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VPAP ADAPT SV prescription setting trouble
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DeepBreathing Offline
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Posts: 2,291
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #11
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 12:28 PM)DavidBol Wrote:  hello!

I just recently purchased a VPAP adapt Sv, after a very complex multilevel surgery (UPPP...). Im currently 26 years old, and not obese. Neither CPAPs nor VPAPs were solving my issue. My diagnoses is Complex Apnea, and its been a nightmare for almost 5 years, no solutions at all.

The supplier couldnt set my pressure needs since I had just taken a recent sleep test. However, they suggested they could guide through the process.

If my needs are IPAP 17 cm H2O, EPAP 14 cm H2O. How can i configure my machine in ASV mode?

THe main issue i have now is that the max and min pressure is 15 and 10 cm H2O respectively, and cannot reach the required while entering clinical menu, those are the highest values It can reach. EPP could only be set to 10 cm H2O.

THanks for the help,

PS: Ive noticed the machine goes out of the limits sometimes, mostly IPAP sometimes is 17 cm H2O

G'day David, welcome to the forum. Welcome

A range of 14 - 17 is quite constrained for an ASV machine but it should be achievable. As far as I know, all Resmed machines go at least to 20 cm H2O, and the VPAP adapt and others go to 25.

However, I've had some trouble tracking down your specific machine - is it the current S9 shape or the older more rounded body? Depending on which model it is, then we can try to provide some more specific advice.

In the mean time, and assuming it works like my VPAP Adapt, you could set Min EPAP = 10, Max EPAP = 10, Min PS = 4, Max PS = 7. This will give you the 14 - 17 range you're looking for. Sleep-well

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 01-12-2014 01:11 AM by DeepBreathing.)
01-11-2014 11:34 PM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #12
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 11:22 PM)DeepBreathing Wrote:  
(01-11-2014 10:20 PM)me50 Wrote:  Thank you. Do you know if the S9 Bilevel Auto is the best Bilevel Resmed has on the market right now?

I know you've had problem doctors and DMEs in the past, but when you're getting into this level of sophistication, you really need to have a thorough in depth discussion with your medical advisors. It's a matter of selecting the most appropriate machine rather than some theoretical "best" machine.

Having said all that, if your main issue is central or mixed apnea, then the VPAP Adapt would be a good place to start. Its an auto-servo (ASV) machine rather than a simpler bilevel which will not treat centrals.

PREVIOUS POST: all I know is that I am supposed to get a Resmed Bilevel Auto but I saw something about a VPAP Auto 25. Since I have not been using a bilevel before, I don't know a lot about them and I want to make sure that I am getting the best there is on the market right now. I don't want to have to change machines again. I am a little untrusting after my experience with my last DME. Since I have to pay some of the cost for this machine, I want the best Resmed Bilevel that treats OSA (I don't have central or mixed)

I don't have an issue with my sleep doctor. As far as my former DME (Apria) many, many people have problems with them. Even my insurance company is trying to get them to deal with their billing issues as they bill for supplies that they have not provided to their customers among other issues.

As far as the bilevel machines (yes, I realize they are called VPAP in the name) my doctor already ordered a bipap auto for me. It was his decision to order that. I am trying to educate myself so I don't get stuck with a machine comparable to the Escape as many others have. As I posted previously, I have to pay a big part of the machine and I want to get the latest and best bilevel available as I already wasted 4 months of expenses on a CPAP auto and now I have to start over paying for 13 months for the bilevel machine. I can't afford to take a chance on getting a low level bilevel machine and waste money on it. So, I am basically trying to educate myself and get the advice of those familiar with the bilevel machines so I know how to identify that I am getting the best bilevel on the market and what my doctor ordered. If the Resmed S9 bilevel auto isn't the one that is the newest technology available to treat OSA, then I want to find out before I start spending money on it and that way, I can discuss it with my doctor ahead of time. Hope this makes sense. We are not a wealthy family so I am doing my homework as best I can.
(This post was last modified: 01-12-2014 09:31 AM by me50.)
01-11-2014 11:54 PM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #13
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 09:23 PM)me50 Wrote:  
(01-11-2014 09:05 PM)DeepBreathing Wrote:  
(01-11-2014 08:55 PM)me50 Wrote:  How many types of Bilevel machines does Resmed have?

At least three in the current Australian catalogue: VPAP S, VPAP ST and VPAP Adapt, all with additional options such as IVAPS etc. Some of these are promoted as ventilators rather than sleep support products.

all I know is that I am supposed to get a Resmed Bilevel Auto but I saw something about a VPAP Auto 25. Since I have not been using a bilevel before, I don't know a lot about them and I want to make sure that I am getting the best there is on the market right now. I don't want to have to change machines again. I am a little untrusting after my experience with my last DME. Since I have to pay some of the cost for this machine, I want the best Resmed Bilevel that treats OSA (I don't have central or mixed) Any help is appreciated

M50 - my machine, "Resmed VPAP Auto 25" *was* the best machine at the time it was made. Think just after the S8 series, but just before the S9 series. Mine has more in common with the S8 series than it does the S9 series. Reporting is fairly minimal, and you must go through hoops to get the data to a computer.

If you are staying with 'Resmed', make sure it's got S9 in the name.

*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."
(This post was last modified: 01-12-2014 01:26 AM by Peter_C.)
01-12-2014 01:22 AM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,291
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #14
RE: VPAP ADAPT SV prescription setting trouble
OK, it looks like there are three candidate VPAP machines for you - VPAP S, Auto and Adapt. I don't see the Auto 25, so I assume this is now superseded.

As far as I can tell from the Resmed site (and it is a bit confusing) all are fully data capable.

The VPAP S seems to be the most limited, probably analogous to the S9 Elite. Likewise, the Auto has several additional modes and is probably analogous to the S9 Autoset. Both the S and Auto are designed for treating obstructive apnea. If I had to guess at a "best" machine for you, I'd go with the VPAP Auto.

The VPAP Adapt is designed for treating central apneas and periodic breathing (eg Cheyne Stokes). It obviously also treats obstructive apneas.

I've been all over the Resmed sites (both Australia and US) and I have to say I can't find anything to actually nail down the exact abilities of each of the machines. I'm sure it's there somewhere. The actual range of machines seems to keep changing, and the names seem to vary between Australia and the US. I've also looked at all the options available in ResScan under "settings" and there are some 14 different VPAP models listed. It's a jungle out there, and you need a guide. If I had to guess at a "best" machine for you, I'd go with the VPAP Auto. But you really need to talk to somebody you can trust in the industry, who really knows what all these different machines can do for you.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-12-2014 01:47 AM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #15
RE: VPAP ADAPT SV prescription setting trouble
What DeepBreathing said. I have made phone calls and am still confused (being told different info from different people on the same call was interesting). The one point I can confirm, having "AUTO" in the name is a good thing as long as you do *NOT* need/want ASV. The 'Auto' version of Resmed's machines basically offer you both (what they call) 'Spontaneous' and 'Auto' mode.Spontaneous = All settings set and locked,and the machine is not allowed to think or mod any settings to improve anything. In 'Auto' mode you get to set MIN and MAX limits, but this setting allows the machine to monitor you breath by breath and to change settings (within the limits set)so if you have a bad day, a cold, etc...it can adjust for you.

Using me, and my older machine, my MIN setting do a max pressure of '15'. I have some days at '15', some days at '15.6', a few days as high as '17.0' - nothing that I could point at in advance to say, hmm, I need a higher setting tonight. This is why *I* like the AUTO setting.

If memory serves, the S9 series has been out for some few years now, either that is a good thing or it means they are about to release something newer and better soon - but who knows when 'soon' is?

*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."
01-12-2014 02:37 AM
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vsheline Offline

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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: #16
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 10:20 PM)me50 Wrote:  Do you know if the S9 Bilevel Auto is the best Bilevel Resmed has on the market right now?

Hi me50,

Yes, according to a chart from the ResMed website the S9 VPAP Auto is their "ideal" machine to treat obstructive sleep apnea.

Just like the S9 AutoSet is the auto-adjusting version of the S9 Elite, the S9 VPAP Auto is the auto-adjusting version of the S9 VPAP S.

In this case, "auto-adjusting" means a range is set for EPAP (exhalation pressure) and the EPAP will automatically adjust throughout this range, as needed, to avoid obstructive events. The Pressure Support setting controls how much higher the IPAP (inhalation pressure) will be than EPAP. As EPAP is automatically adjusted, IPAP will always remain PS higher than EPAP: IPAP = EPAP + PS

I attached the chart, but its graphics did not copy correctly. Along the top are supposed to be pictures of the machines, and inside the chart are supposed to be checkmarks (or empty boxes) to show whether (or not) a feature is supported by a machine. (In the chart, if a box is empty that means the machine does not include that feature.)

Take care,
--- Vaughn


.html  ResMed CPAP:VPAP Machines Comparision Chart.html (Size: 42.08 KB / Downloads: 125)

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: 01-12-2014 04:20 AM by vsheline.)
01-12-2014 03:41 AM
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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: #17
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 12:28 PM)DavidBol Wrote:  hello!

I just recently purchased a VPAP adapt Sv, after a very complex multilevel surgery (UPPP...). Im currently 26 years old, and not obese. Neither CPAPs nor VPAPs were solving my issue. My diagnoses is Complex Apnea, and its been a nightmare for almost 5 years, no solutions at all.

The supplier couldnt set my pressure needs since I had just taken a recent sleep test. However, they suggested they could guide through the process.

If my needs are IPAP 17 cm H2O, EPAP 14 cm H2O. How can i configure my machine in ASV mode?

THe main issue i have now is that the max and min pressure is 15 and 10 cm H2O respectively, and cannot reach the required while entering clinical menu, those are the highest values It can reach. EPP could only be set to 10 cm H2O.

THanks for the help,

PS: Ive noticed the machine goes out of the limits sometimes, mostly IPAP sometimes is 17 cm H2O

(01-11-2014 11:34 PM)DeepBreathing Wrote:  In the mean time, and assuming it works like my VPAP Adapt, you could set Min EPAP = 10, Max EPAP = 10, Min PS = 4, Max PS = 7. This will give you the 14 - 17 range you're looking for. Sleep-well

Hi DavidBol,

If your surgery was recent I think you will need time to heal completely, before again using CPAP of any type. If your surgeon neglected to give you instructions concerning how long to wait, unless it has been already a couple months since your surgery, I suggest you call his office to ask him (or his nurse) how soon it would be okay to use CPAP again.

You can send an email to ask for the Clinician Manual for your machine, using the directions given in the Important Threads section of the Forum. The Clinician Manual will explain how to change the settings. (Or just ask us.)

Regarding settings:

If Min EPAP = 10, Max EPAP = 10, Min PS = 4, Max PS = 7, this would give you an EPAP of 10 and an IPAP somewhere in the range 14 to 17.

If the Max EPAP is too low the ASV machine may be unable to fully treat obstructive apneas. I think 10 may be too low if you need EPAP to be 14.

And if the Max Pressure Support is too low an ASV machine may not be able to fully treat central apneas. Some people need max PS to be 10 or higher.

If when using a non-ASV machine your settings should be EPAP=14, IPAP=17, I would suggest the following settings on an ASV machine:

If EPAP is a fixed number (if not automatically adjusted): EPAP = 14

If EPAP is automatically adjusted across a range:
EPAP min = anywhere 10 to 14 (according to comfort, or best AHI, or least daytime sleepiness)
EPAP max = 15 (this is the max for the ResMed S9 Adapt)

PS min = 3
PS max = at least 8 but preferrably 10 or higher

Max Pressure = 25 (Or at least EPAP Max plus PS Max.)

My ResMed S9 VPAP Adapt model requires that the minimum Pressure Support (PS) be not higher than 6, and I think requires that the max PS be set at least 5 higher than the minimum PS, and requires that the Max Pressure must be at least as high as max EPAP + max PS.

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: 01-12-2014 06:48 AM by vsheline.)
01-12-2014 06:42 AM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,291
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #18
RE: VPAP ADAPT SV prescription setting trouble
Vaughn, I think you're right - I got myself confused with the min EPAP + PS part of the equation.

I'm a bit confused by David's statement "THe main issue i have now is that the max and min pressure is 15 and 10 cm H2O respectively, and cannot reach the required while entering clinical menu, those are the highest values It can reach. EPP could only be set to 10 cm H2O". That doesn't sound at all right to me, which made me wonder if he's using a very old machine or I'm misinterpreting what he's saying. By telling ResScan that my machine is an S9 VPAP SV, I got the same sort of limits I get with my VPAP Adapt Pacewave, as per the attached. This is in line with your post, but quite different from what David has experienced.

   

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-12-2014 09:38 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #19
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 12:28 PM)DavidBol Wrote:  hello!

I just recently purchased a VPAP adapt Sv, after a very complex multilevel surgery (UPPP...). Im currently 26 years old, and not obese. Neither CPAPs nor VPAPs were solving my issue. My diagnoses is Complex Apnea, and its been a nightmare for almost 5 years, no solutions at all.

The supplier couldnt set my pressure needs since I had just taken a recent sleep test. However, they suggested they could guide through the process.

If my needs are IPAP 17 cm H2O, EPAP 14 cm H2O. How can i configure my machine in ASV mode?

THe main issue i have now is that the max and min pressure is 15 and 10 cm H2O respectively, and cannot reach the required while entering clinical menu, those are the highest values It can reach. EPP could only be set to 10 cm H2O.

THanks for the help,

PS: Ive noticed the machine goes out of the limits sometimes, mostly IPAP sometimes is 17 cm H2O

I don't know anything about the machine you are using, but, why, if you know that you need 17 and 14, that the DME couldn't set your machine to that. If they didn't yet have a prescription, I could understand but they had to have a script to know which kind of machine you needed, at least in the US they would need a script (or my DME said they do). Wish I could help more. Hope you get it all worked out.
01-12-2014 12:55 PM
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DavidBol Offline

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Posts: 3
Joined: Jan 2014

Machine: Vpap Adapt Sv (¨S8¨)
Mask Type: Nasal pillows
Mask Make & Model: Resmed Swift
Humidifier: unsure
CPAP Pressure: 14-17
CPAP Software: Not using software

Other Comments: Complex Apnea Diagnosis

Sex: Male
Location:

Post: #20
RE: VPAP ADAPT SV prescription setting trouble
(01-11-2014 11:34 PM)DeepBreathing Wrote:  [quote='DavidBol' pid='54880' dateline='1389461281']


However, I've had some trouble tracking down your specific machine - is it the current S9 shape or the older more rounded body? Depending on which model it is, then we can try to provide some more specific advice.

In the mean time, and assuming it works like my VPAP Adapt, you could set Min EPAP = 10, Max EPAP = 10, Min PS = 4, Max PS = 7. This will give you the 14 - 17 range you're looking for. Sleep-well


Hello,
Mine is the rounded body one, I guess it would be a ¨S8¨ Vpap Adapt Sv. Through clinical menu I can only have access to EPP=EPAP (4-10 cm H2O) in Settings Menu, and to Min PS (3-5 cm H2O) and Max Ps (9-10 cm H2O) in Advanced Menu. How could I get the settings I need?
01-12-2014 01:21 PM
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