Philips Respironics Launches BiPAP autoSV Advanced Sleep Sys

[timbalionguy]

You could consider using an older (read: cheap) PC in your bedroom that translates the RS-232 into something that could be put on a network. You can also get single board computers that will connect to both your machine and ethernet. The advantage of these is they are small and don't consume much power. Wireless versions are available as well.

[mdboze]

mdboze

The pin out data I have is for the Nonin xPod & iPod. These send serial data from an SpO2 unit - the xPod allows an SpO2 probe to be plugged into it & the iPod has the SpO2 chip & the probe integrated into a single finger unit. The xPod & iPod units were forerunners to the very fancy all-in-one Spo2/probe/color screen SpO2 units of today.

But I agree that the data you posted looks like a classic RS232C pinout.

dsm

I have determined the correct pinout of the communications port on the Respironics BiPAP autoSV Advanced:

Pin 1: +5V
Pin 2: Remote Alarm2
Pin 3: RS232 RX
Pin 4: NC (not a pin)
Pin 5: Ground
Pin 6: Remote Alarm
Pin 7: NC
Pin 8: RS232 TX

When Looking at the back of the unit, this is a round connector is on the top left side.
called a "7 pin Din"

So far no luck connecting with Encore Pro2.2 it does not seem to support a direct RS232 connection. Only a smart card reader.
BUT, I did read a post talking about an older version of Encore Pro, that had a port setting under preferences. My version does not have a port setting.
hmm-mmmm

Also, I determined that the:
Respironics "BiPAP autoSV" and the "BiPAP autoSV Advanced" are exactly the same hardware. The only difference is the firmware /software loaded on it.
SO.... if you have a "BiPAP autoSV" there might be a way to update it to be a "Advanced".

[dsm]

mdboze

I have greatly appreciated your talent in looking into the comms port etc:.

I posted a selection of your pics of the inside of the Bipap Auto SV Adv. Thanks a mill for that effort (I trust you saw the link if not pls lemme know ).

I found my sleeplink card & am in discussion with one classic old timer (salt of the earth) at cpaptalk who may be able to organize a sleeplink to PC cable. That will enable me to do upgrades & adjustments to the internal clock (I have a Bipap Pro II that is misbehaving).

Pls keep involved as your talents are rare (like timbalionguy) very capable engineers who are rarely appreciated by people who don't realise the professionalism involved in engineering - specifically, it has to be precise else it wont work & people might die & at worst empires might collapse

Cheers

DSM

[nghy]

Hi, This topic is of great interest as I am a relative newbie (started 1/4/2010). My first and only xPAP is the BiPAP auto SV Advanced. The current settings are working for me. By the normal measures my results are excelent. AHI = 3, HI = 2 down from 7 at the start, with other factors in the right ranges. However, I don't think the settings entered by the DME allow my machine to titrate for either higher or lower pressures should they be needed. I would appreciate your evaluations of these settings.

Max EPAP = 16
Min EPAP = 16
Max Pressure support = 8
Min Pressure support = 6
Max Pressure = 25

Please correct me if I am wrong. The maximum IPAP from the current settings would be 16 + 8 =24, and likewise the minimum IPAP would be 16 + 6 = 22. The maximum pressure of 25 would never be reached and is therefore sort of moot. My feeling is that these settings are so limiting the auto titration feature that I cannot benefit from this machine's ability to find other beneficial therapy settings or adjust to my bodily changes over time. Also, these high pressures cause me to have to tighten the headgear to the point of some discomfort. If the machine found lower pressure settings with the current good results, I could loosen the headgear and be more comfortable. As it is, the average support pressure always = 7 and the EPAP is a flat 16. I don't want to move away from these settings if it results in raising the AHI or HI, but I would like to give the machine some lattitude to discover other therapy settings for me.

[mdboze]

mdboze

I have greatly appreciated your talent in looking into the comms port etc:.

I posted a selection of your pics of the inside of the Bipap Auto SV Adv. Thanks a mill for that effort (I trust you saw the link if not pls lemme know ).

I found my sleeplink card & am in discussion with one classic old timer (salt of the earth) at cpaptalk who may be able to organize a sleeplink to PC cable. That will enable me to do upgrades & adjustments to the internal clock (I have a Bipap Pro II that is misbehaving).

Pls keep involved as your talents are rare (like timbalionguy) very capable engineers who are rarely appreciated by people who don't realise the professionalism involved in engineering - specifically, it has to be precise else it wont work & people might die & at worst empires might collapse

Cheers

DSM

DSM,
you mentioned having a sleeplink cable that allows you to do upgrades & adjustments to the internal clock .
What software do you use to do that ?

I've built my own 7pin din to RS232 cable, that allows me to connect directly to the communications port on the back of the unit; but have no software to control the unit or modify settings (Encore Pro 2.2 does not work for this).

All I need is software.... then, I can monitor the communication ; determine the command structure; then... write software for ALL to use.

When I get something working; I'll build a cable for you if you want one.

My Fav quote:

Those that believe it can't be done need to get out of the way of those who are doing it.

[mdboze]

Hi, This topic is of great interest as I am a relative newbie (started 1/4/2010). My first and only xPAP is the BiPAP auto SV Advanced. The current settings are working for me. By the normal measures my results are excelent. AHI = 3, HI = 2 down from 7 at the start, with other factors in the right ranges. However, I don't think the settings entered by the DME allow my machine to titrate for either higher or lower pressures should they be needed. I would appreciate your evaluations of these settings.

Max EPAP = 16
Min EPAP = 16
Max Pressure support = 8
Min Pressure support = 6
Max Pressure = 25

Please correct me if I am wrong. The maximum IPAP from the current settings would be 16 + 8 =24, and likewise the minimum IPAP would be 16 + 6 = 22. The maximum pressure of 25 would never be reached and is therefore sort of moot. My feeling is that these settings are so limiting the auto titration feature that I cannot benefit from this machine's ability to find other beneficial therapy settings or adjust to my bodily changes over time. Also, these high pressures cause me to have to tighten the headgear to the point of some discomfort. If the machine found lower pressure settings with the current good results, I could loosen the headgear and be more comfortable. As it is, the average support pressure always = 7 and the EPAP is a flat 16. I don't want to move away from these settings if it results in raising the AHI or HI, but I would like to give the machine some lattitude to discover other therapy settings for me.

Hang in there nghy....

There are a lot of knowledgeable people here.

My 30 sec assessment: (at work... can't talk long)
16+6 = 22 equivalent to IPAP min
16+8 = 24 equivalent to IPAP max

I agree with you, a spread of ONLY 2 cm does not seem like much lattitude to let the machine work its magic.

Questions:
1. Since you have the BiPAP autoSV Advanced, I assume you have central/complex apnea (like me) . Correct ?

2. Was your sleep study (tritation) done using a BiPAP autoSV Advanced ?

3. Do you have a copy of your prescription ? if not, get a copy so you know what your intended settings should be. DMEs do make mistakes.


Tips:
Keep a journal / log of whats working for you and whats not. Include how your felt that day;
if you ever change your own settings; be sure to document it, so you can know whats working and what not.
Same with trying different masks.

MOST IMPORTANT: Stick with it. It will become a habit. if you have the wrong maksk.. or constant mask leaks.. work with your DME.

Like a wedding... once she has the dress its all down hill from there.
For us APNEACKs (<-- yes, I made that up) ...once you have the right mask, its all down hill from there.

[nghy]

Hello mbdose, Thanks for taking the time to respond.

To answer your questions:

1. Since you have the BiPAP autoSV Advanced, I assume you have central/complex apnea (like me) . Correct ?

No. I was never diagnosed with central/complex apnea. According to my doctor the people who conducted the study were never able to establish a pressure that reduced the apneas to a reasonable level. She said I could start with my current prescription which would markedly reduce the apneas, but I might need still higher pressures. I found that this machine is one of the few available that can produce controlled pressures up to 30.
As an aside, when I fall into deep sleep I stop breathing sometimes for 30 to 60 seconds. My wife noticed this and became scared. The SV feature detects the stoppage and after ten seconds provides a puff of air that gets me started again.

2. Was your sleep study (tritation) done using a BiPAP autoSV Advanced ?

No. According to the tech I just spoke to they use the ResMed VPAP ST

3. Do you have a copy of your prescription ? if not, get a copy so you know what your intended settings should be. DMEs do make mistakes.

Please excuse my naivete' in these matters. I did not get the prescription nor did I think to double check the DME. I have a meeting with my doctor coming up next week and all your input will help me conduct a better meeting.

[dsm]

Hi, This topic is of great interest as I am a relative newbie (started 1/4/2010). My first and only xPAP is the BiPAP auto SV Advanced. The current settings are working for me. By the normal measures my results are excelent. AHI = 3, HI = 2 down from 7 at the start, with other factors in the right ranges. However, I don't think the settings entered by the DME allow my machine to titrate for either higher or lower pressures should they be needed. I would appreciate your evaluations of these settings.

Max EPAP = 16
Min EPAP = 16
Max Pressure support = 8
Min Pressure support = 6
Max Pressure = 25

Please correct me if I am wrong. The maximum IPAP from the current settings would be 16 + 8 =24, and likewise the minimum IPAP would be 16 + 6 = 22. The maximum pressure of 25 would never be reached and is therefore sort of moot. My feeling is that these settings are so limiting the auto titration feature that I cannot benefit from this machine's ability to find other beneficial therapy settings or adjust to my bodily changes over time. Also, these high pressures cause me to have to tighten the headgear to the point of some discomfort. If the machine found lower pressure settings with the current good results, I could loosen the headgear and be more comfortable. As it is, the average support pressure always = 7 and the EPAP is a flat 16. I don't want to move away from these settings if it results in raising the AHI or HI, but I would like to give the machine some lattitude to discover other therapy settings for me.

nghy

Because I already know a little of your choices I am willing to offer some thoughts on your settings. The following is on the assumption that the machine is in ASV mode based on the settings shown. As always, make any changes gradually & after gathering baseline data in the prior settings. Also, your sleep Dr is king & whenever you can, run any suggestions of changes by him.

I too agree that the SV working range of 2 CMs is miniscule for you. Here are my interpretation of your settings.

1) The epap auto titration is disabled (Max EPAP = 16 Min EPAP = 16) & that is not an issue while you get used to the machine.
at a later date you may want to try EpapMin=14 & allow a 2 CMs auto titration range but make sure you have a couple of
weeks data to compare the results against.

2) Your Epap is high which suggests weight as a contributing factor. An Epap that high will usually create mask management
challenges & I believe you have them under control. If you can get weight down you can also get Epap down.

3) Your Ipap is set to 22 CMs which seems rather high yet again & probably for the same reasons mentioned in 2 above.
It would be very informative to see a nights data. Sometines a big gap like that can add its own problems.
It may be worth (after a couple of weeks data gathering) lowering Min Pressure Support to 4 CMs & comparing results.

4) SV (Servo Ventilation) support can be increased (over the current settings) by adding 2 to the current Max Pressure Support
(Max PS=10 & Max Pressure=26). Also by lowering MinPS to 4 will also extend SV support. The current support of 2 CMs is
all but ineffective and really serves little useful purpose.


All in all, the weight loss opportunity offers you the best chance for getting more out of your therapy.

Hope these thoughts help.

Cheers

DSM

[Banned]

nghy

Because I already know a little of your choices I am willing to offer some thoughts on your settings. The following is on the assumption that the machine is in ASV mode based on the settings shown. As always, make any changes gradually & after gathering baseline data in the prior settings. Also, your sleep Dr is king & whenever you can, run any suggestions of changes by him.

I too agree that the SV working range of 2 CMs is miniscule for you. Here are my interpretation of your settings.

1) The epap auto titration is disabled (Max EPAP = 16 Min EPAP = 16) & that is not an issue while you get used to the machine.
at a later date you may want to try EpapMin=14 & allow a 2 CMs auto titration range but make sure you have a couple of
weeks data to compare the results against.

2) Your Epap is high which suggests weight as a contributing factor. An Epap that high will usually create mask management
challenges & I believe you have them under control. If you can get weight down you can also get Epap down.

3) Your Ipap is set to 22 CMs which seems rather high yet again & probably for the same reasons mentioned in 2 above.
It would be very informative to see a nights data. Sometines a big gap like that can add its own problems.
It may be worth (after a couple of weeks data gathering) lowering Min Pressure Support to 4 CMs & comparing results.

4) SV (Servo Ventilation) support can be increased (over the current settings) by adding 2 to the current Max Pressure Support
(Max PS=10 & Max Pressure=26). Also by lowering MinPS to 4 will also extend SV support. The current support of 2 CMs is
all but ineffective and really serves little useful purpose.


All in all, the weight loss opportunity offers you the best chance for getting more out of your therapy.

Hope these thoughts help.

Cheers

DSM

nghy,

I have to agree for the most part with dsm,

I suggest you trial:
EPAP Min: 14
EPAP Max: 16
Min PS: 4
Max PS: 11
Max Pressure: 25

Banned

[dsm]

mdboze

I have greatly appreciated your talent in looking into the comms port etc:.

I posted a selection of your pics of the inside of the Bipap Auto SV Adv. Thanks a mill for that effort (I trust you saw the link if not pls lemme know ).

I found my sleeplink card & am in discussion with one classic old timer (salt of the earth) at cpaptalk who may be able to organize a sleeplink to PC cable. That will enable me to do upgrades & adjustments to the internal clock (I have a Bipap Pro II that is misbehaving).

Pls keep involved as your talents are rare (like timbalionguy) very capable engineers who are rarely appreciated by people who don't realise the professionalism involved in engineering - specifically, it has to be precise else it wont work & people might die & at worst empires might collapse

Cheers

DSM

DSM,
you mentioned having a sleeplink cable that allows you to do upgrades & adjustments to the internal clock .
What software do you use to do that ?

I've built my own 7pin din to RS232 cable, that allows me to connect directly to the communications port on the back of the unit; but have no software to control the unit or modify settings (Encore Pro 2.2 does not work for this).

All I need is software.... then, I can monitor the communication ; determine the command structure; then... write software for ALL to use.

When I get something working; I'll build a cable for you if you want one.

My Fav quote:

Those that believe it can't be done need to get out of the way of those who are doing it.

PM with belated xmas present sent

DSM

[dsm]

<snip>

nghy,

I have to agree for the most part with dsm,

I suggest you trial:
EPAP Min: 14
EPAP Max: 16
Min PS: 4
Max PS: 11
Max Pressure: 25

Banned

Re the Max Pressure set at 25,

If Epap Min = 14, then that plus PS Max of 11 = 25.

But If during the night (highly likely for nghy), then when Epap rises to EpapMax of 16 and with Max Pressure is set to 25, then PS Max will not be allowed to go over 9 - this is because when epap = 16 (16 + 9 = 25).

I lean towards only trying 1 change at a time & then only after gathering baseline data & discussing the changes with his doc.

Cheers

DSM

[Banned]

But If during the night (highly likely for nghy), then when Epap rises to EpapMax of 16 and with Max Pressure is set to 25, then PS Max will not be allowed to go over 9 - this is because when epap = 16 (16 + 9 = 25).

I lean towards only trying 1 change at a time & then only after gathering baseline data & discussing the changes with his doc.

Understood.

But why not limit Max PS to 25? What is the likelihood he will need higher Max PS? As you well know, the higher you set Max PS (or IPAP MAx), the louder the overall noise output of these Respironics devices become. If he is sleeping alone, he can raise Max PS. I sleep alone and find the device noise level above (IPAP) Max PS 25 to be unacceptably loud.

Ok. Change one parameter and time and discuss with us. Nix the doc. They maybe over-rated.

Banned

[dsm]

Banned,

Only that restricting Pressure Max to 25 means there is so little left for SV to be effective if PSMin remained at 6 - Also SV support is transitory (1-3 breaths max) so higher momentary pressures don't maintain a noise problem.

But then again, my machine never seems to go above 20 CMs no matter what upper limit I set. IN fact, over time the average max pressure reached has dropped as I have become attuned to the SV therapy (and lost weight ).

#2 - In this user case I would look to the nightly data to see just how high the machine feels it needs to push the pressure when applying SV support. If it pushes to 27, I'd let it unless there were apparent side effects that suggest limiting max pressure. With a MaxPS of 11, the machine would only go to 27 if nghy was 1) at Epap of 16 (either because EpapMin=16 or the machine is dealing with OSA & has pushed Epap to 16). & 2) because SV has decided nghy won't achieve the target peak av flow in a particular breath.

Cheers

DSM

[mdboze]

nigh: I'm still figuring out my machine... I'm only a few months into this. But here is my 2 cents:

DSM & Banned: nghy mentioned that he was not diagnosed with Central/Complex apnea; and he selected this machine because he wanted a machine that could go up to 30cm. Indicating OSA.

For OSA shouldn't his machine be set as a bipap somthing like this:
Min EPAP = 16 ; Max EPAP = 30
Min PS= 1 ; Max PS= 1
Max Pressure = 30

Then, let the machine take care of him with its smart algorithms.
DSM, Banned, what do you think ? You know more about this than me.

------------------------------------------------------------------------------------

[mdboze]

Update: I finally got a card reader. and am willing to tweak my settings again.

For the last 3 weeks, my settings have been:

Min & Max EPAP= 9
PS Min = 6
PS Min = 11

During that time:
Avg HYP Index = 5.0
Avg AHI = 6.3 (is this high ?)
Avg Patient Triggered breaths = 85.8%
I don't know what is good or bad ?

On the detailed graphs, almost every days shows patient triggered breaths drop below 5% for 20 to as long as 45 minutes a few times each night.

I want to improve my treatment if possible. Tips are welcome.