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VPAP Adapt pressure question
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DeepBreathing Offline
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Posts: 2,295
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 pressure question
Hi Whitewabit, welcome to the forum. Apart from situations such as rolling over or swallowing, the machine will only go as high as it needs to go to treat your apnea events. (In those cases it might record an apnea by mistake). If it went to 20 many times then it probably needs to be that high. If you are a back-sleeper try sleeping on your side and see if that helps.

One thing I have noticed lately is that if my head is slumped forward, chin to chest, then the pressure goes way up. There's obviously a substantial narrowing going on in that case, which is fixed by changing pillows.

I see you're not using software at the moment. I'd strongly suggest you down load SleepyHead or ResScan (both are available through this forum) and see if you can relate the high pressure episodes to any particular events.

Good luck with your therapy.

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.
09-27-2014 07:17 PM
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vsheline Online

Advisory Members

Posts: 1,908
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: #12
RE: VPAP Adapt pressure question
(09-27-2014 07:17 PM)DeepBreathing Wrote:  If it went to 20 many times then it probably needs to be that high. If you are a back-sleeper try sleeping on your side and see if that helps.

Yes, sleep position usually has a huge effect on how much pressure the machine needs to provide to control/prevent our obstructive apneas and obstructive hypopneas.

Not sure whether sleep position influences central apneas and central hypopneas.

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: 09-28-2014 03:14 PM by vsheline.)
09-27-2014 08:56 PM
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Whitewabit Offline

Preferred Members-2

Posts: 158
Joined: Sep 2014

Machine: ResMed V9 VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX, AirFit P10, AirFit F10
Humidifier: ResMed H5i
CPAP Pressure: 5/4/9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Undisclosed
Location: Somewhere in the midwest

Post: #13
RE: VPAP Adapt pressure question
Thanks for all the suggestions and tips they are very much appreciated being a new user!

I think last night was a bit better though I wasn't able to last all night with it but my apneas dropped below 5 to 4.54 and according to the software (SleepyHead) they were all hypopnea's. I haven't got the ResScan down loaded yet but it is in my mailbox. I was woken several times with the sound of my breath exhausting or the air movement on my arm, not sure which and at least 2 times with the cold hose against my chest. Will see about a sleeve for the hose today, and will look into some way to hold the hose up away from my person, as I had trouble with it sliding around and causing leaks.

I did try sleeping on my side and seems to have had an affect, I am normally a back sleeper because of a lower back injury and is some what difficult to sleep on my side. So am unsure how long each night I will be able lay on my side. I used the Airfit P10 Pillows last night after shrinking the straps in hot water to make them a bit tighter. I also have the Swift FX and am going to try it again tonight. I had used it for a nap but with large pillows in it per a fitting but then found that they irritated the inside of my nose so changed to the medium size pillows and will give them a try tonight. Can always change back rather quickly.

My chest doesn't seem to be as sore or a feeling of discomfort that I had experienced yesterday after getting up. I am guessing that may have been caused by me fighting the machine, till I learned to relax and make it breathe to me and not me to it. Does that make sense to anyone?
09-28-2014 11:18 AM
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PhyllisBalboa Offline

Preferred Members-2

Posts: 155
Joined: May 2014

Machine: ResMed VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for Her
Humidifier: H5i
CPAP Pressure: EPAP: 4.4; PS: 1-6
CPAP Software: SleepyHead

Other Comments: diabetes type 1, fibromyalgia, MTHFR double genetic mutation

Sex: Female
Location: American in Montreal, Qc

Post: #14
RE: VPAP Adapt pressure question
(09-28-2014 11:18 AM)Whitewabit Wrote:  My chest doesn't seem to be as sore or a feeling of discomfort that I had experienced yesterday after getting up. I am guessing that may have been caused by me fighting the machine, till I learned to relax and make it breathe to me and not me to it. Does that make sense to anyone?

Yes, this makes sense to me. The machine seems to be learning our breathing, then steps back a bit to let us lead. When we don't breathe, usually because of centrals, it quickly gives us the next breath to remind us of what we should be doing. If it still feels like it's pushing to the front too much, it's best to relax and go a bit soft. When I do that, I feel like I'm teaching it to be more gentle.

And lowering the pressure, per vsheline's advice on my own thread, is helping with the air swallowing. Still following his suggestions, little by little, to get to a place where the VPAP feels like it disappears and I feel normal.
09-28-2014 11:53 AM
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vsheline Online

Advisory Members

Posts: 1,908
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: #15
RE: VPAP Adapt pressure question
(09-28-2014 11:18 AM)Whitewabit Wrote:  I did try sleeping on my side and seems to have had an affect, I am normally a back sleeper because of a lower back injury and is some what difficult to sleep on my side. So am unsure how long each night I will be able lay on my side.

If you are having any obstructive apneas, then avoiding sleeping flat on your back would probably lower the severity of the obstructive apneas, lowering how much pressure would be needed to prevent the obstructive apneas.

With the S9 Adapt, the way we can tell whether an apnea was obstructive is by looking at the Flow graph and the High Rate Pressure graph in the Detailed Data.

If there is very little or no Flow occurring in response to the large pressure changes between EPAP and IPAP, this indicates the apneas are obstructive.

The Flow graph shows the estimated Rate of airflow in and out of our airway. Positive Flow corresponds to inhaling, and negative Flow corresponds to exhaling.

Tidal Volume (TV or Vt) is the estimated Volume or amount of air we breathed in (or out) each breath, averaged over something like the most recent 5 breaths.

The High Rate Pressure graph shows the estimated pressure at the mask.

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: 09-28-2014 03:17 PM by vsheline.)
09-28-2014 02:23 PM
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Whitewabit Offline

Preferred Members-2

Posts: 158
Joined: Sep 2014

Machine: ResMed V9 VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX, AirFit P10, AirFit F10
Humidifier: ResMed H5i
CPAP Pressure: 5/4/9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Undisclosed
Location: Somewhere in the midwest

Post: #16
RE: VPAP Adapt pressure question
Are your lungs suppose to feel sore after using the ResMed S9 Adapt, or any of the apnea machines? After using it 3+ hours Friday night my lungs/chest feels sore when breathing like my lungs have been over extended/inflated or something. Its to the point that I found my self taking shallower breaths to keep from feeling it. I haven't been able to use it over just a few minutes before the discomfort seems to become over bearing to me. After taking the mask off the soreness last for several hours before slowly dissipating to a feeling of slight soreness.

I have asthma, and my Dr has told me my lungs over inflate naturally and these treatments seem to make it much worse

Any suggestion's on how to over come this .. have a call into my therapist when he gets in to his office ..
09-29-2014 08:40 AM
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PhyllisBalboa Offline

Preferred Members-2

Posts: 155
Joined: May 2014

Machine: ResMed VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for Her
Humidifier: H5i
CPAP Pressure: EPAP: 4.4; PS: 1-6
CPAP Software: SleepyHead

Other Comments: diabetes type 1, fibromyalgia, MTHFR double genetic mutation

Sex: Female
Location: American in Montreal, Qc

Post: #17
RE: VPAP Adapt pressure question
I have the same machine as you, running in the same mode, and started in the same 'wide open' range as you. And had the same problems as you. I've been lowering the pressure to solve this, which it does. See my thread 'this vpap adapt…' for vsheline's detailed advice on what to change. Our machines are different than most, so we have to adjust pressure differently. The pressure shouldn't be wide open in my opinion. With my new changes I'm sleeping almost 10 hours straight (had to make up for a lot of non-sleep), no chest pain or air swallowing, and AHI's running around .1. Yes, that's just above 0. And still might take the pressure down a tad more.
09-29-2014 09:25 AM
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PhyllisBalboa Offline

Preferred Members-2

Posts: 155
Joined: May 2014

Machine: ResMed VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for Her
Humidifier: H5i
CPAP Pressure: EPAP: 4.4; PS: 1-6
CPAP Software: SleepyHead

Other Comments: diabetes type 1, fibromyalgia, MTHFR double genetic mutation

Sex: Female
Location: American in Montreal, Qc

Post: #18
RE: VPAP Adapt pressure question
I wanted to add this from 'journey', who replied over on my thread, about this whole situation:

"Because you have central events you have to be treated with ventilation not pressure. There are some clinical support clinicians at Resmed that will help you. Call them."
09-29-2014 09:31 AM
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Whitewabit Offline

Preferred Members-2

Posts: 158
Joined: Sep 2014

Machine: ResMed V9 VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX, AirFit P10, AirFit F10
Humidifier: ResMed H5i
CPAP Pressure: 5/4/9
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Undisclosed
Location: Somewhere in the midwest

Post: #19
RE: VPAP Adapt pressure question
(09-29-2014 09:25 AM)PhyllisBalboa Wrote:  I have the same machine as you, running in the same mode, and started in the same 'wide open' range as you. And had the same problems as you. I've been lowering the pressure to solve this, which it does. See my thread 'this vpap adapt…' for vsheline's detailed advice on what to change. Our machines are different than most, so we have to adjust pressure differently. The pressure shouldn't be wide open in my opinion. With my new changes I'm sleeping almost 10 hours straight (had to make up for a lot of non-sleep), no chest pain or air swallowing, and AHI's running around .1. Yes, that's just above 0. And still might take the pressure down a tad more.

Am following your thread as it seems we are in the same situation with our Adapt pressure settings ..

Called my Doc and they are changing my max ps to 10 from 15 and we will see how that works for me .. his nurse said they would work with me to enable my use of the treatment. If it is still too much will go a little lower gradually from that point. Am going to rest today and give my chest/lungs a chance to recover from the soreness from the high pressure .. oked with nurse to do that .. she told me to listen to my body as to if I needed to give my lungs a rest for a day ..

Couldn't use it last night as was just too sore and was causing me some breathing trouble from my asthma .

From your thread it sounds like you may have finally dialed in the numbers you need .. 11 housr of sleep seems like such a luxury to me, my wife would panic that there was something wrong with me if I slept close to that long!

How are you feeling after that much sleep in one night?
09-29-2014 10:20 AM
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PhyllisBalboa Offline

Preferred Members-2

Posts: 155
Joined: May 2014

Machine: ResMed VPAP Adapt S9 (36067), ASV mode
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for Her
Humidifier: H5i
CPAP Pressure: EPAP: 4.4; PS: 1-6
CPAP Software: SleepyHead

Other Comments: diabetes type 1, fibromyalgia, MTHFR double genetic mutation

Sex: Female
Location: American in Montreal, Qc

Post: #20
RE: VPAP Adapt pressure question
(09-29-2014 10:20 AM)Whitewabit Wrote:  11 hours of sleep seems like such a luxury to me, my wife would panic that there was something wrong with me if I slept close to that long!

How are you feeling after that much sleep in one night?

Actually, the first long night I had was about 10 days ago, well into the downward adjustments. After many nights of only 3 hours of sleep, I got 12! That morning my lungs had this amazing feeling of coolness to them that has pretty much continued. My lungs feel stronger, more expansive, and like I can finally breathe deeply. I've always been a very shallow breather, and even forget to breathe when I'm awake if I'm focussing on something. Now I feel like I can keep up the regular pattern of breathing that my machine has coaxed me into.

As far as energy goes, it's gradually improving, with some days of intense activity. I'm not pushing that too much, though. I feel healthy and imagine that I have lots of physical healing that takes priority over cleaning house. But still, the house looks great and my husband is happy with all the food I'm cooking now, so I feel like I'm making great progress. And when I sleep now, I sleep deeply while still having my incredible dreams, so I'm happy, too.
09-29-2014 11:04 AM
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