why is resmed Adapt S9 forcing breaths??

[kolchak]

Hi
I'd been using a respironics auto SV to treat complex apnea for last 4.5 years and I recently got a resmed SV adapt s9. My (new) sleep DR used settings of 3, 9, & 10.
I'm trying to determine why it feels like the machine is forcing me to take continuous deep breaths immediately after I exhale. It's so annoying I can't use the machine and feel terrible. The respironics would allow me to decide when to take breaths & pause for a moment.

Is this a breaths per minute setting? I've been trying to find my way into the clinician menu and hoping to stumble on something but no luck.

thanks for any advice

[JohnBFisher]

Greetings! Sorry it took a while for me to respond to this query.

There are major differences between the two algorithms used by Resmed and Phillips Respironics. As I've described it before, the Resmed unit feels more like a sports car steering when you use it than the much looser luxury car steering. Why the differences. In essence, the Respironics algorithm attempts to allow you to breathe on your own. Whereas the Resmed unit is more insistant that you breathe on a regular basis on an ongoing basis.

There are advantages of both approaches - and disadvantages. For example, some nights my patient triggered breathing is pretty low. I both hypoventilate and simply don't breathe. When I use my Respironics unit, it tends to allow more of the central apnea events to occur. Worse, it will alarm when I'm not breathing like I should. And yes, I've turned off all the alarms. This is the "last gasp" effort to get me to breathe. Ugh. That is when I want the Resmed unit, which instead of alarming, will - as you say - force me to breathe. Thank you. I can just continue to sleep.

But getting used to the Resmed unit can take time. That's the downside of having "tight steering" control over your breathing. You will get acclimated to it. But you WILL breathe when it thinks you should. It just takes time to adjust to the unit. Give it about three to four months. Yeah, months. It takes quite a while to adjust to the change.

Hope that helps.

[Loiosh]

Not to change subject, but John, I read one of your posts awhile back about having trouble with your units. Have things settled out for you now, or did you have to go up to a non-invasive?

[Sir NoddinOff]

Thanks, John. That's some pretty fundamental info about the two different machine algorithms that I never really understood before. Finally someone explained it in easy to understand terms. I like the sport car steering analogy

[Guest]

thanks so much John - as already stated - that's a great analogy. I actually drive a 911 but evidently when sleeping prefer a CPAP station wagon. I finally managed to carve out some time & did some searches/reading here to get a slightly better understanding of the Adapt.

I'm worried because many nights I end up turning off the Adapt and that never happened with my respironics sv. I'm not certain the adapt won't be better in the long run but it's rough at the moment. I had my DME print the first couple weeks of data and hoping to review it w/ my doc asap because even the report data is completely different & doesn't make sense now.
I'm now wondering if the first few nights I might have skewed the algorithm by taking quick breaths to "catch my breath" after 1st taping up (I go through more blue painters tape than most contractors), putting on my mask and turning on the machine? I'm trying to slow the BPM avg now by consciously slowing my breathing pattern after 1st turning on the machine and things even out.
Hopefully this learning curve is just slower than anticipated & it ends up being the perfect machine. i think Periodic breathing (especially during REM or early morning hours) was a problem for me w/ the respironics.

So, the idea is the Adapt will gradually learn & adjust to my normal BPM / breathing pattern and using the machine should hopefully get easier/more efficient?
I guess you have both machines? are you saying on the nights you're having less PTB's (centrals i assume) when using the respironics machine, the alarms sounds before the increasingly larger bursts of pressure will eventually force you to begin breathing again? An alarm goes off before the machine does its thing?
The fact it takes longer to recognize the times you've stopped breathing (and it's last resort is an alarm to wake you) makes it ineffective compared to the Adapt?
Before mine broke, I tested it to make certain the alarms were off by simulating centrals. The alarm never sounded and the machine would blow gale force winds that I'd assume would make anyone breath. is that not the case?
thanks again!

[JohnBFisher]

... So, the idea is the Adapt will gradually learn & adjust to my normal BPM / breathing pattern and using the machine should hopefully get easier/more efficient? ...

Actually, it's the other way around. Your body will adjust to the new therapy. It takes time. Be patient. Be persistent. I wish I could offer a quick solution. I would have taken it. But it just does not work that way. But this unit WILL train your body how to breathe in a manner that will minimize centrals.

Yes, I have both machines. One is beside my bed and one is beside my easy chair.

No, I meant that sometimes my Patient Triggered Breathing (PTB) ends up being pretty low. I have more centrals and hypoventilation on those nights. That's when the alarm sounds more than I would like. Essentially the machine does its thing, but I don't respond. The alarm goes off to awaken me. Dang it all. That does work. It's a real nuisance. That's when the Resmed works better for me. This is a case where the "looser steering" of the Respironics does not always suit the needs of the patient. The "tighter steering" of the Resmed works better in those cases.

And yes, both units will increase the pressure to sustain respiration - at a low level. These are not ventilators. But it's enough to help break the central apnea cycle (of undershoot/overshoot).

Hope that helps.

[JohnBFisher]

Not to change subject, but John, I read one of your posts awhile back about having trouble with your units. Have things settled out for you now, or did you have to go up to a non-invasive?

I am still using my ASV units. I was having problems with my DME getting masks to me. They are pretty good, but I'm having to track them down to get new masks. My old mask was leaking like a sieve. My new mask is helping.

I also had a bad case of bronchitis and guests visiting and ... It's been a busy summer.

But I am well. And for the moment, so is my computer. So hopefully I will be able to post more consistently.