VPAP Auto 25 question

[timbalionguy]

I just acquired a VPAP Auto 25 machine. This is a bilevel machine, but I want to run this machine as a straight APAP until such a time as I need bilevel functionality.

According to the clinical manual for this machine, if you set PSs to zero, you effectively turn off the bilevel function. But with the PS at zero, will the machine function as a conventional APAP?

Switching from the IntelliPAP to this machine appears to have been a good decision. I initially set the pressure range to 13-18, which is close to the 14-18 range I have been using with the IntelliPAP. (PS=0) The first night yielded an AHI of 4.5, which is a lot better than the 7 or so (with significant variability on what at times seems like a random basis) I had with the IntelliPAP. AI component was 0.2. Since I have heard that ResMed machines tend to overreport hypopnas by about 50 percent, this suggests a 'real' AHI of about 2.2. Most importantly, there was no tendency for the machine to 'run away' with pressure. With an average pressure of just 13.2, this suggests the machine felt little need to adjust pressure. We will learn more tonight.

I still need to order the card reader for the ResMed smartcards. I seem to remember some reference to a generic card reader, but I haven't been able to locate much data on this device.

Overall, I found this machine to be very comfortable to breathe with, even without using bilevel functionality. Wish I knew what I know now when I started out!

Any other suggestions to getting better therapy with this machine, or with ResMed or bilevel machines in general.

Much thanks to Ozij and DSM, who both encouraged me strongly, to switch machines!

[JohnBFisher]

Glad you are enjoying your new system. From what I read in the manual, it will work as an APAP unit (or as ResMed calls it a VAuto feature):

The AutoSet algorithm automatically adjusts pressure in response to flattening, snore and apneas. Pressure Support (PS) is fixed throughout the night and can be set by the clinician. Min EPAP and Max IPAP restricts the delivered pressure range.

See page 7 of the maual. If pressure support is set to zero, then your Min EPAP and Max IPAP will be the working range for the AutoSet algorithm. And see page 9 and 12.

By the way, I'm impressed with this unit from the reading I just did. May it serve you well.

[timbalionguy]

Glad you are enjoying your new system. From what I read in the manual, it will work as an APAP unit (or as ResMed calls it a VAuto feature):

The AutoSet algorithm automatically adjusts pressure in response to flattening, snore and apneas. Pressure Support (PS) is fixed throughout the night and can be set by the clinician. Min EPAP and Max IPAP restricts the delivered pressure range.

See page 7 of the maual. If pressure support is set to zero, then your Min EPAP and Max IPAP will be the working range for the AutoSet algorithm. And see page 9 and 12.

By the way, I'm impressed with this unit from the reading I just did. May it serve you well.

John,
That was my reading of the manual as well. However, it occurred to me that with the PS set to zero, hte machine might behave differently.
This morning (day 2), I felt a substantial 'let down' in pressure when I turned off the machine. Made the mistake of not looking over and seeing what the pressure was first. (This machine is so gentle with the pressure that you cannot tell it is higher!) So, I suspect that what the manual says actually holds even for PS=0. Still my average pressure was 13.2, just like the previous night. But last night was areally bad night for me for other reasons, and I slept extremely poorly. AHI was 9.8, with the AI component 0.6. I also, for the first time ever, experienced rainout.
This afternoon was a quiet afternoon, and last nights' poor sleep (and the hard work from 'slopping the cats' next door in the morning) caught up with me. I ended up taking an unexpectedly extended nap of about 2 hours. During that time my AHI was 1.2, the lowest AHI I have ever measured for any sleep condition.
I am looking forward to tonight!

[ozij]

How's it going with your therapy, timbalionguy?

[timbalionguy]

How's it going with your therapy, timbalionguy?

Glad you asked, Ozij!

Last night was night 7 with the VPAP Auto 25. The first weekly data was available, and the data was very encouraging. The week-average AHI was just 4.5, with an AI component of 0.2. For the first week, with no attempts meing made to tweak pressure, this is a fantastic start! Average pressure is 13.4, with the highest average pressure being just 15.

The AHI has varied a fair amount, but shows a steady trend towards 'lower'. The first nights were 4.5, 9.8, 6.something, 5.5 and the rest have been below 5. The best was 3.2. Respiration rate, minute ventilation and tidal volume have all pretty much stayed in the range established by the first night. As I lose weight, I am seeing a continued trend towards a lower respiration rate.

I have the humidifier trimmed out well now. Can get at least 8 hours on a tank fill, with reserve, and no more rainout. Could probably go lower still with humidity (current setting is about 37% of max), but won't at this point.

I had one night with significant gastric insufflation, the worst I have ever experienced. That was night 3, and I had 'eaten very wrong' that evening. So, a little indigestion probably contributed to this. Since that night, I have had just a little gas, typically less than what I experienced with the IntelliPAP, passing out the 'exhaust'.

All in all, the results are very encouraging, and I feel a little better. I am not sure at this point how to proceed. I feel an AHI improvement is just as likely from a 1 cm pressure increase, as is from a 1 cm pressure decrease. I am likely to try the increase first because I know I can tolerate the pressure. But I will do nothing until I have another week of data 'under my belt'. The card reader is on order, I have the software and the card for when the reader comes. A lot of my decision to proceed will be based on the data I see.

[rested gal]

All in all, the results are very encouraging, and I feel a little better. I am not sure at this point how to proceed. I feel an AHI improvement is just as likely from a 1 cm pressure increase, as is from a 1 cm pressure decrease. I am likely to try the increase first because I know I can tolerate the pressure. But I will do nothing until I have another week of data 'under my belt'. The card reader is on order, I have the software and the card for when the reader comes. A lot of my decision to proceed will be based on the data I see.

Sounds like it's going very well for you, timbalionguy. You're definitely going about it the right way.

Will be interested in continuing to read about your progress. And what you see in the more detailed data after you get a download of the detailed data. Good job!

[timbalionguy]

Will be interested in continuing to read about your progress. And what you see in the more detailed data after you get a download of the detailed data. Good job!

Thank you! And you most certainly will see my progress detailed here.

[ozij]

How's it going with your therapy, timbalionguy?

Glad you asked, Ozij!

Glad you replied!

It will be very interesting you see your future charts -- just remember that ResScan (or rather, the machine) is only cpapable of storing about 3-5 nights of detailed info. We'll never see what really went on during those first few days...

O.

[lbaquero]

Where can I buy the card reader for vpap auto 25?

How's it going with your therapy, timbalionguy?

Glad you asked, Ozij!

Last night was night 7 with the VPAP Auto 25. The first weekly data was available, and the data was very encouraging. The week-average AHI was just 4.5, with an AI component of 0.2. For the first week, with no attempts meing made to tweak pressure, this is a fantastic start! Average pressure is 13.4, with the highest average pressure being just 15.

The AHI has varied a fair amount, but shows a steady trend towards 'lower'. The first nights were 4.5, 9.8, 6.something, 5.5 and the rest have been below 5. The best was 3.2. Respiration rate, minute ventilation and tidal volume have all pretty much stayed in the range established by the first night. As I lose weight, I am seeing a continued trend towards a lower respiration rate.

I have the humidifier trimmed out well now. Can get at least 8 hours on a tank fill, with reserve, and no more rainout. Could probably go lower still with humidity (current setting is about 37% of max), but won't at this point.

I had one night with significant gastric insufflation, the worst I have ever experienced. That was night 3, and I had 'eaten very wrong' that evening. So, a little indigestion probably contributed to this. Since that night, I have had just a little gas, typically less than what I experienced with the IntelliPAP, passing out the 'exhaust'.

All in all, the results are very encouraging, and I feel a little better. I am not sure at this point how to proceed. I feel an AHI improvement is just as likely from a 1 cm pressure increase, as is from a 1 cm pressure decrease. I am likely to try the increase first because I know I can tolerate the pressure. But I will do nothing until I have another week of data 'under my belt'. The card reader is on order, I have the software and the card for when the reader comes. A lot of my decision to proceed will be based on the data I see.