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New to the forum - lower numbers possible or BiPAP a better choice?
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #11
RE: New to the forum
(04-01-2013 01:22 PM)Always_yawning Wrote:  Date (Clear Airway Apneas) (Hypo Apneas) (Obstructive Apneas)
================================
3/28 21 1 11
3/27 27 21 39
3/26 25 37 41
3/25 14 35 33
3/24 12 6 22
3/23 19 2 25
3/22 7 17 71
3/21 1 33 51

(04-01-2013 06:08 PM)PaulaO2 Wrote:  Take a look at when your central events happened and note what the pressure is.
...
You seem to be regularly hitting the top threshold of your pressure. It's not the bottom number you need to consider changing, but the top one. But then you are also having central events so that may not be a good idea. Instead, try dropping the maximum a notch and see what happens. Try 14 for ten days. It may increase the OA but decrease the CA which may be a happy medium. There's a phenomenon called "pressure induced central events" or something like that where the higher the pressure goes, the more CA events that happen. Usually they decrease with time or starting out at a lower pressure then increasing as the patient acclimatizes.
...
A bilevel CPAP may not help with those central events. A bilevel lowers the exhale pressure more than a regular CPAP does. It does help some people with their central events but not many.

Hi Always_yawning, welcome to the forum!

Please see the thread named "Bilevel Positive Airway Pressure Worsens Central Apneas During Sleep".

What you probably need is an ASV machine. And since 15 cmH2O is sometimes not enough pressure to eliminate your obstructive apneas, I think the Philips Respironics System One BiPAP autoSV Advanced may be better in your case than the S9 VPAP Adapt. This is because an ASV machine needs to use the same pressure you need when on the AutoSet (where 15 is sometimes not enough in your case), and on top of that it will occasionally need to add up to 10 cmH2O of Pressure Support to keep you fully ventilated during your CA occasions. So you probably need an ASV machine which can deliver more than 25 cmH2O. The S9 Adapt cannot do that, and the PR System One autoSV Advanced can.

Most of your apneas are obstructive.

Look at your data for days which have lots of CA events. If your CA events were mostly happening when the pressure was above 14 then it may make good sense to try lowering the Max Pressure. But if most CA events were happening below 14, then I suggest it may help more to raise your max pressure to 16, and/or to make sure you stay off your back by putting a tennis ball in a sock and sewing it to a nightshirt between the shoulder blades.

But first, before changing your max pressure, if you have EPR enabled, I suggest turning it down to 1 or better yet turning it completely off. With some people, turning EPR off can help reduce OA events, and for someone who has CA events, turning off EPR can sometimes hugely reduce CA events.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-02-2013 05:26 AM by vsheline.)
04-02-2013 04:59 AM
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Always_yawning Offline

Members

Posts: 7
Joined: Mar 2013

Machine: ResMed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: H1
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #12
RE: New to the forum
Update: I set up an appointment with my doctor and after the interview, my doctor sent a prescription for a BPAP machine to my equipment provider. I now have the ResMed S9 VPAP Adapt model 36009. Now, I'm a very happy camper. I've used the new machine for 5 days and my ahi's are now 1.8 or less and feeling more alert and rested.
However, isn't there always a however or but Smile, the data on the sd card is not updating. I'm using sleepyhead software and the software can see previous data on the card, the previous user data is readable, but my data isn't showing up. The machine was used for two months previous to my obtaining, with about 325 hours of runtime. So I know the card is good and can be read by sleepyhead. The last entry is the date for the setup change made by the tech that set the machine up for my use.

Before taking the machine home the unit was fitted with a(n) AT&T wireless modem to verify compliance. I haven't tried to disconnect the wireless modem, before I do I'm wondering if anyone may have an idea as to why I can't see the current data?

Thanks
04-22-2013 12:12 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #13
RE: New to the forum
(04-22-2013 12:12 PM)Always_yawning Wrote:  I now have the ResMed S9 VPAP Adapt model 36009.
...
Before taking the machine home the unit was fitted with a(n) AT&T wireless modem to verify compliance. I haven't tried to disconnect the wireless modem, before I do I'm wondering if anyone may have an idea as to why I can't see the current data?

Hi Always_yawning,

Is your model number actually 36007 (like mine)?

Model 36037 is newest S9 VPAP Adapt (manufactured starting Nov 2012) and treats central apneas just as well as model 36007 but can treat obstructive apneas better because offers new feature that EPAP pressure can be set to a range (like on the S9 AutoSet). On model 36007 the EPAP pressure can only be manually adjusted (like on S9 Elite).

I sometimes need to reformat my SD card to get it to record data correctly. I think it could be SD card gets corrupted when I take it out of machine or when I take it out of computer, although I always try to remember to turn off xPAP machine and unplug machine before removal, and tell computer to Eject SD card before removal.

Maybe reformatting SD card (or new SD card) will help.

Some forum members recommend sliding the write protect tab to lock position before putting card into computer, but then you would need to remember to slide tab back to unlock position before putting back in xPAP machine. Maybe my occasional problems would be reduced if I did this, but I would probably occasionally forget to unlock card before putting back in machine, so maybe it wouldn't help much, overall.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-22-2013 01:11 PM by vsheline.)
04-22-2013 01:06 PM
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Always_yawning Offline

Members

Posts: 7
Joined: Mar 2013

Machine: ResMed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: H1
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #14
RE: New to the forum
...
Is your model number actually 36007 (like mine)?
...

I'll check the model number, when I get home, in about 4 hours. I'm pretty sure it's model 36009. But I've been wrong before.

Also, I'll reformat the sd card. I actually have two sd cards. I kept the sd card from the resmed s9 auto CPAP. I tried using the card from the s9 auto into the s9 vpap adapt. The adapt complained, it couldn't read the card.

I'll update on the model number when I get home, and tomorrow on how I make out with reformatting the sd card.

Thanks
04-22-2013 01:40 PM
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Always_yawning Offline

Members

Posts: 7
Joined: Mar 2013

Machine: ResMed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: H1
CPAP Pressure: 7-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #15
RE: New to the forum - lower numbers possible or BiPAP a better choice?
Yep, I be wrong again.
The H5I humidifier model # is 36009. My s9 vpap adapt model # is 36007. AT&T's modem blocks the s9 vpap adapt information sticker. After removing the modem I was able to view the information.

Also, I deleted the data on the sd card last night. My ahi this morning was 0.8. I'll read the card tomorrow to verify my information is updated.
04-23-2013 08:01 AM
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