ResMed S8 Datacard Reader and Software

[ColinP]

Hi All

I'm new to CPAP, and even newer to this group. If I'd found the group before I started, I might well have made a few different choices, particularly with respect to my equipment - I'm not unhappy with what I have, just not that impressed with ResMed's reputation on this site - which is where it counts. The lab who sold me the equipment pushed ResMed quite hard, so they must like the setup, and the control exerted by ResMed and themselves.

On the subject of control, I'm feeling a little at the mercy of people who are more motivated by selling equipment than sorting me out. The machine was setup to run in APAP mode, and it's just doing 4-20 at the moment, and doesn't even switch on and off automatically like the (identical) loan unit I had did. It's a ResMed S8 Elite (I got a no-cost upgrade because they didn't have stock of the cheaper models), and has a data card. I assume it has a port for a cable too, but I'm not certain on that.

I am feeling a bit suffocated when I first put it on, and would like to be able to tweak the settings to increase the minimum a little. My titration indicated 9cm, and after reading many posts here, I would like to narrow the range to something around that and see if I do any better. I've been on the machine for about six weeks, two with theirs and four with my own, and while I no longer catnap on straight sections of the drive home from work, I'm not jumping out of my skin with energy either. I've managed pretty good compliance so far - I threw the mask off twice in frustration, but other than that I keep it on all night, and am getting used to turning over with it, so I've been quite lucky in that way.

Essentially, I want to be able to read my data from the machine, and then change the setup to adapt to what suits me and makes me sleep better. It seems that there are a number of options in the setup to for the clinician to allow the user different levels of control, and given the number of things I see on the menu, I'm not trusted to do anything more than adjust the length of the settling (ramp) time. So making setup changes is high on my list too, but I suspect I'm in for an uphill battle if I ask the lab to set it up that way for me.

My feelings of frustration at not being given all the options and all the information is not being helped by the fact that the (only) technician is about to have a baby, and isn't available right now, so even if they wanted, the lab can't do anything to change my setup.

What options are available for reading data from the machine, and do you need software to analyse the data? Can anyone give me a clue of what options are available? Any information on how to bypass the labs restrictions on my access to menus would be useful too.

Thanks in advance,

Colin

[Slinky]

Welcome to the forum, Colin. Hey, don't be disappointed in your equipment. That Resmed S8 Elite of yours is one heck of a good quality CPAP. There are those of us who don't like their change in sales policy but that doesn't affect the quality of their products or the quality of our therapy. Frankly, I PREFER my Resmeds to the Respironics. My PERSONAL preference.

First off, the Resmed S8 Elite is NOT an autoPAP and can NOT 'run' at pressure range of 4 cms to 20 cms. IF you have an auto what you have is the Resmed S8 AutoSet Vantage.

SmartStart is the option that turns the Elite on and off automatically and if you want that option turned on it can be done. With SmartStart on, Leak Alert won't work. You can only have one or the other turned on. Frankly, I don't like or use either option.

Neither the Elite nor the Vantage have a port for a serial cable. That's not the way they work.

Is the Ramp feature turned on? If so the unit starts out at 4 cms of pressure and gradually builds up to your 9 cms of pressure over a set period of time, generally set to how long it usually takes you to get to sleep.

To access the Advanced/Detailed Patient Menu press the Left and Right buttons and hold them down for 3-4 seconds. From then on in it is a matter of the Left button to Enter, the Right button to Exit, the Up button to return to the previous menu and the Down button to go to the next menu.

I'd say it is a little early yet for you to be changing your pressure setting. It sounds like you were given a Resmed S8 AutoSet Vantage for the first 2 weeks set w/a range of 4 to 20 cms to determine a good pressure setting for you, then the Vantage loaner was replaced w/the Resmed S8 Elite set a 9 cms as your permanent machine.

The Expiration Pressure Relief feature could also be a reason for your feeling of not enough pressure. EPR works all the while the machine is on if you are using that option. A setting of 1 equals a reduction of 1 cms of pressure, a setting of 2 equals a reduction of 2 cms of pressure and a setting of 3 equals a reduction of 3 cms of pressure. So w/a set pressure of 9 cms, your Elite drops to 6 cms of pressure on exhalation if EPR is set at 3.

I really appreciated the Ramp feature and the EPR feature at first. Once I adjusted to CPAP I quit using the Ramp feature first and some time after quit using the EPR feature as well. My set pressure is 8 cms.

To SEE your full data you will want either AutoScan 5.7 or the newer ResScan software and the necessary cable reader. The cable reader plugs into a port on your 'puter and accepts and reads the data card when you insert it. Installation of the software is super easy. I sure can't say that about Resprionics software!!! EncorePro v 1.5.77 was a bear to install!

As I mentioned earlier, I have the Resmed S8 Elite. I wanted an Auto so I self-purchased a RemStar Auto w/C-Flex pre-M series. I got good therapy w/the RemSTar but I missed my easy access to data on my Elite so when a lightly used Resmed S8 AutoSet Vantage complete became available I grabbed it and sold the RemStar Auto to my son in law. I'm still pretty much using my Elite as my main machine and my Vantage as my "travel' machine. I have both the AutoScan software on my desktop and the ResScan software on my laptop. I also have ResLink which I haven't tackled yet. I LOVE my Resmeds. Forget the propaganda from the Respironics fans.

[Slinky]

Colin, for the time being until you can get the software and cable reader, be sure to access the data on the LED screen w/the button combo I gave you and write down all the information each day. Be sure to access the data before noon. These CPAPs run on an internal, 24 hour, noon to noon clock. At noon the previous night's data is rolled over into the averages and no longer available on the LED screen.

I write down the day, date, pressure, leak, AHI, AI, HI, total number of hours used, number of nights used and hours used that night. I include any pertinent info such as took an Ambien, changed mask from ? to ?, etc. For instance:

Sat - 14 Oct 06 - Pressure: 5.6 - Leak: 0.60L/s - AHI: 17.9 - AI: 4.0 - HI: 13.9 - Used: 26 hrs - Usage: 0006 nts - Day: 7.45 hrs (Swift)

[ColinP]

Slinky

Thanks so much for your replies. I'm now officially confused - I don't even know what machine I have! I'm sitting in the office, and the machine is at home. I just checked my invoice and it says Elite, which is what I paid for and ordered, but they didn't have stock in the country (small country) and they upgraded me to an auto at no extra cost. But I don't think it's a Vantage. "Spirit" seems to ring a bell... I'll check this evening when I get home. It doesn't have "ramp" it has "settling" which, IIRC from the documentation means that it's running in Auto mode. It starts at 4 when I put the mask on, and the couple of time sI have looked at it on waking it has been around 9 or 10 - close enough to my titration reading to make me optimistic.

It *must* be auto - I did the sleep and titration at a neurologists' sleep lab, and then consulted an ENT before buying the machine, and the tech at the ENT (who sold the machine to me) did not have the report from the first lab, so she souldn't have set it to anything. (I never do things the easy, straight-forward way lol)

I'll also play with the user settings by using your advice on how to access them. I'll also start logging my readings, because I'm convinced I already know as much as the technician - although she was over 8 months pregnant at the time, and that tends to use up brain cells as far as I can remember from when the ex and I were still breeding.

I'm still bracing myself for the cost of the reader and software - I'm quite far out of pocket already and not reaping huge benefits. My medical insurance isn't interested in paying for the equipment, so I had to use MasterCard for the whole thing - the equivalent of over US$1300 so far, so it'll be a while before I can justify the extra costs. On the other hand, it's a waste to not get the full benefit just because of a few dollars.

Colin

p.s.

Your sig has always tickled my funny-bone.

[Guest]

Colin,

4 cm pressure, for me at least, was not enough air to make me feel comfortable. When I first began my technician set up my machine similar to yours (4 -20 cm on auto, which is the same as not setting it up at all).

I had to adjust my minimum pressure to about 7 cm before I felt I wasn't suffocating.

Spirit = Vantage. I believe it is a marketing difference between the US and rest of the world, but I'm not sure.

as others will tell you, make any incremental changes and give them a few days to see if they are working.

Good Luck

[Slinky]

Duh! Me bad, Colin. I should have paid closer attention to your ID and seen that you are NOT in the USA! Color me red-faced. Yep, you would be right about the Spirit being the autoPAP. Its only the Vantage in the USA and probably Canada as well. Spirit and Vantage are basically the same machine. USA FDA regulations require a little difference. I'm not even sure of the differences, but they are minimal. Watch for posts by BillBolton and DSM. They both know the Spirit/Vantage and Elite better than I. They also know software and 'puters better than I do!!! The button combination remains the same tho.

It is GREAT that they upgraded you to the Resmed S8 AutoSet Spirit!!! CONGRATULATIONS!!! And at no extra cost too. And you are right, it would be Settling in auto mode. The button combo I gave you will only give you access to the advanced/detailed patient menu. You won't be able to change your pressure range from that menu. Your tech who set up your machine probably wasn't all that familiar w/the Resmeds yet - or she was playing dumb. The RT who set up my Elite either was unfamiliar w/the Resmeds or playing dumb and being less than truthful.

Yes, when I first saw the Slinky quote I was in "just" the right mood that I "had" to adopt it for my own. Unfortunately, the person I "purloined" it from couldn't credit whoever came up w/it so I can't either. I think it is TXKajun or 6PtStar who uses a good one I had used for quite some time altho he's had the good taste to water it down a bit from the way I first saw it. Watch for a PM from me.

[billbolton]

Neither the Elite nor the Vantage have a port for a serial cable. That's not the way they work.

Actually they do... the connector behind the slot the ResScan card goes into is also usable for wired data communicatiosn with the right adapter/cable attached to it. In practical terms the ResScan card approach is a much simpler way of handling data transfer for most users, but wired data transfer is still possible and is used for some particular-purpose clinical setups.

Cheers,

Bill

[billbolton]

But I don't think it's a Vantage. "Spirit" seems to ring a bell... I'll check this evening when I get home.

It will be an S8 Autoset Spirit... its the same as an S8 Autoset Vantage.

It doesn't have "ramp" it has "settling" which, IIRC from the documentation means that it's running in Auto mode.

Yes.

You may find over time that CPAP mode works better for you..... you dont HAVE to use the APAP mode!

Cheers,

Bill

[ColinP]

Thanks for the advice everyone, I'm now well on my way to becoming a lab rat.

Looking at my data (I had 1 weeks' worth on the machine, and now last night's with a higher minimum pressure), and it looks like the apneas are much better than pre-treatment, just the hypopneas which are still a problem.

I've got AHI sitting at about 23, with AI around 1, and HI roughly 22. What do people strive for? I've seen that AHI of <5 seems to be the main one. What about AI and HI separately?

My original sleep test had me at 65.6, so there is improvement, but it's also plain why I'm not feeling great yet, as there is some way to go.

I'm off for a combined business / family birthday party trip in a couple of hours, so if I don't respond for a few days, it's because I'm away from my computer, I'm hoping for less coffee breaks while driving, because I am sleeping better than before, just not perfect yet. I've got roughly 2000km driving to do over the next 5 days, so I'd better be awake!

Next weekend I'll test out flying with all this stuff.... Just a local flight though, so no big deal.

Have a great weekend,

Colin

[rested gal]

Colin,

To access the therapy setup menu (clinical menu) in your machine, hold these two buttons down together until you see "Welcome clinical" and then keep holding them down a few more seconds:

"Down" arrow button and right button

If you do decide to go into the setup menu, I'd suggest you have paper and pen handy. I wouldn't make any changes at all the first time you go through the clinical menu. I'd simply go all the way through it, writing down everything you see about each setting...every word, every symbol, every number. That way you'll have a record of all your original settings if you make changes later and find you want to go back to the way it was.

When going through the menu, you'll see the word "Change" in many of the settings windows. It's ok to press the left button under the word "Change" and to toggle (with the up/down arrow button) through the parameters, just to see what changes could be made.

The only way you can make a "Change" stick (automatically be saved) is if you press the left button under the word "Apply." If you don't want to make a change to a setting you've been poking around in, just be sure NOT to press the left button when the word "Apply" is sitting over the button.

In other words, pressing "Change" will not actually MAKE a change. It just lets you see what changes you could make if you wanted to. Pressing "Apply" is what makes a setting you're looking at actually be saved.

If you do explore the clinical menu, you can use the right button under the word "Exit" at any time to back out of whatever menu item you happen to be looking at. Exit works like a browser back arrow button while you're in the clinical menu. If you get lost in the menu tree and just want out of the whole thing, hitting the Exit button 4 times will let you be sure you've exited completely out of the clinical menu.

[FoggyEthan]

Do you know if there are similar clinical menus in the APAP ResMed machine? I'll be switching to it soon, and I expect the level of information it stores is much more involved, since it adapts continuously.

Thanks!
-- Ethan

[billbolton]

Do you know if there are similar clinical menus in the APAP ResMed machine?

There are, and they can be accessed in a similiar manner.

and I expect the level of information it stores is much more involved

Not really, there are a few more parameters that can be set for APAP operation, but otherwise its pretty much the same as the Elite in terms of menu structure, etc.

Cheers,

Bill

[Guest]

I would think that, for the APAP, since it gets to vary the pressure and correct for central apneas, that you'd get information on that. One of my problems with my CPAP is that it does OK for my first several hours, but it seems to induce central apneas ones I hit REM sleep and my AHI goes up dramatically. I'm going to be very curious how the APAP handles this.

Thanks!
-- Ethan

[ColinP]

Hi Ethan

APAP doesn't correct for central apneas, I think you're thinking of the ResMed VPAP.

The data that I get from my ResMed APAP is as follows:-
Pressure - as I understand it this is the pressure at which the machine was at or below for 95% of the night
Leak - in l per minute I think
AHI, AI and HI and usage hours.

Obviously if you have the data card and software (ordered but not arrived yet), you can get the data through the whole night and not just the averages available from the screen. I suspect that the only extra data available on the APAP and not on the CPAP would be the pressure settings.

Colin