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ResMed S9 VPAP S, Auto, Adapt w/ASV
#1
I have a friend that was diagnosed with Central & Complex Apneas after a home study and is going for an in-lab titration study. He remembers the sleep doctor mentioning "VPAP," "backup" and "ASV."

After the study, assuming he does need a VPAP, which S9 machine should he request. I have the S9 Autoset and am thrilled with it so I am recommending he stick with a ResMed S9 but I'm not familiar with the VPAP models.

There is the S9 VPAP S, S9 VPAP Auto and S9 VPAP Adapt (with ASV).

All info and recommendations would be appreciated.

Thanks, John
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#2
Of those three, only one is suitable for treating Central Apneas: the S9 VPAP Adapt. Think of the S9 VPAP S as corresponding to the S9 Elite and the S9 VPAP Auto as corresponding to the S9 AutoSet. The VPAP units, of course, are BiLevel devices, so the difference between inhale and exhale pressures are much more configurable. Only the S9 VPAP Adapt is an Adaptive Servo Ventilator device, meaning that it can instigate an inhale when the patient's brain "forgets" to do so.
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#3
What Ron said...says it all
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#4
(02-14-2014, 02:30 PM)JohnNJ Wrote: I have a friend that was diagnosed with Central & Complex Apneas after a home study and is going for an in-lab titration study. He remembers the sleep doctor mentioning "VPAP," "backup" and "ASV."
Your friend's script will likely specify a bi-level ASV machine with backup rate, and will specify settings for the pressure levels, the backup rate and some variables such as target minute ventilation that control the ASV response needed to treat the central apneas.

In the Resmed world, that means a Resmed S9 VPAP Adapt SV set in ASV mode with a back up rate specified.

In the Philips Respironics world, that means a PR System One REMStar 60 Series BiPAP autoSV Advanced with a back up rate specified.

These machines are much more expensive that the S9 AutoSet that you have.

Best of luck to your friend.
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#5
(02-15-2014, 10:27 AM)robysue Wrote: In the Resmed world, that means a Resmed S9 VPAP Adapt SV set in ASV mode with a back up rate specified.

The S9 VPAP Adapt is less adjustable (and mis-adjustable) than the PRS1 BiPAP autoSV Advanced. This includes not being able to manually set the backup rate. The backup respiration rate of the S9 VPAP Adapt is always in automatic mode.

If a pause in my breathing occurs (for any reason, whether a quick swallow, an obstructive apnea, obstructive hypopnea, central apnea or central hypopnea) the machine simply immediately kicks in to keep me breathing at my recent respiration rate.
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.
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#6
That would drive me bonkers! Often when waiting for sleep to claim me, I focus on my breathing, trying to decide if I am following my dream machine, or if it is following me (my breathing I mean) - one of the *features* of my machine is, if I breathe in and out really fast like 'panting', and then suddenly stop, my machine will keep going for another breath or two.

What can I say? Am still a kid playing with his toys (on the inside)...
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#7
(02-16-2014, 05:22 AM)vsheline Wrote: If a pause in my breathing occurs (for any reason, whether a quick swallow, an obstructive apnea, obstructive hypopnea, central apnea or central hypopnea) the machine [an ASV] simply immediately kicks in to keep me breathing at my recent respiration rate.

(02-16-2014, 12:14 PM)Peter_C Wrote: That would drive me bonkers!

That's part of why they don't start people off with ASV machines. They are harder to get used to than an regular CPAP/APAP or a regular bilevel.
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#8
I'm going to resurrect this thread because my friend has the results of his in-lab titration study.

The recommendation was for "BiPAP-ST therapy on 10/4 cm H2O and back-up rate of 10." The doctor said he would NOT need the S9 Adapt.

So my question is of the two that are left - S9 VPAP S or S9 VPAP Auto - which is the better choice.

Thanks.
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#9
(04-28-2014, 07:31 AM)JohnNJ Wrote: I'm going to resurrect this thread because my friend has the results of his in-lab titration study.

The recommendation was for "BiPAP-ST therapy on 10/4 cm H2O and back-up rate of 10." The doctor said he would NOT need the S9 Adapt.

So my question is of the two that are left - S9 VPAP S or S9 VPAP Auto - which is the better choice.

Thanks.
Neither the S9 VPAP S or the S9 VPAP Auto will do what the script says your friend needs. Resmed makes an S9 VPAP ST, which is the equivalent of the PR BiPAP ST.

Sounds like after looking at the data, the doc figured that the ASV algorithm may not be needed and opted to go with just a back-up rate (i.e. T- mode). Or it could be the friend's insurance requires a trial on the bi-level ST device before being willing to pay for the more expensive ASV device. Many people with central or complex sleep apnea do fine on a bilevel ST device, and in that case, there really is no reason to go to the much more expensive ASV machines.

Since the script says "BiPAP" instead of "bilevel" there's chance the DME will say that the PR BiPAP ST has been specified. If that's the case, it's not a problem. The PR System One Series 60 machines are the equivalent of the Resmed machines in terms of quality and comfort. They are not as common on this particular board, but they are NOT inferior to the Resmed machines in any way.
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#10
The S9 VPAP Auto has ST and T modes as well as the Auto VPAP and one level CPAP. I think that if John's choices are the ones that he mentioned, the S9 VPAP Auto would be the most adaptable. It gives 5 modes of operation; CPAP mode, S mode, ST mode, T mode, and VPAP Auto. The S9 VPAP S appears to be VPAP S(pontaneous) mode and CPAP mode only. As far as the Philips Respironics machines are concerned, I bow to Robysue's far better knowledge.

Best Regards,

PaytonA
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