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S9 VPAP adapt curious results. Am I alone?
#1
I'm a CA patient and long time user of Resmed VPAP adapt machines. First on the S7 VPAP Adapt SV and now on the S9 VPAP Adapt. I would like to update to a newer S9 or possibly an S10 but I have not been able to find a machine that provides the same breathing support as my current old S9 machine. My current machine breathes with me to help me fall asleep. Every new machine seems to wait for my inspiration before contributing any support. Then at the first CA event after I fall asleep, rapidly increasing high pressure awakens me, repeatedly. I have tried 3 new S9 VPAP adapt machines, 1 new S10 VPAP and the latest series in the Respironics line of ASV machines, all with the same result. If I cant figure out what is happening, I may just have to look for old S9 models that exactly match the model (36007) I am using successfully now. Have not been able to get any help from my doctor or my local respiratory support people. Wondering if anybody else has had this experience?
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#2
Ikabodkrane, don't lose your head Smile  The machine you want is the Resmed Aircurve 10 ASV.  You should be able to make a seamless transition using the same settings and may find the Aircurve's ASVauto mode works very well for you.  Like your machine, it uses your own respiratory pace to establish its auto-backup rate and volume.  Not inexpensive but a great machine and the latest in the lineup you already use.  

What machines were you previously looking at.  You clearly need a machine with backup rate, and the Resmed Aircurve ASV as one of the most comfortable and easy to use available.  There aren't many other choices other than Philips Respironics BiPAP Auto SV Advanced.

Here is an example of a chart from a member that just started using the Aircurve 10 ASV, and this was his first night result.  Note the pressure support response that prevents centrals.

[Image: Ot5ZyJ4.png]
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#3
Sleeprider, Thank you for your suggestion. It has been a year or more since I tried a series 10 resmed VPAP adapt. It was the same as the later model S9 units. It is possible the machine was not set up right. I should probably try again.
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#4
G'day Ikabodkrane. Welcome to Apnea Board.

As I understand the problem, you're experiencing an increased pressure as you fall asleep, which then wakes you. It's quite common for us to experience temporary pauses in breathing during the transition to sleep and the machine may see these as central apneas. My machine does that quite frequently, but if I blow back strongly when I feel the pressure going up, the machine backs off and leaves me alone for a while.

The other possible solution is to set your ramp time longer, so that you have a fair chance of being asleep before any interventions can occur. All things being equal, the ramp should be as short as possible, consistent with you being able to comfortably get off to sleep.

Perhaps you could download and install SleepyHead software, which would help us se exactly what's going on (like the sample SleepRider showed above).
DeepBreathing
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#5
(03-15-2017, 10:06 PM)Ikabodkrane Wrote: Sleeprider, Thank you for your suggestion. It has been a year or more since I tried a series 10 resmed VPAP adapt. It was the same as the later model S9 units. It is possible the machine was not set up right. I should probably try again.

Confusing because there has never been a Series 10 VPAP Adapt,  the machine is an Aircurve 10 ASV. There is also a VPAP S ,VAuto and several ST varieties. 

If you can post a chart with the summary data on the left as shown above (seem my signature for instructions), I could probably translate your settings to the Aircurve 10 ASV.
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#6
Deep breathing, thanks for the ramp suggestion. Have not used a ramp since first days on Cpap decades ago. I gave back the 37037A machine but will get one again to try. This time will reconfirm setting to VPAP not auto and will try ramp.
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#7
(03-16-2017, 02:54 AM)DeepBreathing Wrote: G'day Ikabodkrane. Welcome to Apnea Board.

As I understand the problem, you're experiencing an increased pressure as you fall asleep, which then wakes you. It's quite common for us to experience temporary pauses in breathing during the transition to sleep and the machine may see these as central apneas. My machine does that quite frequently, but if I blow back strongly when I feel the pressure going up, the machine backs off and leaves me alone for a while.

The other possible solution is to set your ramp time longer, so that you have a fair chance of being asleep before any interventions can occur.  All things being equal, the ramp should be as short as possible, consistent with you being able to comfortably get off to sleep.

Perhaps you could download and installsoftware, which would help us se exactly what's going on (like the sample SleepRider showed above).

DeepBreathing, Next try with a new machine will use sleepyhead to capture chart data. However my only issue is at startup as I am trying to fall asleep. Best way I can describe problem is to say my older machines breathes with me and provide a smooth transition after I fall asleep. The newer machines wait for me to begin drawing a breath before any air is provided. Then upon falling asleep the newer machines wake me with abrupt pressure.
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#8
If you would go thorough your clinical settings and document the settings, it would help in setting up other machines. Mode, EPAP min, IPAP max, PS min, PS max and any other relevant settings.
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#9
Hi Ikabodkrane,
WELCOME! to the forum.!
Good luck to you as you continue your CPAP therapy and also with getting a new machine dialed in to meet your needs.
trish6hundred
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#10
(03-16-2017, 01:41 PM)Sleeprider Wrote: If you would go thorough your clinical settings and document the settings, it would help in setting up other machines. Mode, EPAP min, IPAP max, PS min, PS max and any other relevant settings.

Sleeprider, Here are the current settings on the S9 VPAP adapt I am currently using:
Mode: ASV
EPAP: 6.0
Min PS: 6.0
Max PS: 12.0
Mask: Nasal Ultra
Tube: Standard
Pressure units: cmH20
Although I have not found anyone else with this same experience, this and another forum posting have provided me with a number of investigative steps I can pursue. Meanwhile, I have purchased a nearly new S9 VPAP adapt model 36007A running the same firmware that my existing machine runs: SX474-0905. My hope is it will behave the same as my current machine. I'll have the machine next week, will post results then. Even so, I will try a new Air Curve ASV again, this time employing sleepyhead and other suggestions made by forum members. Thank you for your help
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