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[Equipment] S9 VPAP Auto
#1
Need help, just received S9 VPAP Auto. I might not be understanding the ability of machine. I had a Respironics BiPap the machine when starts treatment is at a 4EPAP and 7IPAP, it adjust through the night as example I woke and checked machine it was at 7.5 EPAP and 9.5 IPAP. I wanted to try my new S9 VPAP Auto but when I put mask on it started at 4 EPAP and was going to a 14 IPAP very uncomfortable i had to take it off and set up my old Respironics machine.

I was told the S9 works just like the Respironics but why does it start at my max "14" IPAP and not adjust as needed through the night? Dont-know

Please help I have spent 2 months fighting with insurance company to get me new machine Respironics machine Hum. does not work turns off on its own just long nights of not nowing and getting desperate. I saw on the board some one saying you have to be your own advicate I now realize i have to take control and stop depending on the thearipst and insurance companies.
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#2
I have an S8 VPAP Auto and when I tried it in auto mode it felt like it was starting at min then max pressure but with my full face mask I can not get my glasses on in order to read read the display. I was using it with the "settle" (similar to the ramp feature but I think it goes the other direction) turned on. After a short while the machine would decrease the pressure to attain some goal. Then it would raise and lower pressure per its programming. My S8 is not exactly the same as the S9 (in fact I wish I had an S9) but you might want to check if the "settle" is turned on and, if so, turn it off.

Just some thoughts.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#3
Thank you for the suggestion, this has been a nightmare I had to fight for the S9 after using the Respironics BiPap that did not work for a year. I finally argued with my Dr. and Insurance company telling them they both knowingly are putting me in danger, letters were written and after months of stalling the insurance company finally gave me the S9 VPAP Auto.

The Thearipist "very young Kid" new less than I did got home and this has now turned into a second nightmare how does this thing work.

What is "Settle" How do I find the setting and turn it off?
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#4
ok found the "Settle" Ramp did not realize I had already turned that off.
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#5
Ok I think I figured this out, if any body can varify I would greatly appreciate my setting are
MAX IPAP = 16
MIN EPAP = 4
PS = 10

according to another blog I think my PS is to high?

Quote from other blog;
"So, let's say your PS is set to 4. You seem to have IPAPmax set to 12.8 and EPAPmin set to 7. Your machine would begin the night at IPAP=7+4=11 cmH2O; and you EPAP at 7. It can raise pressure to IPAP=12.8 which would imply EPAP would rise to 8.8. At PS=4, your room to hunt for optimal pressure is only 1.8 cm-H2O. Not very useful for an auto machine."

My numbers at the start of the night are;
IPAP = 14 "10 + 4"
EPAP = 6 "16-14 = 2", 4+2 = 6

This is very uncomfortable I need to lower my PS to "6"
my changing the PS to "6" my numbers at the the start of the night are now;
IPAP = 10
EPAP = 10

My concern in lowering my PS to "6" is not understanding the importance of EPAP and what are the affects of lowering my PS to the therapy?

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#6
Hi SouthernCa,
WELCOME! to the forum.!
Hang in there and someone will be along to help you soon with more answers to your questions.
Best of luck to you with your CPAP therapy.
trish6hundred
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#7
(05-17-2014, 12:33 PM)SouthernCa Wrote: Ok I think I figured this out, if any body can varify I would greatly appreciate my setting are
MAX IPAP = 16
MIN EPAP = 4
PS = 10

according to another blog I think my PS is to high?
Your PS is WAY WAY to high and it explains exactly what is going on.

You say you are switching from a PR BiPAP Auto. And that may explain your confusion about how to set the PS. The Resmed VPAP and the PR BiPAP do NOT adjust the pressures in the same way.

The PR BiPAP allows the PS to vary---i.e. the PR BiPAP will adjust the EPAP and IPAP separately. The Resmed VPAP however does NOT allow the PS to vary at all: When it adjusts the pressures, it increases (or decrease) the EPAP and IPAP together so that IPAP - EAP = PS.

To make it clearer, lets look at the behavior of both machine with these same settings.

First of all if a PR System One or a Resprionics M-Series BiPAP set with
  • MAX IPAP = 16
    MIN EPAP = 4
    PS = 10
will behave as follows:

Starting EPAP = min EPAP = 4
Starting IPAP = min EPAP + 2 = 6

At any point in the night:
  • 4 <= EPAP <= 14 = max IPAP - 2
    6 <= IPAP < 16 = max IPAP
    2 <= PS <= 10 where PS = IPAP - EPAP.

The possible pressure combinations for the machine are:
  • EPAP = 4, IPAP = 6, 7, 8, 9, 10, 11, 12, 13, 14 = 4 + max PS
    EPAP = 5, IPAP = 7, 8, 9, 10, 11, 12, 13, 14, 15 = 5 + max PS
    EPAP = 6, IPAP = 8, 9, 10, 11, 12, 13, 14, 15, 16 = 6 + max PS = max IPAP
    EPAP = 7, IPAP = 9, 10, 11, 12, 13, 14, 15, 16 = max IPAP
    EPAP = 8, IPAP = 10, 11, 12, 13, 14, 15, 16 = max IPAP
    EPAP = 9, IPAP = 11, 12, 13, 14, 15, 16 = max IPAP
    EPAP = 10, IPAP = 12, 13, 14, 15, 16 = max IPAP
    EPAP = 11, IPAP = 13, 14, 15, 16 = max IPAP
    EPAP = 12, IPAP = 14, 15, 16 = max IPAP
    EPAP = 13, IPAP = 15, 16 = max IPAP
    EPAP = 14, IPAP = 16 = max IPAP
.

Now lets look at how the Resmed S9 VPAP behaves with the same set of settings. A Resmed S9 VPAP Auto set with
  • MAX IPAP = 16
    MIN EPAP = 4
    PS = 10
will behave as follows:
Starting EPAP = min EPAP = 4
Starting IPAP = min EPAP + PS = 4 + 10 = 14

At any point in the night:
  • 4 <= EPAP <= 6 = max IPAP - PS = 16 - 10
    14 <= IPAP < 16 = max IPAP
    PS = 10 where PS = IPAP - EPAP.[/quote]

    The possible pressure combinations for the machine are:
    • EPAP = 4, IPAP = 14 = 4 + PS
      EPAP = 5, IPAP = 15 = 4 + PS
      EPAP = 6, IPAP = 16 = 6 + PS = max IPAP

    As you can see, with these particular settings, your PR BiPAP has a lot more leeway in the potential pressure combinations AND it will NOT be starting you out with an extremely high IPAP.


    Quote:Quote from other blog;
    "So, let's say your PS is set to 4. You seem to have IPAPmax set to 12.8 and EPAPmin set to 7. Your machine would begin the night at IPAP=7+4=11 cmH2O; and you EPAP at 7. It can raise pressure to IPAP=12.8 which would imply EPAP would rise to 8.8. At PS=4, your room to hunt for optimal pressure is only 1.8 cm-H2O. Not very useful for an auto machine."
    The above comment applies to the S9 VPAP auto. It does NOT apply to a PR System One BiPAP Auto.

    Quote:My numbers at the start of the night are;
    IPAP = 14 "10 + 4"
    EPAP = 6 "16-14 = 2", 4+2 = 6
    This does NOT make sense. Why are you subtracting 16-14?? Why are you adding 4+2???

    On the S9 VPAP your starting IPAP = 14 because 14 = min EPAP + PS = 4 + 10. Your max EPAP = max IPAP - PS = 16 - 10 = 6.

    Quote:This is very uncomfortable I need to lower my PS to "6"
    my changing the PS to "6" my numbers at the the start of the night are now;
    IPAP = 10
    EPAP = 10
    NO.
    If min EPAP = 4, max IPAP = 16, and PS = 6 on a Resmed S9 VPAP, then:
    • Starting EPAP = min EPAP 4
      Starting IPAP = min EPAP + PS = 4 + 6 = 10
      Max EPAP = max IPAP - PS = 16 - 6 = 10
    And so the machine will always be at one of the following pressure combinations:
    • EPAP = 4, IPAP = 4+6 = 10
      EPAP = 5, IPAP = 5 + 6 = 11
      EPAP = 6, IPAP = 6 + 6 = 12
      EPAP = 7, IPAP = 7 + 6 = 13
      EPAP = 8, IPAP = 8 + 6 = 14
      EPAP = 9, IPAP = 9 + 6 = 15
      EPAP = 10, IPAP = 10 + 5 = 15

    Quote:My concern in lowering my PS to "6" is not understanding the importance of EPAP and what are the affects of lowering my PS to the therapy?
    EPAP is used to control the OAs and snoring. IPAP is used to control the Hs and flow limitations. You want your min EPAP to be (close to) the EPAP needed to control your OAs. You want the PS to be high enough so that the min IPAP is (close to) the IPAP needed to control the Hs and flow limitations. As events happen, the S9 will increase the EPAP and IPAP at the same time. This is VERY different from how the PR BiPAP does things.

    Finally you write:
    Quote:I had a Respironics BiPap the machine when starts treatment is at a 4EPAP and 7IPAP, it adjust through the night as example I woke and checked machine it was at 7.5 EPAP and 9.5 IPAP.
    It would help me help you if you can tell me the following things about your Respironics BiPAP Auto:

    1) Is the pressure being adjusted only because you are using the ramp, or is the Resprionics machine set to Auto mode? In other words, does your Respironics BiPAP adjust the pressure after the ramp period?

    2) Is the Resprionics BiPAP a Series 50 BiPAP (with a white panel around the LCD) or a Series 60 BiPAP (with a gray pannel around the LCD)?

    3) Exactly what ARE your settings on the Respironics BiPAP? Are they comfortable enough at the beginning of the night for you to get to sleep?

    4) You say that you've been using the BiPAP for a while. And it doesn't work very well for you. Can you describe what's not working and why or how you think the S9 VPAP might address the issue?
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#8
First Thank you so much for your response to my blog. I learn more from reading your blog then what was ever explain to me by so called technicians. I was so frustrated yesterday with the Technician "Young Kid who knew nothing" I walked out.

[/quote]Your PS is WAY WAY to high and it explains exactly what is going on.

So it is safe to say I should change my PS on the Resmed S9 VPAP to "6" from a "10"?
I did not change the other Settings they are as follows;
Max IPAP = 16
Min EPAP = 4
PS =6 "After I changed from 10.


[
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#9
Just FYI, I run that same machine; and you can see my PS in my details to the left.

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#10
(05-17-2014, 05:08 PM)SouthernCa Wrote: First Thank you so much for your response to my blog. I learn more from reading your blog then what was ever explain to me by so called technicians.
You're welcome!

Quote:So it is safe to say I should change my PS on the Resmed S9 VPAP to "6" from a "10"?
I did not change the other Settings they are as follows;
Max IPAP = 16
Min EPAP = 4
PS =6 "After I changed from 10.
With these settings, here's how the S9 VPAP Auto will behave:

Starting EPAP = min EPAP = 4
Starting IPAP = min EPAP + PS = 4 + 6 = 10
Max EPAP = Max IPAP - PS = 16 - 6 = 10.

Your EPAP will always satisfy 4<= EPAP <= 10
Your IPAP will always satisfy 10 <= IPAP <= 16

Possible pressure combinations are:
  • EPAP = 4, IPAP = 10
    EPAP = 5, IPAP = 11
    EPAP = 6, IPAP = 12
    EPAP = 7, IPAP = 13
    EPAP = 8, IPAP = 14
    EPAP = 9, IPAP = 15
    EPAP = 10, IPAP = 16

Whether these settings are correct or good for you depends on what you are trying to fix as compared to the BiPAP.

Since you are used to starting with EPAP = 4 and IPAP = 7 on the BiPAP, you may still find a starting IPAP = 10 uncomfortably high. You may also find that a 6 cm difference between EPAP and IPAP feels like a strong blast of air hitting you every time you start to inhale. And that may also be quite uncomfortable when you are trying to get to sleep.

I'm not sure if you are trying to duplicate the settings on your BiPAP or not and I'm not sure what you are hoping the S9 VPAP will do for you that the Respironics BiPAP has not done.

But I'll offer this piece of advice anyway: You are apparently used to a difference of about 3 cm in pressure between EPAP = 4 and IPAP = 7. In other words, you're used to starting out the night with a PS = 3. Since large changes in settings can be difficult to adjust to, you might want to start by setting the PS on the Resmed S9 to 3 or 4 rather than 6.

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