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New Here - Strange Behaviour
#11
(05-03-2016, 05:27 PM)justMongo Wrote: These bilevels are only spec'ed to be run with up to 5 LPM of O2. Running at 8 LPM may throw off the bilevel switching.

the Resmed S9 vpap S/ST/T/Vauto machines are spec'd to operate with up to 15lpm supplemental o2 in all modes except vauto.

Op is in S mode.
#12
(05-03-2016, 03:44 PM)QT2U Wrote: I have a ResMed VPAP S with H5i humidifier
it helps to avoid confusion if you get the terminology right.
you have a "Resmed S9 VPAP S" 'easy breath' is just an optional feature the machine has.

(05-03-2016, 03:44 PM)QT2U Wrote: A rep came out with two identical machines, programmed with the same settings as mine. BUT.. neither one blew air hard enough so that I could breathe.
...
I need to know how to make the machines blow hard (17/10) when I put the mask on my face and inhale, instead of discontinuing to blow (go flat) when I try to take a breath. The machine shows the bar moving up to the 17 but there is little if any air coming out of the mask.. hardly any pressure.

what machines did the rep bring? exactly
you need to make a note of *all* the settings on your machine, mode, ipap, epap, easybreath, TiMax, TiMin, Rise Time, Trigger, Cycle.

Then make sure that *all* those settings are the same on the new machine.

my guess is that you may have easybreath turned off on your machine, and it's on on the new machines, OR the trigger setting is different.

easybreath ON gives you a gentle smooth increase in pressure from the base pressure, easybreath off gives you a much more abrupt pressure jump.
#13
Hi QT2U,
WELCOME! to the forum.!
I hope you can get your machine problems straightened out.
I'm sorry you are having such a rough time ,hang in there for more responses to your post.
trish6hundred


#14
(05-03-2016, 07:31 PM)srlevine1 Wrote: One, I will say a prayer for you. Two, because this may become a life-threatening issue, you need your doctor to do more than write an Rx to the DME's respiratory tech. There should be detailed settings derived in a sleep lab and conveyed to the RT. Three, you may need to take backup procedures for power-out conditions and possible machine failure. Four, is your oxygen delivery continuous or pulsed? -- because pulsed delivery can confuse the settings. Best of luck.

Thanks for the prayer. The oxygen delivery is continuous. I have a external battery for outages that should last up to 4 hours. There is also a generator. However, neither will do any good if the bipap stops working. I have 3 bipap machines sitting here beside me and only one gives sufficient pressure to keep me breathing. The other two do what I said earlier, when I put my face to the mask, instead of blowing, they go flat, then I try to inhale forcefully and get nothing.. after a few attempts at inhaling the machine begins to 'buck'.. like breathing very quick.. short fast bursts of air.. with very little pressure. I would like to get at least one of the machines working with the same pressure as mine, in case mine goes down, which could happen any second.
#15
QT2U,

Others have asked you this question, but you haven't provided all the information.

We need all the settings on all three machines.

Please go into the clinical menu for the old S9 VPAP S and check all the setting. And please confirm and tell us what each of the following settings says in the clinical menu:

TiMin =
TiMax =
Rise Time =
Trigger =
Cycle =
easybreath =


After you write down that information, you need to go into the clinical menu of the new VPAP Autos and and check all the setting. And please confirm and tell us what each of the following settings says in the clinical menu:

Mode =
TiMin =
TiMax =
Rise Time =
Trigger =
Cycle =
easybreath =

The problem you are describing is most easily explained by a difference in one or more of these settings. In particular if the VPAP Auto was set up in Auto mode, then easybreath is on by default and my understanding is that it cannot be turned off.

My guess is that on your old S9 VPAP S, easybreath is probably set to "Off", your Rise Time is set to 100, and your Trigger is set to VeryHigh. If the new machine still has the default settings except for the pressure settings, then it is probably set with Easybreath set to ON (in which case there is no Rise Time setting) and that the Trigger is set to Medium.

Questions about SleepyHead?
See my Guide to SleepyHead
#16
(05-03-2016, 09:20 PM)QT2U Wrote: The other two do what I said earlier, when I put my face to the mask, instead of blowing, they go flat, then I try to inhale forcefully and get nothing.. after a few attempts at inhaling the machine begins to 'buck'.. like breathing very quick.. short fast bursts of air.. with very little pressure.
This sounds as though the machine cannot reliably detect the beginning of your inhalations. And that it is using the FOT algorithm to either try to determine if there is a live person at the other end of the hose OR it thinks you might be experiencing an apnea and it is trying to classify it using the FOT algorithm.

The most likely reason the machine would not be able to reliably detect the beginning of your inhalations would be an incorrect Trigger setting. From the sound of your description of your respiratory problems, you need the Trigger set to "Very High", but the default Trigger setting is Medium.

You really need to determine what the Trigger setting and EasyBreath settings on the new machine are. And compare those to the settings on the old S9 VPAP S.

Questions about SleepyHead?
See my Guide to SleepyHead


#17
(05-03-2016, 10:30 PM)robysue Wrote: QT2U,

Others have asked you this question, but you haven't provided all the information.

We need all the settings on all three machines.

Please go into the clinical menu for the old S9 VPAP S and check all the setting. And please confirm and tell us what each of the following settings says in the clinical menu:

TiMin =
TiMax =
Rise Time =
Trigger =
Cycle =
easybreath =


After you write down that information, you need to go into the clinical menu of the new VPAP Autos and and check all the setting. And please confirm and tell us what each of the following settings says in the clinical menu:

Mode =
TiMin =
TiMax =
Rise Time =
Trigger =
Cycle =
easybreath =

The problem you are describing is most easily explained by a difference in one or more of these settings. In particular if the VPAP Auto was set up in Auto mode, then easybreath is on by default and my understanding is that it cannot be turned off.

My guess is that on your old S9 VPAP S, easybreath is probably set to "Off", your Rise Time is set to 100, and your Trigger is set to VeryHigh. If the new machine still has the default settings except for the pressure settings, then it is probably set with Easybreath set to ON (in which case there is no Rise Time setting) and that the Trigger is set to Medium.

S9 VPAP S Easy-Breathe (My machine)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON
Mode = S
Start EPAP = 4


S9 VPAP AUTO (Techs Loaner)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300 (was 200) change made no difference
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON (was off) change made no difference
Mode = S
Start EPAP = 4 (was 6.0) change made no difference
These were tried with H5i humidifier on and off of the machine. The only difference was on the Techs loaner machine, it acted like a CPAP in that it continue to blow air with the H5i removed. With it attached, after a minute or so the machine stopped blowing if the mask was laying on the desk. No idea if that info helps or not. My machine stops blowing anytime there is no backpressure.
#18
(05-03-2016, 10:54 PM)QT2U Wrote: S9 VPAP S Easy-Breathe (My machine)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON
Mode = S
Start EPAP = 4


S9 VPAP AUTO (Techs Loaner)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300 (was 200) change made no difference
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON (was off) change made no difference
Mode = S
Start EPAP = 4 (was 6.0) change made no difference
These were tried with H5i humidifier on and off of the machine.
Something seems off on these settings. According to page 19 of the S9 VPAP clinical manual if EasyBreath is ON, then RiseTime is not available. (The S9 VPAP user guide is available at https://www.resmed.com/content/dam/resme...er_eng.pdf.)

I would suggest making the following changes to one of the loaner machines to see if they make any difference:

Change the Trigger to VERY HIGH.
Change EasyBreath to OFF
Change Rise Time to 100

It's also possible that the machine thinks its detecting the beginning of your exhalation before you finish inhaling, and hence, it's dropping the pressure to EPAP too soon. To try to delay the drop to EPAP you might also want to change these settings:

Try increasing TiMin to 0.5 (or even longer)
Try changing Cycle to MEDIUM or LOW

Also do you have any idea what your normal respiratory rate is in terms of breaths per minute? I mean when it's taken by someone else---it's impossible to get an accurate RR estimate by yourself because as soon as you start focusing on your breath, it typically changes the RR.

Quote:The only difference was on the Techs loaner machine, it acted like a CPAP in that it continue to blow air with the H5i removed. With it attached, after a minute or so the machine stopped blowing if the mask was laying on the desk. No idea if that info helps or not. My machine stops blowing anytime there is no backpressure.
Check the SmartStart setting as well. My guess is that your machine has SmartStart OFF and the loaner has SmartStart ON.

Do you use your machine with the humidifier? And is the loaner currently attached to the humidifier?
Questions about SleepyHead?
See my Guide to SleepyHead
#19
(05-03-2016, 10:54 PM)QT2U Wrote: S9 VPAP S Easy-Breathe (My machine)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON
Mode = S
Start EPAP = 4


S9 VPAP AUTO (Techs Loaner)

TiMin = 0.3
TiMax = 2.0
Rise Time = 300 (was 200) change made no difference
Trigger = HIGH
Cycle = HIGH
Easybreathe = ON (was off) change made no difference
Mode = S
Start EPAP = 4 (was 6.0) change made no difference

Three more things to check:

1) Start EPAP ought to be the starting EPAP if the ramp is used. You say that your ramp is turned off. Make sure the ramp on the loaner machine is also turned OFF. The default setting for the Ramp is 45 minutes.

2) Is the mask type set correctly on the loaner machine?

3) Is the tube type correct? The default is for a slimline tube. If you are using a regular tube, make sure the tube setting is set to STANDARD.
Questions about SleepyHead?
See my Guide to SleepyHead


#20
While I am waiting for the manual to arrive here....
No surprise I agree with what Robysue is suggesting. I don't have the S9 but then next model up and I don't use "S" mode.

That said, I can get mine to "buck" also if I start a breathe and then stop/start again, the machine thinks I have stopped and starts to drop the pressure then I inhale again like it's mid cycle and it has to turn around and go back to inhale mode again. It feels very strange and I have to focus on completing my breaths.

I have also experienced that cut off feeling when I had the Timax setting too short. Robbysue's suggestions for your Timin and Timax settings might address that, in case you are not familiar with these:

Timin will try and keep you inhaling for at least that long, even if the machine "thinks" you are stopping.
Timax will try and stop you from inhaling longer then this length of time. Mine is set to 4 the max available.

What you have been used to doing with the "older" machine may not work with the "auto" machine. I understand what you are trying to do by holding the mask to your face and removing it to talk/eat/sneeze..... but I have not heard of anyone doing this before.

My system will stop blowing if I take the mask off (some amount of delay here with this) as it thinks I have take the mask off and set it down and walked away, so it shuts down. If I pull the mask away from my face to reseat it, the machine will ramp up and then back down several times, no idea why. It settles down once I put the mask back in place.

It kind of sounds like you are triggering some behavior like this in your system. This is what I am referring to:
"I put my face to the mask, instead of blowing, they go flat, then I try to inhale forcefully and get nothing.. after a few attempts at inhaling the machine begins to 'buck'.. like breathing very quick.. short fast bursts of air.. with very little pressure."

You do something, the machine responds, you react, it reacts and none of these are doing any good. It may have worked with your older machine, but not this one. I suggest you try to find another way to make it "play nice" and get it to work like you need it to. It is "trying" to correct what it "thinks" is going on and it is getting it wrong.


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