Which ASV Machine Is It That Can Be Switched To APAP Mode?

I can't remember which companies machine it is that you can turn off the ASV and change the settings so the machine will act like just an APAP. Is it the ResMed S9 series of the Respironics System One Series 60?

Neither allows "turning off ASV" but you can maybe effectively dumb the machine down to APAP mode by some setting choices.
PS needs to be set to 0 for both minimum and maximum.
EPAP minimum and maximum need to be equal to each other and would function like APAP minimum pressure
IPAP max would be similar to APAP max setting.
At least I think the above will do it.
I think the Adapt offers cpap mode...not sure if the 960 offers cpap mode but neither offers apap mode all by itself.

My ResMed S9 Adapt model 36007 won't let me set PS below 3.0 and won't let me go below 8.0 cm max PS
I don't know what the 36037 model offers with its PS choices but it looks like while it offers minimum PS of 0 the lowest PS max it offers is 5.0 at least from the manual I am looking at.

We have some PR S1 model 960 users and ResMed Adapt model 36037 users here on the forum. Perhaps they can confirm what the PS will or won't do.

Looks like the 960 might do the PS to 0 thing. I don't have one of these machines to test though....I think Squid13 just got a new 960 to play with though. I will ask him.

Pugsy wrote:My ResMed S9 Adapt model 36007 won't let me set PS below 3.0 and won't let me go below 8.0 cm max PS
I don't know what the 36037 model offers with its PS choices but it looks like while it offers minimum PS of 0 the lowest PS max it offers is 5.0 at least from the manual I am looking at.

the 36037 manual, says minps=0-6 and maxps=5-20.

the 007 couldn't even get close to apap since it won't vary epap anyway

you could bastardize the 037 into apap mode with a set ps of 5 it looks like, or a varying 0-5.

the auto makes a better autoset though

EPAP minimum and maximum need to be equal to each other and would function like APAP minimum pressure

I don't think that is quite right. You would not need to set EPAP min and EPAP max equal to each other.

On the PR 960, you could set the PSmin to 0 and set PSmax to as low as it can go (might be zero, not sure). You can also turn off the backup rate.

EPAPmin would then be something like APAP minimum pressure, EPAPmax would be something like APAP maximum pressure.

I have not tried this, and I am not sure it would it would do anything useful. The algorithms of the ASV and the APAP are likely quite different, and simply limiting parameters may not cause the ASV to emulate a functional APAP.

I can't really figure out when the PR 960 figures it is good time to raise EPAP. Sometimes it seems to do it periodically with no real indication why, other times it does not raise it even after events flagged as OA. It is constantly raising and lowing PS, that seems to be its main control.

I have been tempted to try something like this and lock my machine down to the absolute minimum setting for one night to try to get a baseline. On the other hand, it is working so well I hate to mess with it.

You can set PS min and PS max to zero, I just did it on my 960 ASV.

cnaumann wrote:I don't think that is quite right. You would not need to set EPAP min and EPAP max equal to each other.

For something to function like APAP mode there can only be one pressure and if EPAP min and max aren't the same then there's not one pressure because we still have IPAP setting to contend with unless IPAP max can be set to equal EPAP max...and I don't know if that can be done. I don't know what choices would be available when PS is totally 0. IPAP would be the one I would wonder about.

Squid tells me that PS on the 960 can indeed be set to 0 for both PS min and max. So that part of it is doable.

It does sound like the 960 could be more closely dumbed down to mimic APAP mode than the S9 Adapt Auto though unless we set the Adapt to function like the AutoSet but use EPR of 5 (if the AutoSet would go to 5 EPR) which to me would be a very nice setting...apap with EPR of 5...probably quite comfy to someone who likes EPR.

I think with either one we can get close to APAP mode and maybe with the 960 really close.

For something to function like APAP mode there can only be one pressure and if EPAP min and max aren't the same then there's not one pressure because we still have IPAP setting to contend with unless IPAP max can be set to equal EPAP max...

Doesn't an APAP by definition change its pressure settings in response to an event? If you are having a bunch of OA events, doesn't an APAP automatically raise its pressure? Am I very confused here?

On the PR 960, IPAP = EPAP + PS

You set an allowable range for EPAP and PS as well as a maximum pressure limit.

If you set PS to zero, IPAP and EPAP will always be the same. EPAP can change between it minimum and maximum in response to an event, IPAP will change with it.

Am I missing something?

cnaumann wrote:Doesn't an APAP by definition change its pressure settings in response to an event? If you are having a bunch of OA events, doesn't an APAP automatically raise its pressure? Am I very confused here?

Yes...but it's a single pressure and not a dual pressure thing.
Technically with APAP there is only one pressure (no EPAP or IPAP) with maybe the exception of the S9 AutoSet when EPR is being used.

I don't have a 960 to play with the settings...see if you can come up with settings that mimic APAP with minimum being 10 and maximum being 20. PS minimum and maximum will need to be 0...that I am sure of for true single pressure and not something similar to what EPR does. Minimum EPAP will need to be 10 (using this example above) but from there I don't know what to do with EPAP max or IPAP max. I can do it easily with my 760 but I don't have a 960 to see if I can do it.
See if your idea of just using EPAP min and maximum will work...see what happens to IPAP.
You may be right...we may be able to mimic apap by just using EPAP settings but I don't know what happens to IPAP max.

What we want would be for the machine to stay at 10 cm both inhale and exhale while awake and not change until a person falls asleep and the apnea events drive the pressure changes.
I am pressure sure it will work with EPAP min and max to equal each other...I am not sure what happens if EPAP min and max aren't the same even is PS is 0 all the way around....and what happens to IPAP?
For all I know there could be 2 ways to mimic APAP mode.

Seems like the 960 was the one I was thinking of. Sounds like it can be adjusted to pretty much function as an APAP.

With PS set to zero, you effectively turn off the bi-level support. IPAP and EPAP will be equal when PS = 0.

If you set EPAPmin and EPAPmax to the same value and set PS to zero, you would have an expensive CPAP machine. The inhale and exhale pressure would be the same constant value.

If you set EPAPmin and EPAPmax to the different values and set PS to zero, you would have an expensive APAP machine. The inhale and exhale pressure would be the same value, but that value could change in response to events.

Pugsy wrote:

cnaumann wrote:Doesn't an APAP by definition change its pressure settings in response to an event? If you are having a bunch of OA events, doesn't an APAP automatically raise its pressure? Am I very confused here?

Yes...but it's a single pressure and not a dual pressure thing.
Technically with APAP there is only one pressure (no EPAP or IPAP) with maybe the exception of the S9 AutoSet when EPR is being used..

as much as I hate to do it, I have to agree with cnaumann on this one, *lol*. you want epap min=lower apap pressure and epap max=upper apap pressure, and ps=0 (or whatever).

that's what a regular apap does, and what the 037 does... varying epap in reaction to OAs and hypos, and varying the ipap in reaction to CAs

palerider wrote: as much as I hate to do it, I have to agree with cnaumann on this one, *lol*. you want epap min=lower apap pressure and epap max=upper apap pressure, and ps=0 (or whatever).

Okay...I concede. I thought it would work like the 760 does..I was wrong. That's why I asked others who had this machine to check the settings available.
I did say this...

Pugsy wrote:At least I think the above will do it.

So I thought I had done a good job of the CYA thing...

as much as I hate to do it, I have to agree with cnaumann on this one, *lol*

So PR, how is the weather down there? Getting cold outside?

I did a quick experiment last night. Although it is not conclusive, it does not look hopeful that the PR 960 would make a useful APAP machine. I set the PS to zero and went to sleep for bit. Note that in spite of the really ratty breathing, it did not flag any events. I also had EPAPmin and EPAPmax set to the same value so this was more like a CPAP mode than an APAP mode.

The highlighed area show the bad breathing during the experiment. After the experiment, I reset the machine to its normal setting for the rest of the night and events were flagged normally.

cnaumann wrote:

as much as I hate to do it, I have to agree with cnaumann on this one, *lol*

So PR, how is the weather down there? Getting cold outside?

wet, at the moment.

cnaumann wrote: I did a quick experiment last night. Although it is not conclusive, it does not look hopeful that the PR 960 would make a useful APAP machine. I set the PS to zero and went to sleep for bit. Note that in spite of the really ratty breathing, it did not flag any events. I also had EPAPmin and EPAPmax set to the same value so this was more like a CPAP mode than an APAP mode.

The highlighed area show the bad breathing during the experiment. After the experiment, I reset the machine to its normal setting for the rest of the night and events were flagged normally.

did you *have* any events?

it's impossible to tell the duration at the zoom size shown, how long were your pauses? could be, that as crappy as that was, you didn't have anything that would be classified as an apnea.

Seems like I'm better off keeping my APAP machine until its mine then getting him to switch me to ASV so I can use either machine depending on my symptoms at that time