Need help with settings for ResMed S9 VPAP Auto

I haven't used a cpap machine for some time, because of horrible sinus problems from it But I'm to the point of severe problems anytime I am asleep. Last time I used this machine, it seemed to make me breath too fast at times.
I would like some suggestions on how you think it should be set.
Here is how it is set now, is it a problem to have these no's so close together, I don't need a very high pressure, even though my apnea is severe. I seemed to breath easier with this mode rather than straight cpap mode. I can go back to my doctor but I really dislike him. I bought this machine from someone on here and set it myself, so I would appreciate any help I can get.
Mode.......................V Auto
Max IPAP...................8.4
Min EPAP...................7.0
PS...........................0.4
Ti Max......................2.0
Ti Min.......................0.3
Trigger......................Med
Cycle........................Med
Max ramp...................off
Start EPAP..................4.0
Mask.........................nasal
Tube........................slimline

Do you have any reports to post?

From my limited knowledge with VPAPs, your settings (EPAP & IPAP) appear to be "almost CPAP" anyway.


Den

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No I don't, all the old ones were lost when my other laptop bit the dust.
I'm trying to figure out if some of these no's on these settings look way off. I sent an email for a manual, so that I might understand what more of the settings mean. Thanks for your reply.

All of my VPAP manuals are for the older ( pre-S9 ) models.
I don't know if this will help, but I did find a file (text) of something I copied from some VPAP manual once upon a time.

Den

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VPAP assists spontaneous breathing by cycling between two pressures in response
to the patient flow or a preset fixed time.
The inspiratory positive airway pressure (IPAP, or the sum of EPAP and the pressure
support level) assists inspiration.
The lower expiratory positive airway pressure (EPAP) eliminates exhaled air through
the mask exhaust vent. This facilitates exhalation comfort while providing a splint to
maintain an open upper airway.
The difference of the two pressures—pressure support level—contributes to
improved patient ventilation.

(So PS is pressure support)

Triggering and Cycling
(S, ST and VAuto modes) Under normal conditions, VPAP triggers (initiates IPAP)
and cycles (terminates IPAP and changes to EPAP) as it senses the change in patient
flow. Patient breath detection is enhanced by VPAP’s automatic leak management
feature—Vsync.
In addition, VPAP has adjustable trigger/cycle sensitivity to optimize the sensing level
according to patient conditions.

Rise Time Adjustment
(S, ST and T modes) Rise time sets the time taken for the VPAP to reach IPAP. The
greater the rise time value, the longer it takes for pressure to increase from EPAP to
IPAP.
Patients with a high ventilatory demand may prefer a shorter rise time, while patients
who are slow breathers may prefer a longer rise time.
Note: A prolonged rise time inhibits fast pressurization, therefore, rise time should
not be set longer than Ti Max or the patient’s normal inspiratory time.

TiControl™ – Inspiratory Time Control
(S, ST and VAuto modes) Unique to ResMed bilevel devices, TiControl allows the
clinician to set minimum and maximum limits on the time the device spends in IPAP.
The minimum and maximum time limits are set at either side of the patient’s ideal
spontaneous inspiratory time, providing a ’window of opportunity’ for the patient to
spontaneously cycle to EPAP.
The minimum time limit is set via the Ti Min parameter and the maximum time limit
is set via the Ti Max parameter.
TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing
synchronization by effectively intervening to limit or prolong the inspiratory time
when required. This ensures synchronization even in the presence of significant
mouth and/or mask leak.
The following table is a guide to selecting the Ti Max and Ti Min values that best
correspond to the patient’s respiratory rate and inspiration and expiration ratio,
depending on the respiratory conditions.Notes:
• Factory default values are Ti Max = 2.0 seconds and Ti Min = 0.3 seconds.
• I:E = 1:1 – Ti Min prevents the premature cycling to EPAP for patients whose
inspiratory effort is extremely weak.
• I:E = 1:3 – Ti Max limits the inspiration time for patients who require a longer
expiration time.
(Table omitted)

Exhalation
(VAuto mode) You can adjust the Exhalation rate so the rate of pressure drop is at a
level that is most comfortable for the patient. The medium rate is usually most
comfortable. If required, you can select a rate that is faster or slower.

Min EPAP, Max IPAP & Pressure Support
(VAuto mode) Pressure support allows you to set the difference between inspiratory
and expiratory pressure. Min EPAP and Max IPAP settings allow you to restrict the
range of pressures in which the AutoSet algorithm can operate.
The AutoSet pressure will vary across the session according to the patient’s needs.
It responds to snoring, apneas and flattening of the patient’s flow curve.
Min EPAP and Max IPAP can be adjusted to limit the upper and lower delivered
pressure limits.

Notes:
• The device will stay at Min EPAP (with the selected amount of pressure support)
during the Settling time (if selected) at the beginning of a session.
• If Pressure Support is set above 6 cm H2O, treatment efficacy may be reduced.


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Looks like it gives the meanings of a lot of things I have on my machine that I need to know, if I can just figure them out. I am a shallow breather and it causes me problems during the day also. I don't get enough excersise, never been a smoker.
Thank you, I will try and study this.

Marce wrote: it seemed to make me breath too fast at times.
Mode.......................V Auto
Max IPAP...................8.4
Min EPAP...................7.0
PS...........................0.4
Ti Max......................2.0
Ti Min.......................0.3
Trigger......................Med
Cycle........................Med
Max ramp...................off
Start EPAP..................4.0
Mask.........................nasal
Tube........................slimline

first, those settings will NOT cause you to breath too fast, in fact, with a ps of 0.4, many people would be hard pressed to even tell any difference in the ipap and epap pressures.

if you feel that it's cutting off the marginally higher inhale pressure too soon, increase TI Max. if you feel it's switching to the higher pressure too easily, set trigger to low, or extra low. that machine is completely, 100% controlled by YOUR breathing rate, not the other way around.

Wulfman... wrote:All of my VPAP manuals are for the older ( pre-S9 ) models.
I don't know if this will help, but I did find a file (text) of something I copied from some VPAP manual once upon a time.

Rise Time Adjustment
Exhalation

rise time isn't available in vauto, it is controlled by the easybreath algorithm... I don't believe exhalation exists in the s9 vpaps, though. (fwiw). the rest is relevant.

Thank you for the information, I received the manual that I requested by email and printed parts of it. Sometimes it is better to get information from the ones that have used and studied about the different machines.