What would be the best machine to purchase

[sleepy1235]

What would the best machine be to purchase. I don't mind spending the money.

Also, I want access to the data. This is a critical must have. 

I am retiring. I have the money to purchase the best machine. I have seen what machines Medicare pays for, which is a brick without data capability. Or at least that is what one friend got.

[SarcasticDave94]

I was just about to post the same question. I won't at this time as it could be redundant enough. I'm currently on the Respironics DreamStation Auto BiPAP and the FFM by Respironics, Amara View. I've only been on the DreamStation for 1 week of the insurance rental BTW. I think the mask has been great, and not really looking to changing that choice. And I know I'm needing to post my Sleepyhead info for the gurus to give feedback, which I'll do today in my own post. I'm wondering though, if I had the choice, would the ResMed 10's brand be better? As I recall elsewhere on the board, Sleeprider said the ResMed was better in some ways than the DreamStation, again as I sort of remember what I'd read. Unfortunate for me, I can't find that thread again right now. I do know Respironics and ResMed are the choices you want to focus on, by the way.

[OpalRose]

sleepy and Sarcastic,

Since you are both asking pretty much the same question, here is a link that will help you in machine choice and which ones to avoid.

http://www.apneaboard.com/wiki/index.php...ne_Choices

This article does need to be updated a bit, but you can get a general feel.
#SleepyHead works with both the new DreamStation and ResMed Airsense machines.

Yes, the top two brands are ResMed and Respironics.
As far as one brand being better than the other, well you will find that to be personal preference.

ResMed's algorithm reacts faster to apnea events (will raise pressure faster) in response to events.  
ResMed's newer auto airsense machines have the cpap, auto, and soft mode.  The soft mode is the same as in the Airsense for Her cpap.

Respironics algorithm is slower to react, but this is managed by the proper pressure settings.

[SarcasticDave94]

Thanks OpalRose. I did read the device thread earlier, so I'm certain on my brand choices and that my current DreamStation is a good choice. I'm just considering whether the ResMed may be better yet.

On ResMed, can any shed light on AirSense vs AirCurve? (I'm searching my own answer as well.) Thumbnail sketch is fine.

Algorithm was the word I was looking for. Personal preference aside, will that faster responding algorithm make the ResMed the better choice for therapy results? I'm just wanting the best BiPAP I can get. And it's not that I don't like the DreamStation, I'm just wondering if the ResMed will be an even better choice for results. Note that I'm also a COPD in a relatively early stage according to my primary care doc FWIW.

[SarcasticDave94]

So, I think I answered one of my own questions. The ResMed AirCurve is the bilevel model versus the AirSense is not. It looks to me also that it is going to be a current DreamStation Auto BiPap vs ResMed AirCurve 10 VAuto decision. Hmm...

[OpalRose]

There are many here that prefer the ResMed AirCurve VAuto.  
You may want to start a new thread with those two machines in the thread title to attract folk that use these machines to get a better perspective of what is right for you.

[SarcasticDave94]

OK I'll follow up on that. Thanks

[Sleeprider]

Aircurve Vauto vs auto BiPAP is one of the closest contests out there, and reasons for choosing either one are valid.  

Philips Respironics Dreamstation auto BiPAP is distinguished by having variable pressure support with automatic algorithms that can optimize results for RERA and hypopnea treatment.  With Philips you set an EPAP min, PS min, PS max and IPAP max. This machine also records RERA and periodic breathing not included on the Resmed.  Philips machines can sometimes seem slightly out of sync with breathing, and I resolved that with a longer Ti setting of 2.3. The Philips algorithm constantly tests higher EPAP pressure of 1.5 cm increase over a 90 second period every 20 minutes. This is not obtrusive, but gives the IPAP pressure wave-form the characteristic sawtooth pattern 

Resmed Aircurve 10 Vauto uses fixed pressure support, so EPAP and IPAP always move together.  This is identical to performance of the Airsense 10 Auto CPAP when set to 3-cm pressure support.  Note, unless you use more the PS 3, there is virtually no difference in this machine from the auto CPAP except it does not record RERA and periodic breathing.  Resmed is very good at changing between IPAP and EPAP very smoothly, following the lead of the user.  I have never felt the machine was controlling the breathing rate or volume. Resmed Vauto is faster to increase pressure in response to obstructive cues, the same as it's auto-CPAP cousin. This won't matter if you use an optimized pressure that resolves most obstructive events.

To see a comparison of how these machines perform on Sleepyhead could require more graphs than I have available, but here are a couple of mine from a PRS1 auto BiPAP and Aircurve 10 below.  Note, I keep EPAP relatively high and there is not a lot of pressure change through the night.  Someone with more hypopnea, and pressure support range would definitely benfit from the Philips algorithm, while pure obstructive and limited CA would find the steady pressure and very comfortable "following" of the Resmed nice.   The bottom line is, there is no wrong choice, and no best choice.  These are both fine machines that can help you to dial in very comfortable and effective therapy.  In the examples below, the Philips is at a PS range of 4-9 which I have reduced in the Resmed. The most notable effect was a drop in tidal volume and CA. So here you go:

Philips:



Resmed:

[SarcasticDave94]

Nice info and thanks. I think I have enough enemies that I don't want to add more to it. I'll work with the DreamStation that was issued unless it's discovered that it's not what will help my specific needs. Then I'll deal with it if that is what it becomes.

[SarcasticDave94]

How would the possibility of higher central apnea be addressed? I'm seeing it listed also as severe in my sleep report.