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Help is needed - What is wrong with me? (S9 VPAP ADAPT user)
#11
Ebit asked me about the incompatibility issue between the P10 and the ASV machines. These are my thoughts on that:

It seems like I heard that before. It's interesting, because it disagrees with Resmed's home site. It might be interesting to ask them how come.

I believe the problem is with ASV therapy, sometimes it's necessary to raise the pressure considerably to treat a CA event. The P10 is a great little mask, but gets a bit unhappy with higher pressures. So leakage becomes a much greater issue.

In your case I don't think ASV therapy is called for at this point. At least not given the results you have at hand. For you I am suggesting a VPAP therapy with a reasonable low and high pressure. Just what the P10 likes.

But as an alternative? If it's a concern for you, take a look at the Piliaro Q pillows mask. It's very similar in design to the P10, but has a more substantial headgear arrangement that would make it a happier camper with pressures in the 20's.
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#12
I know a number of people that use the P10 with ASV machines with great success. If you get a good seal on a nasal pillows mask, I think it withstands leaks better than a FFM, and applies therapy pressure much more effectively...

But then again, I'm in the cult.
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#13
This might be wrong, but how about slamming the Max pressure setting to a tolerable 15, and the PS to 3 or 4 for a few days? At least he could sleep with some therapy.
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#14
(05-21-2015, 09:25 PM)trailrider Wrote: This might be wrong, but how about slamming the Max pressure setting to a tolerable 15, and the PS to 3 or 4 for a few days? At least he could sleep with some therapy.

Yes, I agree. I'll stick with my original recommendation of VPAP mode, 8 minimum, 14 maximum, EPR 2, and no ramp. (however all of that gets defined with an ASV) Then see what Sleepyhead has to say about all this after a day or two.

Again, given the results of OP's sleep tests, I just don't personally see where an ASV should have been ordered. It's ok that it was, it's certainly a fine machine, but I am not convinced the ASV features are anything he needs to use at this time.
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#15
OP Quote:
after reading many threads here I decided on my own to do the following:
1. get climate control and set it to automatic on 72F
2. change the mode to ASV AUTO with default which is: Min EPAP 4.0 Max Ipap 30.0 PS 3-15

then after talking to one of the advisers here on this forum changed the default settings to:
Min EPAP 8 Max Ipap 25 PS 4-10 but somehow still kept it using ASV auto mode

R-G quote:
VPAP mode, 8 minimum, 14 maximum, EPR 2, and no ramp. (however all of that gets defined with an ASV)

I think R-Gs translates into :
Min EPAP 8, Max IPAP 14 PS 2. And change the max pressure to 15 for good measure.

I'm wondering about that OP value of PS 4-10 or 3-15 is causing the problem. Get rid of the second number in the PS, or set it to first number +1 .

If I read it correctly the OP's second setting PS could result in an exhale pressure of 15 with an inhale pressure of 25. That would be horrible! And the OP 1st setting PS would be a worst case of exhale pressure 15, inhale of 30. Yikes!!

So Ebit, here is my recommendation:
Min EPAP 8, Max IPAP 14 PS 2-3. Max pressure =15.
If 8 is too hard to deal with at first, move it to 7. The program should run and adapt as you sleep and keep things flowing without choking you.

I know you probably won't see this until tomorrow. Those settings will mimic an APAP, min 8, max 14, EPR 2 or 3.
I hope this helps.
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#16
Thanks TR..... Sounds like a fine idea to me too.
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#17
Lot of arithmetic going on here but we're probably not quite on the right wavelength for a VPAP Adapt. The available modes are CPAP, ASV and ASV Auto. To emulate an Autoset, you need to select the ASV Auto mode. The available settings in this mode are Min EPAP, Max EPAP, Min PS, Max PS and Max IPAP.

EPAP + PS = IPAP

Min PS can't be set lower than 3. So to achieve a pressure range between 8 and 14 with the equivalent of a 3 EPR you would need to set Min EPAP = 8, Max EPAP = 10, Min PS = 3, Max PS = 4. Max IPAP is irrelevant provided it's set above 14, as the machine won't go above Max EPAP + Max PS.

I don't recommend using this machine while awake to get used to it - normal pauses in breathing (which happen all the time) are sensed as incipient centrals and the machine will react in a few seconds to start pumping the pressure up. This gets quite unsettling.

I agree with the previous posters that ASV seems overkill for this patient, unless the test is seeing something that hasn't come through on the reports. The problem with an ASV if you don't need it is that the machine tries to breathe with you, which is only necessary if you have a lot of centrals. It won't necessarily do you any harm, but it does take some getting used to. When you're having problems adapting anyway you don't need this additional complication.
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#18
(05-21-2015, 08:37 PM)ebitansky Wrote: Thanks for the good words.
Apparently (according to the mask manual ) this mask is not compatible with VPAP adapt SV machines. ......

The only thing that I can find in the manual that might be construed to indicate that the mask is not compatible with the VPAP adapt SV machine is the following statement: "This mask should be used only with flow generators (CPAP or bilevel) recommended by your physician or respiratory therapist."

The fact of the matter is that the VPAP Adapt is a bilevel flow generator. I do not think that statement was meant to rule out ASV machines.

Best Regards,

PaytonA
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#19
I took it from airfit p10 manual page 3 section "Using your mask" at the notes:

Notes:
This mask is not compatible for use with ResMed
AutoSet CS™ 2 and VPAP™ Adapt SV devices.
SmartStart may not operate effectively when using this mask
with some CPAP or bilevel devices that have this feature.

Is airlift p10 the wrong mask ?

(05-22-2015, 10:41 AM)PaytonA Wrote:
(05-21-2015, 08:37 PM)ebitansky Wrote: Thanks for the good words.
Apparently (according to the mask manual ) this mask is not compatible with VPAP adapt SV machines. ......

The only thing that I can find in the manual that might be construed to indicate that the mask is not compatible with the VPAP adapt SV machine is the following statement: "This mask should be used only with flow generators (CPAP or bilevel) recommended by your physician or respiratory therapist."

The fact of the matter is that the VPAP Adapt is a bilevel flow generator. I do not think that statement was meant to rule out ASV machines.

Best Regards,

PaytonA

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#20
(05-22-2015, 01:05 PM)ebitansky Wrote: I took it from airfit p10 manual page 3 section "Using your mask" at the notes:

Notes:
This mask is not compatible for use with ResMed
AutoSet CS™ 2 and VPAP™ Adapt SV devices.
SmartStart may not operate effectively when using this mask
with some CPAP or bilevel devices that have this feature.

Is airlift p10 the wrong mask ?

Oh, ok.... Smartstart and it's evil twin Smartstop may not work right. What that feature is supposed to do is automatically start the machine when you put on your mask and start breathing, and automatically stop it when you take your mask off.

That saves significant wear and tear on your index finger which otherwise has to push the start button to accomplish the same purpose.

It's a ridiculous feature, adored by some, and a real trouble maker for others.

Use your index finger. It's why God gave you two of them.
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