW^^)
All I said comes from looking at the data from other people and generalizing from my SomnoBalance (but I have looked at the data from quite some Prisma-Users. So in my not so humble opinion I think I can say the aforementioned.)
take the FOR HER! - in the european firmware for the resmeds only the for her can track RERAs and has the For Her Mode (the For Her has everything the "normal" Autoset has PLUS the For-Her-Mode AND the RERA-scoring)
ETA for SH to be able to read the Prisma-Line is .... well ... don't get your hopes up - summer looks like an overestimation (might get cold again outside before that really happens^^)
maybe they are more "forthcoming" if you explain to them that a machine whithout the software is absolutely no option for you! (you might want to emphasize that you don't want any support for the software from them - other than a woking initial installation and maybe a way of reinstalling (at their office!?) it in case you change your computer / it melts down or whatever^^)
I really can understand, that the manufacturers are not that keen to give the software away, because they don't want ganny and grandpa calling them and asking about the computer-troubles they experience^^ (and of course they believe it only comes from that very software - 99% of all pc-related problems are sitting in front of the screen^^[period])
----
For what it's worth I give you my few cents anyway:
I'm not that long into CPAP (a little over half a year). I'm totally biased towards Heinen + Löwenstein / Weinmann as I do have the SomnoBalance (different line from H+L - let's call it the "little brother"). I never had the chance to try a different machine and I do love mine^^ (I would take the prisma at first chance^^)
I do believe that I have some pretty extensive knowledge about my machine and the way it reacts or regulates. (and for that matter how the H+L-Algorithms "function")
so, please keep that in mind regarding the following:
The Prisma 20A seems to be pretty awesome.
One main-disadvantage compared to the ResMed is: the climate-tube has no "auto-control" ... you can change the temperature by hand, but (If I remember correctly) there is no such thing as "automatic".
compared to resmed the algorithms to respond to events are totally different. Resmed mainly reacts to flowlimitations. H+L reacts to obstructions - and to be precise: they react to the "epochs". (in the graphs you showed us the "obstruction-graph" is the closest thing H+L has to offer compared to the "flowlimitations" on resmed)
Resmed raises the pressure pretty fast on flowlimitations - H+L reacts just a bit to epochs of flowlimitation (and mainly just to the first - not to each and every epoch^^).
H+L reacts in about the same speed and range to obstructive epochs as resmed does to flowlimitations.
(so speaking in terms of plain AHI the resmed-devices would produce a (slightly) lower AHI ... if your device is fine-tuned very well you will not really get a difference!)
H+L reduces the pressure slower than resmed does (after the events are over).
the softPAP is comparable to the resmed - but not the same - softpap gets deactivated during (some) events. (+ H+L has the inhalation assistance where it raises the IPAP 1cmH20 and lowers the EPAP 2cmH20 - giving you a "PS" of about 3cmH20)
H+L does make a difference between Hypopneas - H+L knows obstructive and "central" Hypopneas. (resmed only knows hypopnea and they don't score a length for that - for RERAs resmed does not score a length as well)
Besides that H+L does score "artefacts". They say that's a falsification of the signals - like when you cough, speak, change your position. (I totally love the artefacts^^)
for scoring RERAs they are very ambitious
... if you look closely enough some of them turn out to be just artefacts. (but that is a good thing and with that the algorithm leans a bit more towards resmed's behavior)if you are in the lower pressure range (with your 7 you should be above that range) the H+L devices tend to misinterpret obstructive events as centrals (only in the lower pressure-range of the device!). I don't want to say that H+L is worse than resmed or resmed is better, as resmed reacts mainly to flowlimitations and with that they don't really get to that very situation. In the end they both might be or are equally bad or good in detecting centrals.
It's really no big deal - if you notice central-events while on the lower pressure end just raise the pressure and see if they vanish (or become obstructive ones) (if you are really interested on that matter you can read up here: http://www.apneaboard.com/forums/Thread-...ssifies-it )
In terms of "interpreting" the data:
H+L scores epochs. Straight from their manuals: (this is taken from Weinmann-Support - the software which came before PrismaTS and the prisma-series)
Quote:Epoch
An epoch is a period lasting approx. 2 minutes. Within this epoch, the therapy device collects obstructive events and evaluates them. Depending on the degree of severity of the obstructions found, an epoch is classified as an
- epoch with severe obstructions
- epoch with mild obstructions
- epoch with flow limitations
- epoch with snoring
An epoch event is saved if the mean value of the event index during the epoch is greater than its threshold value or if oH, oA or RERA occur. The events threshold value is pressure-dependent.
This makes it very easy to identify the "interesting" parts in your data. (if there is no epoch scored it is uninteresting^^)
-----
I'm only telling you this because I have never read a first-hand direct comparison between the Prisma and Resmed-devices. Overall I don't read that much at all from Prisma-Users. (I come from germany where H+L comes from as well - so I know the german board^^)
[to be completely honest in germany there is some talk against the prisma - but that comes from people who had a resmed-device and are now about to get a H+L-device ... we have a completely different health-insurance system - we cannot really choose what machine we get - so that does not say anything about resmed or H+L]
If we are honest this can have 2 reasons: 1st Prisma works very well ... noone has a problem with it - or (more likely in my eyes)
2nd: noone has access to PrismaTS and therefore doesn't know how they are doing or what to do^^
As mentioned before my own experience comes mainly from the SomnoBalance (same manufacturer - the line that came before the prisma. the somnoBalance is not the "old version" - it still gets manufactured and is up-to-date and totally comparable to the resmed-devices! if we take the comparison from SleepRider (I hope I got you right this time) think of them as the mercedes and the VW^^)
All I said comes from looking at the data from other people and generalizing from my SomnoBalance (but I have looked at the data from quite some Prisma-Users. So in my not so humble opinion I think I can say the aforementioned.)
again!![[Image: A6Vx1Jt.jpg]](http://i.imgur.com/A6Vx1Jt.jpg)
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![[Image: sYjR6TB.jpg]](http://i.imgur.com/sYjR6TB.jpg)
![[Image: Sadi1ko.jpg]](http://i.imgur.com/Sadi1ko.jpg)
![[Image: KNsMt87.jpg]](http://i.imgur.com/KNsMt87.jpg)
