ResMed VPAP Adapt confusing results

[terp1984]

I had been using a ResMed S9 VPAP S for almost two years. For most nights, the SleepyHead software reported numerous OA (Obstructive Apnea) and CA (Clear Airway or Central Apnea) events (about equal number of each). There were occasional H (Hypopnea) events, but almost never any A (Apnea) events.

I have been using a ResMed S9 VPAP Adapt for about 10 days. The SleepyHead software now reports numerous A events and some H events, but never any OA or CA events. As I understand it, ResMed reports an A event when it cannot distinguish between a CA and OA event.

One of the selling features of the VPAP Adapt is that it can distinguish between OA and CA events and respond accordingly. But, in this case, it is unable to do the former, so how is it ever going to be able to do the latter?

On the one hand, my old machine seemed to have no problem distinguishing between OA and CA, but was unable to deal with the different events. On the other hand, the new machine is supposed to be able to deal with the different events but is unable to recognize them.

Am I missing something here?

[skyler]

I agree that is puzzling. All things between machines- settings- being equal the only thing I can think of is to let the machine get to know you better.
I have a Respironics ASV and have been able to dial in pressures to reduce my ahi by checking the epap numbers and pressure support numbers. Since you have been on ASV for several years you already know about titrating. How numerous is numerous- can you list your total AHI regardless of the breakdown between kinds of events, please?

I gave my ASV 6 months for us to acclimate to each other (it took three), perhaps it's just going to take more time with the new machine. Perhaps with some research we can find out what is different in machine software, and I guess firmware. Sorry I don't have something more concrete to suggest. Keep us posted, please. I would like to see where this goes, Terp1984.

[terp1984]

For the last 10 days, my AHI has been as high as 9.38 and as low as 1.06 with a 4.31 average. There is no doubt that I now have a better machine, I have just been surprised by the results so far.

[LOVEDOG]

For the last 10 days, my AHI has been as high as 9.38 and as low as 1.06 with a 4.31 average. There is no doubt that I now have a better machine, I have just been surprised by the results so far.

terp.....This is me!! I am about to have my 3rd night on ASV. But I am having the same results as you........a lot of hypopneas and apneas, no centrals or osa. But the desats are gone. I, like you do not understand why more hypopneas and why can't the machine distinguish between osa or centrals??? However I too, am sleeping better. I guess time will tells us more, and we will also learn more as we go along.... hopefully. My ahi was 2.1 last night.

Glad to know that someone else is in my boat! keep me posted and I will do the same.

LOVEDOG

[terp1984]

My AHI for the last three nights was 3.01, 2.15 & 2.18. I seem to be getting closer to my optimal settings. Currently using the following:
Mode: ASVAuto
Min EPAP: 9
Max EPAP: 12
Min PS: 3
Max PS: 10
However, the high airflow is really drying out my mouth despite using Biotene. In any case, getting back to the original issue of this thread, after 15 days, still only "A" and "H" events and no CAs or OAs.
One thing though that is particularly impressive is that even though the IPAP is maxed out at 22, according to SleepyHead, the Medium IPAP is 15.28. I really like that I only get the pressure I actually need when I need it.

[RonWessels]

If your IPAP pressure is regularly maxing out in SleepyHead plots, you should consider increasing its limit. That means that the machine probably thinks that, on occasion, it needs a pressure higher than 22 to prevent your apneas. That might be where you are going to get that last point or two of AHI reduction. Although what you are getting now is perfectly serviceable.

[Peter_C]

If your IPAP pressure is regularly maxing out in SleepyHead plots, you should consider increasing its limit. That means that the machine probably thinks that, on occasion, it needs a pressure higher than 22 to prevent your apneas. That might be where you are going to get that last point or two of AHI reduction. Although what you are getting now is perfectly serviceable.

I was thinking the same thing. Ron beat me. I guess I wonder why you would limit the high end, when the machine won't use it unless it believes you need it?

[terp1984]

Valid question Peter. When I first used this machine the limit was the max allowed. The airflow oscillations were killing me. So, I limited the range to 15 and gradually increased it. I fully intend to continue to increase the pressure, but I'm not there yet.

[Peter_C]

Makes sense. Sorry, read so many posts that I sometimes forget the entire thread.