CPAP Machine Choices - from a patient’s perspective Don't let a Durable Medical Equipment $upplier (DME) bamboozle you. Never accept or settle for what we nickname a dumb "brick" CPAP machine (one that is not fully data-capable). If you get a good, data-capable CPAP machine - you and your doctor will be greatly empowered to monitor the effectiveness of your treatment on an ongoing basis. You can also use free software -Sleephead for your personal computer to monitor and chart your progress - as long as you have a data-capable machine.
Good vs. Bad Machines - Don't Get Taken Good CPAP machines will record every breath taken during the night and attempt to detect apneas and tell the patient treatment is working. Unfortunately, many manufacturers still make "brick" CPAP machines that only record the total hours of use on the machine, but don't record data on how therapy is working. Having data can allow the patient and doctor to understand problems and target those problems with changes in therapy pressure or even show the need for a different type of machine. Data avoids the need for repeat sleep studies to diagnose and treat problems, and to fine-tune CPAP or bilevel (BPAP) therapy.
Many DME's (Durable Medical Equipment supplier / CPAP salesmen) will try to sell patients a "brick" CPAP because they make a higher profit with that type of machine. Patients should not unconditionally trust a DME. Many will claim a brick does record data when in fact it only records "compliance" data, i.e. the time you use it. Don't blindly trust a doctor to make sure the right machine is prescribed, either. Many doctors are simply uninformed about modern CPAP machines and some put too much faith in the DME. Although not comprehensive, this article contains a general consensus on which machines to favor and which machines to avoid.
Remember that even a "dataless" CPAP machine is a marvelous, life-saving device. However, a fully data-capable CPAP machine is a much more useful device that will provide far better therapy for most patients.
With the Philips recall, top-tier CPAP machines are in short supply, and retail prices have nearly doubled. In response to that, suppliers are pushing much less expensive Chinese-manufactured CPAP machines by Resvent (iBreeze) and BMC (Luna) out the door and into the hands of unwitting consumers. Be wise when you’re about to make a decision.
My DME Dispensed a Used CPAP Unfortunately, there are many examples of used CPAP machines dispensed to patients initially or as replacement devices. This has been the case with both private insurance and Medicare. In most cases where the recipient identifies the machine as used before accepting delivery, and refuses delivery, the machine is replaced with a new one. In most situations, someone who complains about a used machine prior to delivery will be given a new machine. Relatively few patients are either aware or knowledgeable about this issue and how to deal with it, and it is very difficult to leverage a return once the machine is accepted and used. Buying a used or reconditioned machine is a smart way to save money.
Makes and Models Although there are many CPAP manufacturers, the CPAP market is dominated by two players: ResMed and Philips Respironics. These companies make some excellent machines as well as a few to be avoided. Their research and development seem to be well in advance of other makers. There are a number of second-string manufacturers including Fisher & Paykel, DeVilbiss, Puritan Bennett, and Weinmann. While these companies make good machines they are not as widely known and in some cases, support software is either not available or not very useful. Newly arriving on the market is a range of Chinese machines such as Apex, BMC, Luna, and others. While they may be excellent machines, apnea community support is lacking and software support may not exist. Patients should be careful - it's easy to be confused by the names of the machines. For example, a ResMed S9 Escape Auto is a totally different machine from an S9 AutoSet. A BMC RESmart is not the same as a ResMed. Note also that many machines have different names and model numbers in different countries. Patients should be absolutely certain about the exact model they want, and it's wise to double-check the Apnea Board forum if there are any questions.
Software To get the best possible results from a CPAP machine it's necessary to see in detail what's happening during sleep. Most major manufacturers have simple web-based software that provides some basic data, such as the hours used and AHI. Examples are ResMed MyAir and Philips Respironics DreamMapper. Much more detailed data can be viewed using the manufacturer's professional software (eg ResMed's ResScan and Philips' Encore). Generally speaking, these professional software packages are complex and difficult to use. SleepyHead ResScan https://document.resmed.com/en-us/secure/software/resscan/installation_packages/31302_ResScan_7.0.zip
Recommended Models The following is a list of recommended and non-recommended machines created by experienced patients. In general, autosetting machines with full data capability are recommended, while fixed pressure CPAPs with full data are considered acceptable and machines with limited or no data capability are not recommended. Note that many machines are sold worldwide and may be called by different names in different markets. The model numbers will likely also be different for the same machine sold in different countries.
Philips Respironics DreamStation Series The DreamStation was introduced in 2015 and replaced the System One series. Notice: All Philips-Respironics DreamStation machines are under a safety-related recall notice (not the DreamStation 2 models).
Recommended (Full data capability and automatic pressure)
DreamStation Auto (DSx500)
DreamStation BiPAP Pro (DSx600)
DreamStation BiPAP Auto (DSx700)
DreamStation BiPAP AutoSV (DSx900)
DreamStation BiPAP S/T (DSx1030)
Acceptable (Full data capability and fixed pressure)
DreamStation CPAP Pro (DSx400)
Not recommended (Compliance-only data capability)
DreamStation CPAP (DSx200)
DreamStation 2 (All Models) (Encrypted Detailed Data not accessible to the user)
Philips Respironics System One (PRS1) 50 and 60 Series Notice: All Philips-Respironics System One machines are under a safety-related recall notice.
Recommended (Full data capability and automatic pressure)
Auto CPAP (DS550 DS560)
BiPAP Pro (DS650, DS660)
BiPAP Auto (DS750, DS760)
BiPAP Auto SV (DS950, DS960)
BiPAP ST (DS1050, DS1060)
Acceptable (Full data capability and fixed pressure)
CPAP Pro (DS450, DS460) (Fixed pressure)
Not recommended (Limited or no data capability)
CPAP Plus (DS250, DS260) (Fixed pressure "brick")
Note: All of the above machines also use the trade name REMstar, including legacy machines such as the M-Series and earlier models.
Resmed Airsense 11
Airsense 11 Autoset - Early support: Time zones and C/F conversion not yet implemented
(Elite model has not yet been tested)
ResMed Airsense 10 and Aircurve 10
Recommended (Full data capability and automatic pressure)
Airsense 10 Autoset and AutoSet for Her
Aircurve 10 S (Lumis 100 VPAP S)
Aircurve 10 ST (Lumis 150 VPAP ST)
Aircurve 10 ST-A (Lumis 150 VPAP ST-A)
Aircurve 10 VAuto
Aircurve 10 ASV (PaceWave CS)
Acceptable (Full data capability and fixed pressure)
Airsense 10 Elite
Not recommended (Limited or no data capability)
AirStart (all models)
Airsense 10 CPAP
AirMini
ResMed S9 Series
Recommended (Full data capability and automatic pressure)
Autoset and Autoset for Her
VPAP S
VPAP Auto
VPAP ST
VPAP Adapt (AutoSet CS)
VPAP ST-A iVAPS
Acceptable (Full data capability and fixed pressure)
Elite
Not recommended (Limited or no data capability)
CPAP SE (Limited or no detailed data)
Escape CPAP (Limited or no detailed data)
Escape Auto (Limited or no detailed data)
ResMed S8 and earlier series
These machines are obsolete
DeVilbiss
Acceptable
DV54 Auto Note: does not provide the very important Flow Rate chart
DV64 CPAP
DV64 Auto
Fisher & Paykel
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Lowenstein / Weinmann
Prisma series including CPAP, APAP, bilevel and ASV.
ResMed vs Phillips Respironics AutoSet is a much more capable machine. The following outlines their comparison of ResMed vs. Philips-Respironics auto-CPAP machines: Why ResMed?
Faster algorithmic response to events than PR.
ResMed Responds to Flow Limits and PR responds to Snores
Lower average pressure (PR requires a higher pressure to ward off obstructive events).
Better to avoid Aerophagia.
Flex is not the same as EPR.
EPR provides for better treatment of hypopneas, RERAs, Flow Limits, UARS, and snores
EPR acts like a BiLevel up to a limit of 3cmw (1,2, or 3cmw) and a max pressure of 20 cmw. Phillips Respironics does not do this.
EPR follows your breathing whereas Flex predicts it with a feeling of fighting to get a breath when it predicts incorrectly.
More flexibility in treating a greater variety of Apneas and respiratory events.
In general ResMed provides better therapy.
THE ABOVE INFORMATION SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED IS PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.