Resmed Auto 25 vs Resmed AutoSet CS 2

blogginsjoe@hotmail.com wrote:I am a new patient/user of CPAP equipment and someone who is still basically trialing different products while waiting for a further sleep study which is not until late May 2009. My question is whether RMS or anyone on this site for that matter, know whether the Resmed VPAP Auto 25 has the required algorithms necessary to take care of Central or Complex Apneas. I first trialed a Resmed Vantage 8 machine but to no avail. Numbers still very high. I next trialed a Resperonics M series A-Flex machine but still no luck.

I am happy to add my thoughts on this topic: 1st The VPAP Auto 25 is a bilevel that can auto adjust its ipap/epap pressures. Put simply, it delivers 2 pressures at a pre-determined gap ( i.e. 11/14 = gap of 3) and can adjust these pressures in reponse to OSA events (not CA events) while maintaining that gap. The Autoset CS2 is the non US version of the Vpap Adapt SV (no matter what any rep tells you ) both machines are identical except for the name & perhaps one software feature. The Vpap Adapt SV is approved by the FDA for the US market the Autoset CS2 isn't. You are right that the Autoset CS2 was designed initially to normalize Cheynes-Stokes respiration. Because CA (Centrals) are *one* characteristic of CSR, CAs are naturally addressed by the Autoset CS2

After researching my possible condition, reading as much as I can from this site and from consulting with my Dr., (who has the information from my initial sleep study and downloads from my various machines I have tried), we think that maybe I have Complex Apnea.

Complex Apnea is specifically related to CAs occuring because the patient is placed on CPAP therapy. Whilst a sleep study may show a normal pattern of OSA, when the patient is placed on CPAP, CAs develop as a side effect and are significant enough that they require addressing as part of the overall therapy. Prior to the SV machines, CAs were addressed with bilvels that have the 'Timed' feature. This feature allows a breaths-per-minute rate to be set in the machine, then if the sleeper's BPM drops below this rate, the machine starts to cycle on its own, between the inhale & exhale pressure, at that preset backup rate. This cycling attempts to induce the CA sufferer back into normal breathing. The Autoset CS2 applies exactly this same technique whan a CA occurs (it does add some extra tricks such as raising the ipap pressure each failed breathing cycle during a CA situation).

This, being a combination of a number of possible issues, my provider believed that the VPAP Auto 25 may be an intermediate step to the next level of care being the Resmed AutoSet CS 2 which is the newest version that is available in Canada by Resmed. I have spoken with a technician in Resmed’s office in California and he assured me that this CS 2 machine is replacing Resmed’s Adapt AV.

This might be true but they are the same machine with minor software differences related to FDA approvals.

A two speed easy-breath motor configuration with all the bells and whistles. The difference, I believe between the Autoset CS 2 and the VPAP Auto 25 is that the VPAP Auto 25 as NO ability to take a breath for the patient

Yes the Vpap Auto 25 does not have the 'Timed' mode in it, as explained above.

I also believe from my research is that the AutoSet CS 2 was primarily developed for Cheyne Stoke patients but they have since found that it can resolve Central Apnea issues as well.

CA was always part of the CSR pattern - the discovery was that the machine could normalize many types of SDB including mixed apnea, complex apnea, Periodic Breathing, etc: etc:

I don’t believe that I need that level of care at this point but yet have found no solution for whatever problem exists.

The first night that I tried this latest (Auto 25) machine I found it to tremendously different from the A-Flex Remstar in a positive way. My breathing became much more regular and compliance throughout the night was very good (didn’t have to take the mask off at all). The second, night however, seemed to revert back to the ‘olden days’ in that I awoke numerous times for whatever reason and wasn’t getting the same results at all. I am using a Swift Lt nasal mask that the Resmed Regional Manager assured us could be used with the settings that exist on my machine. Not sure exacting what they are. The machine is set for Auto and my IPAP setting tops out at 20 cm H20. Pressure support is set at 4 cmH20 but I’m not sure what the EPAP settings are. I have read RMS’s thoughts previously about using a full face mask as the Resmed Adapt SV is leak sensitive although that didn’t seem to present a problem the last few nights. I believe that RMS uses a Resmed Adapt SV and a Quattro mask if I remember correctly. Maybe he will respond to this fact:))

I am guessing you mean DSM rather than RSM

Basically my question is whether or not this VPAP Auto 25 should be able to deal with Central, mixed or Complex apneas and whether anyone is using a VPAP Auto 25 machine to address the issues just presented????

No it is not designed to deal with them due to not having a timed mode.

Thank you to all who are willing to share.