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Help with a ResMed BiPAP
#1
Help with a ResMed BiPAP
This is a very complex report/thread, I am trying to figure out ResMed machines.

I am really looking for good help here. I have been on Phillips systems for the past 8 years and am trying to switch to ResMed.

So I am looking for some real ResMed people to see if we can make this machine work right, or is this Normal for them??
 
Here is my latest report on my Nearly new ResMed Air Curve 10 Model S BiPAP with only 20 Hours on the fan.
 
So I did my standard set and got it ready for a night: And masked up and activated sleep mode:
 
The first thing is I really dislike how long it takes the system to wind up to speed, it is like four breathes before it is up to operating speed/pressure.
 
Next was the slow breathing cycle, unless I took a good long full breath the system would not even reach my higher control pressure before I exhaled.
 
So I shut down for the next night.
 
I requested the Clinician manual and find almost no info there, so I  found a utube video that explained how to turn off the Easy Breath control to allow the using some manual settings…
 
THAT is when this nice Dr. Jackal machine turned into a Mr. Hide machine
 
No matter what setting I use I cannot seem to get it to get up to my high pressure fast, and I followed the directions, I turned off Easy Breath, which allows me to adjust The Rise Time I tried 900MS and then lowest MS still was slow…I adjusted the trigger again trying to get the reaction time faster, and still could not get to respond fast. It was faster but not fast enough.
 
I left Cycle on its defaults as they make total sense.
 
Two GLARING problems presented themselves: First no matter what setting I used I could not get to stop thumping my face at the end of each rising pressure cycle, it would thump me as it jumped to the higher pressure and again right at the end of a breath cycle blam a thump...
 
Lowing the Trigger setting helped but by then my nose was getting sore.
 
The next was a bit disturbing, I found myself not breathing. I kept finding I had to think of taking a breath..I just seem to forget to breathe…and I was wide awake.
 
This kept happening as I tried to relax, I was waiting for something…
 
Then I relised that I was waiting for the machine to read a very faint and small impulse to draw a breath. As My Dreamstation does that.
 
I switched right away back to my Dreamstation and everything is AOK.
 
Power on and I have full pressure with my first breath, both my base pressure of 10 and my high of 16, now NOT 4 breaths down the road. And it is NOT harsh, just smooth full pressure with both low and high breathing.
 
And there is no thumping at the beginning and end of each breath.
 
And now I am breathing normally, the Dreamstation seems to anticipate when I want to inhale, and is there in a split second with air.
 
NOTE my backup rate is 20 and it is not engaged, I can hold my breath and the system does not push for a few seconds.
 
Also, this is an impression, but it seemed the ResMed has more airflow, a little too much, or rather more than the Dreamstation, on it I would have to set the mask setting to X2 to get such volume. This setting on a Dreamstation allows some adjustment to the airflow/volume.
 
As far as I can find there is no adjustment for this on the ResMed. (There are so few adjustments…)
 
I cannot sleep with this machine even a 1/2 hour was too much.
 
I am stunned, this is like going to a Doctor and having him act like a bully, hitting and slapping you around.
 
Thus far I spent 3 Years on System One ASVs, nearly 2 years on a Dreamstation APAP and the next last nearly 2.2 years back on a System One ASVs and the last 8 months on a Dreamstation ASV.
 
I also have bought a used Dreamstation BiPAP, and have slept with it a couple of nights and found it did not take care of my Apneas as well as my ASV, BUT nothing as racial and off-putting as this ResMed BiPAP.
 
I also have used a Resmed Air Curve ASV for about three to four nights, full nights , that did not have anything as off-putting as this ResMed BiPAP.  Also there is NO settings to set ..just 4 settings and you have to leave it all up to the machine…?
 
So here is the BIG question, what’s up with this machine??
 
Has anyone turned off Easy Breath and manually set their Machine??
 
Is the pressure popping normal or a malfunction of this machine?
Inquiring minds want to know.
Thanks.
 
Rich
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#2
RE: Help with a ResMed BiPAP
I'm bumping your post so others may respond.

But, it would be helpful if you could post an OSCAR chart. This way, folks could see your actual settings before offering advice.
OpalRose
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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.
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#3
RE: Help with a ResMed BiPAP
Everyone must do what is right for them. I don’t see how so many problems can be solved. Use the Phillips it seems to give you the best therapy.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Help with a ResMed BiPAP
You are moving from an AutoSV to a VPAP S. These are two different animals. The Resmed algorithm follows your spontaneous breathing, while the Philips Flex, anticipates trigger and will increase pressure ahead of your spontaneous effort. The SV also supplements pressure support if your inspiration is weak, and will actively trigger IPAP based on settings for BPM. The work around is to increase trigger sensitivity which reduces the amount of flow needed before the Resmed will trigger IPAP. If not using Easybreathe, a short rise time less than 300 ms will give you a much faster increase in IPAP pressure. We should compare settings between the two machines and look at a detailed chart. You seem to want the machine to breathe for you, and the VPAP S won't do that, although you can increase pressure support to get more of that effect.

I found your post meandered from one problem to another and was hard to follow. The best way to optimize this machine is going to be to focus on one issue at a time and resolve that before moving to the next. Let's try to keep it simple and limit the changes so we know what works, and what doesn't. You basically changed everything you could find, and I don't think that is your best approach.
Sleeprider
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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.
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#5
RE: Help with a ResMed BiPAP
Yes, you are right there are a number of problems pressenting them selfs.

First, there are my problems with ResMeds standard operation; slow start, and controlled slow rising from the exhale to the full pressure on inhaling.

I feel there is NOTHING that can be done about that.

Also my frustration with the major lack of controls and settings...TRUST in ResMed, we know better.

Again I feel there is NOTHING that can be done about that.


Then there is with the BiPAP Model S there are settings I can adjust once Easy Breath is turned off.

And again you're right I tried too much too fast.

I did try each setting one at a time. And nothing worked.

I read the manual and found little help and some slight hints and tried again last night and did calm down the pop pressure on the switch from exhaling to only poping at the end of an inhale but it was still there.

The one thing I really need is very full instructions as to what and how each setting changes things AND how they all interact with one and another. The Clinician Manuals are nearly worthless.

I have found this very needed info to be nearly totally impossible to find.

With Phillips, I found over the years titbits and hints of how things work.

So I keep digging and prying info out as best as I can.

Like this little tidbit: From another person's thread on switching from a DS to a ResMed:

"SarcasticDave94
In theory and according to Respironics, Flex is very much like ResMed's EPR. Real life usage says they're not close in being the same at all. This also pertains to the whole machine. Since the ResMed targets different info to run the algorithm than the Respironics, it's going to be difficult to set a ResMed up in any way to feel like Respironics. I think it'll be easier on you to just do a self-titration on the ResMed and skip the Respironics adjustments. I believe these 2 machines are so different, you could not plug in an identical pressure set on both and get the same treatment or therapy feel."

That can really say it all.

Rich

PS Sadly the more I try ResMed the more I find I really prefer Phillips. I really hate that.

I really seem to have to sleep with the devil.

PPS I really cannot see why so many people here love ResMed....
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#6
RE: Help with a ResMed BiPAP
(07-30-2021, 11:39 AM)racprops Wrote: PPS I really cannot see why so many people here love ResMed....
Simply because we generally see better results with ResMed.  That said there are those that do better on PR.

You pick your poison, we'll pick ours.
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#7
RE: Help with a ResMed BiPAP
I posted this in another thread but want to say it here as you brought up the core question:

From my experiences so far and my finding how ResMed is so limiting on control and settings, I am really wondering why SO many people here love them.

We are all so mad at Phillips for betraying our trust yet is seems with ResMed you have to trust their systems MUCH deeply than we on Phillips have to..and with Phillips, we can more fine-tune our systems.

So as for so many people saying the AHIs are lower on a ResMed machine….Has anyone considered that the two systems may have different sensitivity when it comes to how well they report apneas??


I do a lot of machining and over the decades I learned that accurate calibers are a major problem, when you're ordering a product at say 1.236 size you really need an accurate tool to both read that as a need and then for the shop to make a part to the same size. IF either of you do not have accurate calibers, and that both of your tools do not read the same 1.000 100% the same you will never get a part that fits.

You can cause a change of sat .0000 to .0025 just by just tighten on the caliber a little harder, so how hard is the correct amount of pressure??

Last night I saw a machine that was NO way as sensitive to my breathing needs as another machine is, it missed by a country mile.

So I now question if ResMed reads and reports the same amount of sleep apneas as Phillips?? In the same way?

For example in a case of a mile per gallon is it the same mile and the same gallon?? In the UK there say MPG but the Imperial Gallon is larger than the US gallon, so a car in the UK that was reported to travel 1000 Miles on a tank of gas corrected to our US gallon would only be reported to have done 850 Miles per the same tank full of US gallons.

This is a real case.

So with the differences between ResMed and Phillips reports are they more or less a case of one under-reporting or the other overly sensitive reporting??

The numbers can be meaningless as compared if they are not reporting the same Miles and the same Gallons….

Has anyone ever tested both machines side by side with real medical systems to see??

I am aware most sleep studies use one or the other machine in testing...so that seems not a good way to compare.
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#8
RE: Help with a ResMed BiPAP
And I am really asking these questions looking for real understanding.

Rich
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#9
RE: Help with a ResMed BiPAP
Rich, I understand your frustration. This is a deep and mysterious pond we are diving in!

Not sure if this article is relevant you:

https://drive.google.com/file/d/1ZuXKZpw...sp=sharing

and not sure I understand it all, but do sense there are major proprietary differences between machines' algorithms.

For me, I have felt in the past both my Resmeds (For Her and the Vauto) may be too aggressive for me, and thought I would try a PR to see if it felt better/gentler.

Then the foam recall news broke, so I canned that idea.

I will stick with what I have and try and make the most of it.

Again, not sure if the article is relevant to you: just thought I would throw it out there.

I too sometimes feel like this,

 Hate-cpap

but am grateful for what it offers me, and the amazing insight from this board.
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#10
RE: Help with a ResMed BiPAP
The main reason we are so 'supportive' of ResMed machines is simply that over many years we see better results therapeutically from them. We see a lot of that recently as, because of the PR recall, users are telling us that was their experience. Usually, in addition to the results (AHI and other charts) they often cite that they prefer the very same things that you cite as what you don't like for their preference for ResMed.

There are some people that honestly do better with PR machines, again, for the reasons you cite and for them we work with them to optimize their PR machines. For new users we try to guide them toward ResMed, but work with what they have.

I believe that you are one of those that is better off with PR machines. With the recall I'd suggest otherwise but you have worked around the recall issues. Stick with the PR pachines.
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