Sleeprider wrote:One of the things I'm curious about with your 960 experiment is if the number of machine initiated breaths significantly exceeds your CAI. What was your experience on that with the S9 VPAP Adapt? Do you ever feel the machine is taking over, and are you aware of the machine initiated breaths when they occur?
Remember I never really had a problem with centrals. I do have them occasionally just like everyone else and the Adapt did seem to respond with a big puff but I always slept right through whatever it wanted to do to me.
It's always been that way. I go to sleep and that's it...never really notice any pressure changes. It was the same when I was on apap and the bipap auto when I would see pressures around 18 in probable REM stage sleep but in non REM my minimum pressure would stay in the 10 to 12 range. Pressure changes have never bothered me at all.
It's a rare night that it takes me very long to go to sleep. I have looked at the flow rate up close and most of the time it's easy to spot the change to asleep...and sometimes it's just barely 2 or 3 minutes.
When I do wake in the night it's always been something unrelated to what the machine might be doing. I don't think I have ever woke up and looked over to see what the pressure was at because it never feels like anything other than normal breathing to me.
I know that people talked about the Adapt as being a fairly strict task master but I never felt like it wanted me to do anything that wasn't what I was doing.
Comparing the Adapt to the S9 VPAP auto...to be honest if it wasn't for the pressures that I use for that short time while awake I would be hard pressed to tell the difference between the 2 machines in terms of my sleep.
With the VPAP Auto I had to use 10 EPAP and 14 IPAP when first starting the night while awake and then it did its thing while I was asleep and I never knew what it did until I saw a report. Sometimes some big changes and sometimes not but I never knew it.
With the Adapt I use 6.6 EPAP and 9.6 IPAP when first starting the night and then it does its thing with a rather wide range but I am asleep so I don't care.
My preference for the Adapt is mainly from that awake time difference...6.6/9.6 is simply more comfortable than 10/14 or 10/13. I know it's a silly little thing because I don't spend much awake time on the machine. Since the adapt can respond faster to obstructions too...I don't have to use as much baseline pressure. Now for some people that rather rapid response might be a problem but it isn't for me at all.
So overall I spend more time at lower pressures and let the machine deal with the OAs when it needs to and it does it rapidly but since the changes aren't a problem for me...it's a win win situation overall.
I have seen EPAP go from 6.6 to 14 in about 20 seconds...the apaps and bilevel autos can't do that and that's why we have to use a higher baseline to give the machine a better head start.
I am of the mind set that anything that lets me be more comfortable in general, and that includes that piddly awake time at lower pressures, will translate into more natural and comfortable sleep in general. Does it make any difference in how I actually feel during the day...I don't know that it does but it sure doesn't hurt me.
You know STL Mark was instrumental in getting me to try the Adapt because of just what I described above. We don't technically need what it can do in terms of centrals but what it can do in terms of OA response and let us use lower pressures overall works well for us.
It's not for people who find pressure changes to be a problem though. If APAP changes are a problem for someone than I sure wouldn't be using this therapy for OA stuff unless centrals were a problem and we just have to tell someone to suck it up and you will get used to it (and a person would but it would take some time).
I know the 960 supposedly isn't quite so quick to respond and I haven't had a chance to really see if it impacts the OA stuff that much because last night I inadvertently didn't set minimum EPAP quite to where it needed to be.
I will know more after a few nights when I see where EPAP/IPAP needs to be and how that compares to what I was using on the Adapt.
I have always been rather fortunate in that I seem to adapt easily to whatever changes I might make in my experimenting. The very first time I tried bilevel and it was on a bipap pro that I was testing out for someone I knew immediately that I wanted one for my own.
I never really had a problem exhaling on apap single pressures but using bilevel was night and day different in comfort for me and I figure if I am going to have to have this alien strapped to my face that I damn well want to be as comfortable as possible.
I may have to RISE but I refuse to SHINE.
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