School me on the S9 Auto please.

[Sparky223]

This machine will be a totally new experience for me. It has Bi level, but do I need it if I have never used it? Can I turn it off? What is VPAP? In the description it says it has easy breathe technology. Is this similar to A flex or C flex?

[chunkyfrog]

You have a sweeeeet machine!

[TheUglyTruth]

This machine will be a totally new experience for me. It has Bi level, but do I need it if I have never used it? Can I turn it off? What is VPAP? In the description it says it has easy breathe technology. Is this similar to A flex or C flex?

Why are you changing machines and exactly which model are you getting?

[robysue]

This machine will be a totally new experience for me. It has Bi level, but do I need it if I have never used it? Can I turn it off? What is VPAP? In the description it says it has easy breathe technology. Is this similar to A flex or C flex?

The Resmed S9 AutoSET is NOT a bilevel machine. This machine has something called "easy breathing technology with EPR".

The Resmed S9 VPAP Auto is a bilevel machine. Yes, you can use the VPAP Auto in plain CPAP mode. I don't know if the S9 VPAP has an auto CPAP mode, but it does have an auto VPAP (bilevel) mode. This machine has something called "easy breathing technology", but doesn't have "EPR" because the PS setting acts like EPR. In VPAP Auto mode with PS set to 1, 2, or 3, the machine will act very much like an S9 AutoSet with EPR set to 1, 2, or 3.

The easy breath technology refers to a combination of things, one part of which is the Resmed EPR (exhalation pressure relief) system. EPR is similar to A-Flex/C-Flex in that it reduces the pressure at the start of the exhalation phase of your breath and increases the pressure back up to the therapeutic setting when the inhalation starts.

But the easy breathing technology (with EPR or with PS) is also different from A-Flex/C-Flex. A-Flex/C-Flex provide a variable amount of pressure relief based on both the Flex setting and the force of the exahalation. The more forcefully you exhale, the more the pressure drops during the exhalation. The EPR/PS setting on the S9 AutoSet/VPAP reduces the pressure by a fixed amount on every single exhalation. On an S9 AutoSET, setting EPR = 1, 2, 3 reduces the pressure by 1, 2, 3 cm respectively. And the pressure drop is constant: If EPR = 2, the pressure drops by 2cm regardless of whether you exhale really forcefully or very gently. On an S9 VPAP, setting the PS = 1, 2, 3 reduces the pressure by 1, 2, 3 cm respectively on every exhalation. (One critical difference between the S9 AutoSET and the S9 VPAP is that the PS setting on the S9 VPAP can be set to numbers greater than 3, which provide even more of a drop in pressure at the start of the exhalation.)

The easy breathing technology controls how the pressure is dropped and how it is increased on a Resmed machine.

The PR machines with Flex have a kind of "squareish" pressure curve: The pressure drops at the beginning of the exhalation, and it rises partway back to the full pressure as the exhalation slows down and increases the pressure all the way back to full pressure when you start inhaling. Here's a picture that shows how Flex affects the pressure being delivered to the mask:



With the easy breath technology on a Resmed, the pressure increases from its minimum amount to the therapuetic setting during the most active phase of inhalation. As the inhalation starts to slow down, the easy breathing technology starts to drop the pressure just a bit and it drops the pressure all the way through the most active part of the exhalation. This makes the pressure curve take on a "wave like" shape. Here is picture that shows how the easy breathing technology combined with the EPR/PS affects the pressure being delivered to the mask:


The upshot is that most people can't tell much difference between the way Flex and EPR/PS with easy breath technology feel. But some people can. Of the people who can tell a difference here at cpaptalk, many of them do prefer the way EPR/PS with easy breath technology feels.

One final note:

The way the therapeutic pressures are set on the S9 AutoSet and the S9 VPAP Auto are also different.

On the AutoSet, the pressure settings control the pressure on INHALATION (IPAP), and the EPR setting represents the drop in pressure when you exhale.

On the VPAP Auto, the pressure settings control the pressure on EXHALATION (EPAP), and the PS setting represents how much pressure is added when you inhale.

So: If you are using a Respirionics APAP with min pressure = 7, max pressure = 12, and A-flex = 2, then you probably want to start with these settings:

S9 AutoSET: Min pressure = 7, max pressure = 12, EPR = 2

S9 VPAP Auto: Min EPAP pressure = 5, max EPAP pressure = 10, PS = 2.

In both of these settings, your pressure on inhalation will range from 7-12, and your pressure on exhalation will range from 5-10.

[palerider]

This machine will be a totally new experience for me. It has Bi level, but do I need it if I have never used it? Can I turn it off? What is VPAP? In the description it says it has easy breathe technology. Is this similar to A flex or C flex?

which s9 auto? there's three very different models with 'auto' in the name somewhere.

vpap is resmed's name for bi-level, like 'bipap is respironics name for bi-level.

easybreath is not similar to aflex or cflex.

easybreath makes the change from an exhale to inhale pressure smooth and natural feeling, as opposed to abrupt.

it only has an effect when you've got a difference between inhale and exhale pressures.

[palerider]

The upshot is that most people can't tell much difference between the way Flex and EPR with Easy breath technology feel. But some people can. Of the people who can tell a difference here at cpaptalk, many of them do prefer the way EPR with easy breath technology feels

I can't speak to the difference between flex and easybreath, but I can *definitely* say that I VASTLY prefer easybreath on to easybreath off.

[Sparky223]

I should specify it is the vpap auto. Right now mine is a PR system one Auto with the pressure set at 8-20 so I need to set this one up similar.

[robysue]

The upshot is that most people can't tell much difference between the way Flex and EPR with Easy breath technology feel. But some people can. Of the people who can tell a difference here at cpaptalk, many of them do prefer the way EPR with easy breath technology feels

I can't speak to the difference between flex and easybreath, but I can *definitely* say that I VASTLY prefer easybreath on to easybreath off.

And I'm one of those outliers: EPR with easy breathing made me feel like my S9 was rushing me to inhale before I was done exhaling. And Bi-Flex on my PR System One Bi-Flex does the same thing. But turning Bi-Flex off and using the abrupt change from EPAP to IPAP feels natural to me.

There's a really old thread on comparing CPAP to APAP to BiPAP that discusses the differences between EPR with easy breathing, easy breathing + PS on the S9 VPAP, and Bi-Flex and plain Bilevel without any flex. The relevant part of that thread starts here, about half way through the thread at viewtopic.php?t=58773&start=30#p555399 with a post of mine. In the following responses there are some really great graphs drawn by -SWS illustrating the differences and similarities of the two systems.

[palerider]

There's a really old thread on comparing CPAP to APAP to BiPAP that discusses the differences between EPR with easy breathing, easy breathing + PS on the S9 VPAP, and Bi-Flex and plain Bilevel without any flex. The relevant part of that thread starts here, about half way through the thread at viewtopic.php?t=58773&start=30#p555399 with a post of mine. In the following responses there are some really great graphs drawn by -SWS illustrating the differences and similarities of the two systems.

I'm pretty sure that I've read through that, avidly in the past. reading posts like that is where a lot of the stuff in the back of my head has come from.

it's only recently that I've been able to create things like this:

and see the actual effects changes have on the delivered pressure.

I was going to make one showing the difference in pressure response between easybreath on, and easybreath off, but I'm not getting that option at the moment on the machine my monitor is plugged into.... perhaps later.

[ChicagoGranny]

Why are you changing machines

I guess he has no interest in answering your question.

Although I see it regularly here, it still surprises me that there are people who will give advice on a treatment without knowing what condition is being treated and people who will request advice on a treatment without revealing what they are trying to treat.

[Sparky223]

This machine will be a totally new experience for me. It has Bi level, but do I need it if I have never used it? Can I turn it off? What is VPAP? In the description it says it has easy breathe technology. Is this similar to A flex or C flex?

Why are you changing machines and exactly which model are you getting?

My old one is breaking down and I got a sweet deal on this resmed vpap auto.

[palerider]

And I'm one of those outliers: EPR with easy breathing made me feel like my S9 was rushing me to inhale before I was done exhaling. And Bi-Flex on my PR System One Bi-Flex does the same thing. But turning Bi-Flex off and using the abrupt change from EPAP to IPAP feels natural to me.

here's a view of what happens when you turn on easybreath, vs having it off, with a vpap.

[Sparky223]

I also should say that my initial sleep study recommended a pressure of 11. When I check the data on my sd card on the old machine it appears that I typically stay in the 11-12.7 area. So I need help with my initial settings. Thanks

[palerider]

I also should say that my initial sleep study recommended a pressure of 11. When I check the data on my sd card on the old machine it appears that I typically stay in the 11-12.7 area. So I need help with my initial settings. Thanks

you haven't clearly stated what you want.

lay out in detail:
what you had.
what it was set to
what you're moving to
what you hope to accomplish with the move.

[Sparky223]

I also should say that my initial sleep study recommended a pressure of 11. When I check the data on my sd card on the old machine it appears that I typically stay in the 11-12.7 area. So I need help with my initial settings. Thanks

you haven't clearly stated what you want.

lay out in detail:
what you had.
what it was set to
what you're moving to
what you hope to accomplish with the move.

Ok I get what you are saying. As soon as I can get back to my computer I will be more specific.