Replacement machine

[Kalenful]

I currently have a Resmed S9 VPAP ST.  I've had it for years. It really needs to be replaced but it has been discontinued.   I need a back up breath rate and will be meeting with the MD soon.  I want to be very informed at this appointment.  I  can't seem to figure out what replaced this machine.  Can anyone help me?  Thanks so much.

[Crimson Nape]

It's an AirCurve 10-ST model. Currently, the AirSense 11 models are standard CPAPs and don't have any advanced machine offerings.

- Red

[Sleeprider]

It would be really helpful to see some data on how well you responded to the VPAP-ST to help with your choice. Many people treated with the ST should have been on ASV due to central or complex apnea. The Aircurve 10 ST-A is a step up from the ST by providing the fixed pressure ST algorithm as well as the smart iVAPS (intellegent volume assures pressure support) which gives a backup rate and maintains the respiratory volume with adaptive pressure support. What was your pulmonary diagnosis? Is this for pulmonary restrictive disease, COPD, neurological disorder, or do you have complex or central apnea?

[Kalenful]

I have complex.  They don't know why. I am not over weight and have no lung issues. 48 episodes an hour. I have responded excellently to my treatment and am 100% compliant.

[Sleeprider]

It's not a problem that you have complex sleep apnea, the issue is to get you the correct treatment, and that is the Resmed Aircurve 10 ASV, not the ST. We have many members using ASV with great success. ASV provides pressure support to ensure a breath when central apnea results in no spontaneous effort, or a weak spontaneous effort that would normally result in a low-flow or hypopnea event. ASV is used to treat central and complex apnea as well as Cheyne-Stokes respiration, and this condition is often the result of a reduction in serum CO2 that reduces respiratory drive. It is a natural process and is especially common in higher altitudes. We can discuss all of this in more detail. What I think you need to know is that ST is intended to treat pulmonary diseases like COPD and hypoventilation, and it provides fixed pressure and pressure support to help mechanically increase the volume of inspired air in every breath. ASV on the other hand is basically a simple bilevel that resolves obstructive sleep apnea with a minimum positive pressure and uses adaptive or intelligent pressure support to mitigate central apnea and to maintain the respiratory rate. It targets your natural 90=second minute vent (amount of air inspired or expired in 90 seconds) to target a breath by breath volume, and it uses pressure support to ensure a breath occurs when it should. Your ST is simply a timed fixed switch from exhale pressure to inhale pressure. The ASV does this automatically and stays out of the way when not needed and is far superior for your needs than ST.

I am going to provide a link to the Resmed Clinical Titration Protocol so you can see how ASV and ST machines work and what conditions they are intended to treat. I'm sorry to say you have been using the wrong machine for your condition and should experience much more comfort and efficacy if you switch to ASV. We can help you negotiate this change, but getting some data from your past use of ST will help. Here is a link to the Resmed titration protocol Please read why ASV is used and how it works starting on page 28, and compare that to the ST on page 34. Note ST is an outdated therapy mode, but is still used, but only offers fixed pressure and timed switching between EPAP and IPAP pressure. https://document.resmed.com/en-us/docume...er_eng.pdf