Adapt SV Newbie Questions

[FeistyWifey]

We're so new to this machine that we lost the whole first night's data by not accessing the menu soon enough. The second night we captured only the last four hours because he went to the bathroom and the machine cut off. Last night was the third night but only the second set of results. We do not have any card in the machine or any link or software.
Night #2
Leak: 14L/min
AHI: 15.3
AI: 0.6
Avg Pressure 9.6
VT 173-732
Respiratory Rate: 12-17
MV: 2-8
Usage: 16 Hours 4/45 days (two nights with one bathroom trip per night)

Night#3 We used Delicate Painter's Tape under his eyes and around the connection between his mask extension and the proximal cuff. He slept on back and also both sides.
Leak: 10L/min
AHI 5.8
AI 0.4
Avg Pressure 9.4
VT 205 - 501
Respiratory Rate: 13-18
MV 3-7
Usage: 26 Hours 5/46days 9.25 hours/day Did not make any trip to bathroom this night.

He uses a Mirage Vista Nasal mask and loves it. However, that's a lot of leaks above, right? We realize the Quattro is recommended for the Adapt SV and with his beard we may need to go to a new mask. There are four that are in the machine menu that are compatible. The first tweak we made was to tape along the mask edge under under his eyes and against the sides of his nose as well as on the proximal cuff where it meets the hard plastic end of the mask extension hose. I read in the Forum's wisdom section about which masks work best with full beards that one full-bearded user puts a tiny amount of lanolin on his beard right where the mask should seal and that took care of all leaks for him. Is lanolin okay to use with all masks? Second question: I hear a slight high-pitched whistle after his machine gets going well. Is this the pressure sensor line and is the noise normal? The manual says to connect the proximal cuff as closely as possible to the mask. Impossible with the Mirage Vista to get closer than the extension hose end. Talked to DME and they were mystified. Talked with ResMed Tech and he said just take off the swivel and hook right into the mask itself. That doesn't work, of course, because the proximal cuff just falls right out. I wrote ResMed an email and included my contact info and ask about connectors, adapters, etc. and they didn't respond. Finally, when I went to list his pressures on here, I checked the script and it's different from the doctor's recommendations in his notes. I've called the sleep nurse to ask her to ask him to clarify. The notes recommend end expiratory of 8, maximum pressure support of 12, and a minimum "port" [support?] of 3. The script says end expiratory 8, maximum support 8, and minimum 3. The roller coaster is at a slow steep climb....

[JohnBFisher]

... We're so new to this machine that we lost the whole first night's data by not accessing the menu soon enough. ...

This machine holds three days of data, not just three sessions. But you will need a null modem cable and the ResScan software to retrieve it. The following parts will allow you to plug into the back of the unit (on the bottom right hand side when you are looking toward the back of the unit ... it is the port furthest away from the power plug with the plastic cover over it.

Null Modem Cable
http://www.newegg.com/Product/Product.a ... 6812200051

USB to Serial (DB9M) Adapter
http://www.newegg.com/Product/Product.a ... 6812339013

ResScan 3.7 Software
https://www.cpap.com/productpage/resmed ... tware.html

I will also provide a PM pointing to how you can find out more information from the ASV unit. Not to change any settings. But it can show you the averages for the day, for the week, for the month and for 30 days.

... The second night we captured only the last four hours because he went to the bathroom and the machine cut off. ...

You can disable the automatic cut off, if you want. I do not use it ... since I used to stop breathing so long my old BiPAP unit thought I was no longer connected to it. It would just turn off.

... Last night was the third night but only the second set of results. ...

As I noted. They are there, just harder to reach.

... We do not have any card in the machine or any link or software. ...

See above. If you can afford it, and your husband is having problems with his therapy, I do suggest getting the software and cable stuff. Then you just start the software, and hook up the machine, power up the machine and the software will start to download the data. But it's a nuisance to use a cable. You either need to take the computer to the machine or the machine to the computer.

... Night #2
Leak: 14L/min
AHI: 15.3
AI: 0.6
Avg Pressure 9.6
VT 173-732
Respiratory Rate: 12-17
MV: 2-8
Usage: 16 Hours 4/45 days (two nights with one bathroom trip per night) ...

14L/min is a good leak rate. Of course, the less the more effective it will be.

AI of 0.6 means he had 36 apneas per hour (0.6 * 60 = 36). That's higher than he probably would like.
AHI of 15.3 is definitely too high. He should work toward 5.0 or less.

... Night#3 We used Delicate Painter's Tape under his eyes and around the connection between his mask extension and the proximal cuff. He slept on back and also both sides.
Leak: 10L/min
AHI 5.8
AI 0.4
Avg Pressure 9.4
VT 205 - 501
Respiratory Rate: 13-18
MV 3-7
Usage: 26 Hours 5/46days 9.25 hours/day Did not make any trip to bathroom this night. ...

No trips! Whooo Hooo! That's always a good sign!

And MUCH better AHI numbers. The tape probably helped. Those are almost considered normal numbers.

... He uses a Mirage Vista Nasal mask and loves it. However, that's a lot of leaks above, right? ...

Not really. You can use the following URL to check the flow rate compared to the pressure his machine uses. At 9.4 to 9.6cm H2O the flow rate of the Vista is about 32l/m. At 8cm H2O (his prescibed EEP value) the flow rate is 30l/m. So both 14 and 10l/m are well below the therapeutic flow rates.

http://www.resmed.com/us/assets/documen ... sa_eng.pdf

... We realize the Quattro is recommended for the Adapt SV and with his beard we may need to go to a new mask. ...

The quattro has a higher flow rate, which means it can handle higher leak rates. That's important if his system needs to swing his pressure quite a bit to kick start his breathing. Masks tend to leak a lot when the ASV unit does that.

... There are four that are in the machine menu that are compatible. The first tweak we made was to tape along the mask edge under under his eyes and against the sides of his nose as well as on the proximal cuff where it meets the hard plastic end of the mask extension hose. I read in the Forum's wisdom section about which masks work best with full beards that one full-bearded user puts a tiny amount of lanolin on his beard right where the mask should seal and that took care of all leaks for him. Is lanolin okay to use with all masks? ...

Uh, I don't know about that. I would think the oils would stiffen up the silicon fairly quickly. You might want to search the board for mask and beard.

Check the document in the link above. Torward the bottom it has a column for the Adapt SV. You can look down that column to see which masks are supported. It's not just the four. Masks from other manufacturers will work. But the mask should be as close to the pressure cuff as possible.

... Second question: I hear a slight high-pitched whistle after his machine gets going well. Is this the pressure sensor line and is the noise normal? ...

I think it's just the machine. I don't really notice it anymore. But I've been hooked to a leaf blower for the past 20 years!

... The manual says to connect the proximal cuff as closely as possible to the mask. Impossible with the Mirage Vista to get closer than the extension hose end. Talked to DME and they were mystified. Talked with ResMed Tech and he said just take off the swivel and hook right into the mask itself. ...

Huh... The link above says it is supported. But you are right. Try changing the mask type to Vista AND use the short tube. It is possible that setting allows the machine to compensate. It will learn the circuit. If it passes, it should be fine.

... That doesn't work, of course, because the proximal cuff just falls right out. I wrote ResMed an email and included my contact info and ask about connectors, adapters, etc. and they didn't respond. ...

They respond very well if you call. But not so well with just email. They are not alone in that. It's a common problem with companies that have web sites.

... Finally, when I went to list his pressures on here, I checked the script and it's different from the doctor's recommendations in his notes. I've called the sleep nurse to ask her to ask him to clarify. The notes recommend end expiratory of 8, maximum pressure support of 12, and a minimum "port" [support?] of 3. The script says end expiratory 8, maximum support 8, and minimum 3. The roller coaster is at a slow steep climb....

EEP is 8. Min PS is 3. Max PS is 8 (or is that 12?). So, if he has no problem, he will exhale at 8 and inhale at 11 (EEP + Min PS). If he is having problems, then he will exhale at 8 and inhale at 16 (EEP + Max PS). Sounds as if they did not set the Max PS correctly. Not a real surprise. But Max PS of 8 should be okay. But to completely eliminate central apneas and periodic breathing it might need to go higher.

Hope this epistle helps.

[FeistyWifey]

John, does it help? Does it ever! I'm so relieved to have some input instead of flying by the seat of my pants here. You addressed every single one of my concerns, and that took a ton of work. Silver will be so happy to find a printout of your posts by his supper plate tonight. We are deeply grateful. Thank you so much.

[sleepgem]

Hi John,

I just signed up on this forum after reading your reply. I just got ResMed Adapt SV and looking for cheap serial cable to transfer data to PC. Thanks so much listing serial cable(s) from NewEgg. I would like to find even more low cost solution. I know that Monoprice carries cables at much better price. However, I can't figure out which one is comparable they have to the one you listed from Newegg. Could you point me to comparable FtoF serial cable at Monoprice?

Here's their website:
http://www.monoprice.com/products/subde ... id=1021205

I'd appreciate your help.

Thanks!
sleepgem

... We're so new to this machine that we lost the whole first night's data by not accessing the menu soon enough. ...

This machine holds three days of data, not just three sessions. But you will need a null modem cable and the ResScan software to retrieve it. The following parts will allow you to plug into the back of the unit (on the bottom right hand side when you are looking toward the back of the unit ... it is the port furthest away from the power plug with the plastic cover over it.

Null Modem Cable
http://www.newegg.com/Product/Product.a ... 6812200051

USB to Serial (DB9M) Adapter
http://www.newegg.com/Product/Product.a ... 6812339013

ResScan 3.7 Software
https://www.cpap.com/productpage/resmed ... tware.html

[JohnBFisher]

... I just got ResMed Adapt SV and looking for cheap serial cable to transfer data to PC. Thanks so much listing serial cable(s) from NewEgg. I would like to find even more low cost solution. I know that Monoprice carries cables at much better price. ...

I love Monoprice. I use their cables for my entertainment system. They are every bit as good as Monster cables for a mere fraction of the cost.

Here's the null modem cable:

http://www.monoprice.com/products/product.asp?p_id=477

If you don't have a DB9 Serial port, then you will also need the following cable:

http://www.monoprice.com/products/product.asp?p_id=2276

The null modem cable is needed to allow proper communications between your computer and the VPAP Adapt SV unit. The USB to Serial adapter converts the transmission to USB format from a serial cable.

Hope that helps.

[robysue]

[
AI of 0.6 means he had 36 apneas per hour (0.6 * 60 = 36). That's higher than he probably would like.
AHI of 15.3 is definitely too high. He should work toward 5.0 or less.

John,
I don't mean to embarrass you, but this error is an order of magnitude (or two) off:

AI = 0.6 means the dear hubby had an average of about ONE apnea every TWO hours or so----not 36 apneas per hour.

Why oh why did you multiply the 0.6 by 60?

To the OP (John, I know you know this): Here's how the machine calculated the 0.6:

AI = (total number of apneas during time machine was running)/(time machine was running in hours) = 0.6 apneas per hour

Since you can't have 6/10 of an apnea (apneas are discrete events), and since 6/10 is about 1/2, a better way of explaining the significance of AI = 0.6 is to say that the dear hubby had an average of ONE apnea every couple of hours. Technically your hubby had an average of 6 apneas for every 10 hours the machine was running.

AHI = 15.3 does mean that your dear hubby had an average of 15.3 (about 15) apneas and hypopneas per hour that the machine was running. Since the AI = 0.6, we can conclude that almost all the recorded events were labeled as hypopneas. And yes, John's right, that's too high.

[JohnBFisher]

[
AI of 0.6 means he had 36 apneas per hour (0.6 * 60 = 36). That's higher than he probably would like.
AHI of 15.3 is definitely too high. He should work toward 5.0 or less.

... I don't mean to embarrass you, but this error is an order of magnitude (or two) off:

AI = 0.6 means the dear hubby had an average of about ONE apnea every TWO hours or so----not 36 apneas per hour.

Why oh why did you multiply the 0.6 by 60? ...

Surely, I made an intentional mistake to see if anyone noticed.

The truth is I made that error because I was being fuzzy headed! I wish I could blame it on the apnea or something. But I fear it was just a sloppy answer.

Thanks for catching that. You are of course correct that an AI of .05 means there would be exactly one apnea per two hours:

... 1.0 / 0.5 = 2.0 ...

So, it takes two hours before we have one apnea. Then if we use the 0.6 in that equation, we see:

... 1.0 / 0.6 = 1.66 ...

In other words, in one and two thirds hours we have an apnea. That's a faster rate than 0.5, so the number of apneas during the night would be slightly higher. (Duh!)

Thanks Robby Sue for catching that fuzzy headed math answer.

[sleepgem]

... I just got ResMed Adapt SV and looking for cheap serial cable to transfer data to PC. Thanks so much listing serial cable(s) from NewEgg. I would like to find even more low cost solution. I know that Monoprice carries cables at much better price. ...

I love Monoprice. I use their cables for my entertainment system. They are every bit as good as Monster cables for a mere fraction of the cost.

Here's the null modem cable:

http://www.monoprice.com/products/product.asp?p_id=477

If you don't have a DB9 Serial port, then you will also need the following cable:

http://www.monoprice.com/products/product.asp?p_id=2276

The null modem cable is needed to allow proper communications between your computer and the VPAP Adapt SV unit. The USB to Serial adapter converts the transmission to USB format from a serial cable.

Hope that helps.

Thanks very much for your help! I just ordered these to download data along w/ 12 gauge sp. wires to expand my HT to 7.1. I hope the sp. wires are as good as monsters which I use currently. btw, I am impressed with your knowledge about sleep apnea and appreciate sharing your knowledge and providing good explanation/information to community here.

[JIMCHI]

I just bought the DB9 to USB cable from Radio Shack. Windows recognized it. But ResScan does not recognize the VPAZP Adapt machine conneted. Any ideas?