How do I match current settings in the ResMed AirSense 10

How do I match current settings in the ResMed AirSense 10 Audoset to the Philips Respironics BiPAP Auto Bi_Flex?

I'm only a few weeks into CPAP, where, on another thread, I found out, much to my chagrin, that the new Resmed A10 I received from Kaiser uses a hugely non-standard power supply when camping.

In discussing possible solutions with a very good friend of mine, he mentioned that I can borrow his spare Philips Respironics Bi-PAP Auto Bi-Flex 750P any time I want to go camping (or if my power goes out for an appreciable period of time).
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My friend says he hooks it directly up to a normal 12VDC car battery, and he has had no problems, and that I can borrow it for months at a time (he said to simply give it back if his current machine ever breaks).

So my only question here is how to "match" my Resmed A10 clinical settings to the strange words used on this Philips Respironics Bi-PAP Auto Bi-Flex 750P machine.
----------------------------
I was able to get the ResMed AirSense 10 Audoset machine in "clinician mode" by simultaneously holding down the round button and the home button for a few seconds until the machine beeped and put me in Clinician Mode.

Here are my ResMed AirSense 10 Audoset settings from Kaiser
THERAPY:
- Mode = Autoset
- Max Pressure = 20.0
- Min Pressure = 10.00
- Mask = Nasal
COMFORT:
- Ramp Time = Off
- EPR = On
- EPR Type = Full Time
- EPR Level = 2
- Humidity Level = Off
Accessories:
- Tube = SlimLine
- AB Filter = No
Options:
- Essentials = Plus
- SmartStart = On
Reminders:
- Mask = Off
- Water Tub = Off
- Tube = Off
- Filter = Of
----------------------------
I was able to get the Philips Respironics BiPAP Auto Bi-Flex machine in "clinician mode" by setting the display to "Settings" and then holding down the round and ramp buttons simultaneously for a few seconds until the machine beeped and put me in Clinician Mode.

Here are my friend's current Respironics BiPap settings:
Blower Hours:
- Total hours: 15834.1
Setup:
- Mode = Auto
- Max IPAP = 20.0
- Min EPAP = 8.0
- Max PS = 3.0
- Flex Type = Bi-Flex
- Bi-Flex = 3
- SYSTEM = X2
- LOCK SYS = off
- Ramp Time = 0:10
- Ramp Start = 7.5
- Auto on = on
- Auto off = on
- Mask alert = on
- Humidifier = off
- Show AHI = on
- Split night = off
----------------------------
From what I understand of the Kaiser settings, all I really need to know are these three data points, right?
1. The ResMed is set to automatic,
2. Between 10 and 20 cm of water,
3. With an expiration of 2 cm below that of inspiration

Given those are the 3 fundamental settings (AFAIK), this post is to ask what would the equivalent settings be for the Philips Respironics BiPAP Auto Bi_Flex?

The only problem is maybe going to be the PS setting.
Think of your EPR as PS because that's essentially what it is. The 750 machine has a minimum default of minimum PS of 2 that you don't see because in this model they didn't offer a specific minimum PS...they do in the 760 model. I don't know if it will let you go lower than PS of 3 but if it doesn't..not the end of the world.
It won't move off PS of 2 unless it needs to and the difference between 2 and 3 PS isn't going to be a deal breaker.

For the pressure settings

Your current 10 cm minimum APAP with EPR of 2 means 8 cm on exhale...so set the minimum EPAP to 8
Maximum IPAP set it to 20.

8 EPAP plus 2 PS (the initial default) will equal the 10 cm you are now getting with the ResMed.
I don't remember if it will allow a 2.5 PS setting..if it does you can use that..if not just use the 3. You will be asleep when it moves off of 2 anyway and that 1 cm difference isn't going to hurt anything at all.

BiFlex is a little extra "rounding" of the breaths...use what feels good or turn it off. Not a critical setting.

System X2 is for the Resistance control for a certain Respironics mask.. if using a ResMed mask turn it off.
It is not a critical setting at all..and has nothing to do with leak numbers.

Pugsy wrote:The only problem is maybe going to be the PS setting.

Thanks for your help and advice, which I appreciate.

Pugsy wrote: Think of your EPR as PS because that's essentially what it is.

The good news is that I don't need much, if any exhalation pressure support, so I'm very flexible on that setting.

Pugsy wrote: The 750 machine has a minimum default of minimum PS of 2 that you don't see because in this model they didn't offer a specific minimum PS...they do in the 760 model.

Ah, that explains why some sites say to set the minimum pressure support, while I couldn't find any setting for that in the "BiPAP Auto 750P" that I am trying to set up.
It's tidbits like that which make this site (and you!) very worthwhile!
Thanks.

Pugsy wrote: I don't know if it will let you go lower than PS of 3 but if it doesn't..not the end of the world.

You are correct in that the 750P won't let me set the "Max PS" any lower than 3.0; but, as you said, exhalation pressure support is the least of my worries anyway.

Pugsy wrote: It won't move off PS of 2 unless it needs to and the difference between 2 and 3 PS isn't going to be a deal breaker.

Now that I know this missing information, that the minimum pressure support is already set at 2.0 cm of water, I'm fine with that as my current ResMed EPR setting is 2 cm of water, so, the pressure relief is already matched by default.

Pugsy wrote: For the pressure settings
Your current 10 cm minimum APAP with EPR of 2 means 8 cm on exhale...so set the minimum EPAP to 8
Maximum IPAP set it to 20.

Ah. That makes sense!
Up until now, I had thought I needed to set the following settings, but that's because I had no idea there was a 2cm water minimum pressure support, by default:

My First Attempt at a Matching Setup on the 750P:
- Mode = Auto
- Max IPAP = 20.0
- Min EPAP = 7.0 <---------- previously assuming 7 + 3 = 10 <---------- but you're explaining that expiration pressure should be 8 + 2 (where the 2 is hidden)
- Max PS = 3.0 <---------- previously assuming 7 + 3 = 10 <---------- but you're explaining that pressure support should be 8 + 2 (where the 2 is hidden)
- Flex Type = None <---------- I turned this off to simplify the calculations (I think)
- Rise Time = 0 <---------- this appeared when I set flex type to none!
- Bi-Flex = 3 <---------- this disappeared when I set flex type to none!
- SYSTEM = X2
- LOCK SYS = off
- Ramp Time = 0:10
- Ramp Start = 7.0 <---------- this dropped from 7.5 to 7.0 when I set flex type to none!
- Auto on = on
- Auto off = on
- Mask alert = on
- Humidifier = off
- Show AHI = on
- Split night = off

Pugsy wrote: 8 EPAP plus 2 PS (the initial default) will equal the 10 cm you are now getting with the ResMed.
I don't remember if it will allow a 2.5 PS setting..if it does you can use that..if not just use the 3.
You will be asleep when it moves off of 2 anyway and that 1 cm difference isn't going to hurt anything at all.

You are correct that 3.0 is the lowest max pressure support the 750P will allow me.

Pugsy wrote: BiFlex is a little extra "rounding" of the breaths...use what feels good or turn it off. Not a critical setting.

I've subsequently turned it off (I wasn't able to respond sooner due to technical difficulties).

Pugsy wrote: System X2 is for the Resistance control for a certain Respironics mask.. if using a ResMed mask turn it off.
It is not a critical setting at all..and has nothing to do with leak numbers.

Ah. I'm using a "Fisher & Paykel" Nasal Mask "For CPAP or bi-level ventilation", model 400451.
When they asked what kind of mask I wanted, I didn't know what to tell them; so I said to give me the same mask as the original loaner mask.
That nasal mask is not made by Philips or ResMed, so, I'll turn the X2 setting off.
Thanks for that advice.

The choices were 0, X1, X2, X3, X4, and X5, so I set it to 0.

Given all that great advice, the current Philips BiPAP Auto Bi-Flex 750P settings are:
- Mode = Auto
- Max IPAP = 20.0
- Min EPAP = 8.0 <---------- i.e., 8 + 2 (where the 2 is hidden) = 10 cm water
- Max PS = 3.0 <---------- the lowest it will go (bearing in mind the default Min pressure support is 2 for the 750P)
- Flex Type = None <---------- I turned this off to simplify the calculations (I think)
- Rise Time = 0 <---------- this appeared when I set flex type to none!
- SYSTEM = 0 <---------- I'm not using any of the Philips X1, X2, X3, X4, or X5 masks
- LOCK SYS = off
- Ramp Time = 0:10
- Ramp Start = 7.0 <---------- this dropped from 7.5 to 7.0 when I set flex type to none!
- Auto on = on
- Auto off = on
- Mask alert = on
- Humidifier = off
- Show AHI = on
- Split night = off

How does that look to match the original ResMed settings?

NOTE:
Sorry I couldn't respond sooner, but the site has implemented a new cloudflare captcha requirement that couldn't possible have been tested, not even once, because if anyone tested it once, they'd see there is no way to log into this site securely (protecting your password). Anyway, I apologize that I had to spend a lot of time to work around that site error, so I couldn't respond sooner. Maybe they'll try to log in, just once, using the Tor Browser Bundle, and they'll instantly see what I'm talking about.

Don't worry about the ramp thing....ramp won't even come on unless you push the ramp button itself.
If you don't push it then it doesn't matter how long it is set for or what it starts at.

Rise Time only shows up when BiFlex is turned off. It has to do with the timing of the inhale/exhale thing.
BiFlex does the timing of the inhale/exhale based on your own breathing pattern per the setting.
So you have one or the other available. I have owned a 750 and to be honest I tried it with the BiFlex settings and also with the Rise Time settings and I really couldn't tell any huge difference. I felt BiFlex of 2 seemed to match my own breathing more naturally so that's what I ended up using just from a comfort aspect. That's what I usually suggest that people do...try each setting to see what feels more natural and use the one that feels the best. If you are okay with rise time at 0...then use that.
BiFlex itself doesn't work so much as a per cm reduction like the ResMed machines...it's more flow based and more of a timing issue than a reduction/exhale relief thing. Even at the maximum BiFlex setting the amount of reduction isn't going to be all that much on top of PS.

The only real difference going with the 750 when matching setting to setting (or as close as we can get) is that Respironics auto algorithm is a little slower/gentler algorithm when compared to ResMed's algorithm.
You might see a change in the AHI...probably not a huge change but Respironics way of doing things might allow a few OAs/hyponeas to happen before it reaches the pressure needed to hold the airway open...but that might be offset by the fact that it reduces more slowly after it has been up there holding the airway open and since it goes down more slowly it may hold the airway open a little longer at the higher pressures while coming down. Should there be a marked change in AHI to the point it's too ugly...just use a little higher minimum EPAP to help out the slow response time a bit.

We can adjust and make the settings very similar and I think that most people won't see any huge differences in the results (AHI, etc) but we still have the differences in the algorithm that we can't adjust for to make things exactly the same between the 2 brands.

verbatim wrote: Sorry I couldn't respond sooner, but the site has implemented a new cloudflare captcha requirement that couldn't possible have been tested, not even once, because if anyone tested it once, they'd see there is no way to log into this site securely (protecting your password). Anyway, I apologize that I had to spend a lot of time to work around that site error, so I couldn't respond sooner. Maybe they'll try to log in, just once, using the Tor Browser Bundle, and they'll instantly see what I'm talking about.[/i]

cloudflare doesn't like sneaky bastards using tor.

Pugsy wrote:Don't worry about the ramp thing....ramp won't even come on unless you push the ramp button itself.
If you don't push it then it doesn't matter how long it is set for or what it starts at.

Rise Time only shows up when BiFlex is turned off. It has to do with the timing of the inhale/exhale thing.
BiFlex does the timing of the inhale/exhale based on your own breathing pattern per the setting.
So you have one or the other available. I have owned a 750 and to be honest I tried it with the BiFlex settings and also with the Rise Time settings and I really couldn't tell any huge difference. I felt BiFlex of 2 seemed to match my own breathing more naturally so that's what I ended up using just from a comfort aspect. That's what I usually suggest that people do...try each setting to see what feels more natural and use the one that feels the best. If you are okay with rise time at 0...then use that.
BiFlex itself doesn't work so much as a per cm reduction like the ResMed machines...it's more flow based and more of a timing issue than a reduction/exhale relief thing. Even at the maximum BiFlex setting the amount of reduction isn't going to be all that much on top of PS.

The only real difference going with the 750 when matching setting to setting (or as close as we can get) is that Respironics auto algorithm is a little slower/gentler algorithm when compared to ResMed's algorithm.
You might see a change in the AHI...probably not a huge change but Respironics way of doing things might allow a few OAs/hyponeas to happen before it reaches the pressure needed to hold the airway open...but that might be offset by the fact that it reduces more slowly after it has been up there holding the airway open and since it goes down more slowly it may hold the airway open a little longer at the higher pressures while coming down. Should there be a marked change in AHI to the point it's too ugly...just use a little higher minimum EPAP to help out the slow response time a bit.

We can adjust and make the settings very similar and I think that most people won't see any huge differences in the results (AHI, etc) but we still have the differences in the algorithm that we can't adjust for to make things exactly the same between the 2 brands.

Thanks for all that WONDERFUL information, clarification, definitions, and advice!
I used the settings below last night on the Respironics 750P, and the experience felt comparable (to me) to what I had experienced the night before using the ResMed A10 set up by Kaiser.
I'll try again tonight to see if there is anything I'd want to tweak, but, I'm relatively easygoing when it comes to such things (I will check the AHI to ensure it's below 1.0 which mine usually is lately on the ResMed).

- Mode = Auto
- Max IPAP = 20.0
- Min EPAP = 8.0 <---------- i.e., 8 + 2 (where the 2 is hidden) = 10 cm water
- Max PS = 3.0 <---------- the lowest it will go (bearing in mind the default Min pressure support is 2 for the 750P)
- Flex Type = None <---------- I turned Bi-Flex off where BiFlex handles timing of the inhale/exhale depending on how you breathe)
- Rise Time = 0 <---------- appears when flex type is none in order to set in/out timing
- SYSTEM = 0 <---------- I'm not using any of the Philips X1, X2, X3, X4, or X5 masks so this is set to 0
- LOCK SYS = off
- Ramp Time = 0:10 <---------- only works when you press the ramp button (which I don't need)
- Ramp Start = 7.0 <---------- this dropped from 7.5 to 7.0 when I set flex type to none (but it only matters if I hit the ramp button)
- Auto on = on
- Auto off = on
- Mask alert = on
- Humidifier = off
- Show AHI = on
- Split night = off

I understand your prejudice against people who want security.
The problem is that it worked just fine, just a few days ago when I last posted; it's only in the past couple of days where something changed, where the site admins screwed something up such that the Tor Browser Bundle (with the default setup) no longer allows one to log in. It could be that the Tor Browser Bundle changed something in the last update (perhaps its javascript settings, or its cookie settings, or its web canvas settings, etc.) - but even so - any decent site admin would test such a thing, the test taking all of ten minutes to complete (assuming the site admin needs to download the latest Tor Browser Bundle).

Remember, honest people want privacy too.
Also remember, only a fool hands out his password to EVERYONE within earshot (figuratively speaking), which is what happens to anyone using this web site sans encryption (whether they realize that fact, or not).
And, please remember, the Tor Browser Bundle is nothing more than a hardened Firefox, with onion routing.

I'm currently using VPN, which is encryption by another means - however - the browser I'm using isn't hardened, so, a ton of bad things are happening to my privacy at this very moment (e.g., browser fingerprinting, cookies, super cookies, etc.).

I repeat: Only a fool goes on the net without privacy protection of some sort.
BTW, I don't blame the admins for not adding any security; but I would like them to TEST (at least once) their cloudflare implementation!
And, of course, every user should be aware that they're handing out their login credentials to EVERYONE who has access to their packets (which is potentially a huge number of people) every time they log in, such that EVERYTHING they do on this site is open to the public, so to speak (including their private PMs and their settings, etc.).

This is all extremely basic computer-networking 101, which everyone who knows anything about computers already knows - so I'm only repeating the obvious to respond to your comment that intimates anyone who wants privacy wants it for nefarious purposes. Nobody should ever have to defend WHY they desire privacy; it's those who deny that privacy that would need to defend themselves (that's a Snowden quote, not mine).

Anyway, thanks for all your help - I will sleep better tonight with the Philips.
Meanwhile I've been designing a portable power supply for the ResMed, which I posted a preliminary diagram of over in this thread just now:
viewtopic.php?f=1&t=112232

The numbers from last night look good, so, I thank you for helping me set up the standard-power-supply Philiips device to match (as close as necessary) the settings of the Resmed device in order to work around the hugely non-standard power supply that ResMed marketing foisted upon us.


As another potential solution to work around the non-standard power supply of the ResMed device, this thread covers how to build for a few bucks your own 3.3-Volt 90W-Sensing circuitry that the ResMed device is expecting:
viewtopic.php?f=1&t=112025&st=0&sk=t&sd=a&start=60

Glad those settings worked out well for you. Mission accomplished.

Thank you for the information about rigging up some other sort of power supply for my ResMed but all that stuff is way over my head and I have no desire to learn. We all have things that we are good at and things that we aren't so good at and power/batteries/electricity are not things that I know much about other than on/off and don't mess with electric unless I throw the main breaker to the house. Beyond that my eyes glaze over and it's just an area that I am not motivated to expand my knowledge.
So I will stick to stuff that I am good at and ignore the stuff that I am not good at and am to lazy to learn.

I have a Respironics machine if I ever go camping and want to do the battery thing.
For the house ...I have a portable generator that powers the whole house should we end up with a prolonged power outage here.

Pugsy wrote:Glad those settings worked out well for you. Mission accomplished.

Thanks to you, the mission was accomplished (a) successfully, and (b) very quickly!
I much appreciate your astute help and advice!

Pugsy wrote: Thank you for the information about rigging up some other sort of power supply for my ResMed but all that stuff is way over my head and I have no desire to learn. We all have things that we are good at and things that we aren't so good at and power/batteries/electricity are not things that I know much about other than on/off and don't mess with electric unless I throw the main breaker to the house. Beyond that my eyes glaze over and it's just an area that I am not motivated to expand my knowledge.
So I will stick to stuff that I am good at and ignore the stuff that I am not good at and am to lazy to learn.

I understand. If we were all blonde and pretty, we wouldn't have to think, we could just smile and say almost nothing intelligent, and everyone would be wowed by us and they would set up everything for us without us having to think or learn anything.

But, not being even close to blonde and pretty, we pretty much have to know what we're doing, and if we don't know, we have to learn.
It's the hard fact of life.

To that end, I've only spent a couple of hours tackling this non-standard power-supply issue, but, at this point, I can suggest three viable solutions:
1. Buy the noisy ResMed 12VDC-to-24VDC up converter and power supply adapters, and then make sure you add plenty of EMI filters to filter out the power supply noise.
2. Build the simple 90W-sensing 2.7K Ohm 3.3VDC sense circuitry, and use two EMI-free 35Amp-Hour batteries (total cost about five bucks, sans the batteries).
3. Borrow a CPAP machine that uses a standard 12VDC power supply, and simply set it up to match that of your non-standard ResMed machine

Pugsy wrote: I have a Respironics machine if I ever go camping and want to do the battery thing.
For the house ...I have a portable generator that powers the whole house should we end up with a prolonged power outage here.

Ah, I agree.

Everything technical involves choices, which involve understanding the pros and cons, which requires a bit of technical acumen to evaluate properly.

For example, if you're using a whole-house generator, you'll have to worry about the amount of fuel it consumes, e.g., a 14KW propane generator can consume a gallon an hour, depending (of course) on the load; so you'll need to stock at least as much fuel as you'd expect to consume for a typical power outage.

If you go the battery route, you generally only get a couple of days out of an average-sized (e.g., 35 Amp Hour) SLA battery - but we can ramp that up for home use with larger batteries if necessary.

I can tell you are well aware of how to assess technical pros and cons, just by the way you advised me to set up the Philips 750P to match that of the Resmed A10, so, I know you have that assessment well under control.

After you assess the available power, you then have to work to reduce the required power that the machine is going to draw.
For example, here's a snippet out of the ResMed manual for how much current is consumed by my A10, based on the settings:

Pugsy wrote:Beyond that my eyes glaze over and it's just an area that I am not motivated to expand my knowledge.

What's interesting is that the "sense" circuitry on the non-standard ResMed devices seems to be relatively simple analog sense circuitry that only affects the non-standard center pin.
To fool that ResMed center-pin analog-sense circuitry into thinking it's connected to a 90W ResMed power supply, apparently only takes this simple circuit.

It's important to understand how the ResMed power supply works, in order to make intelligent decisions for portable use.

We know (from the patent and from measurements made by others) that the power supply appears as a 2.7KOhm resistance at 3.3VDC.
And we know that the 0.1uF capacitor setting works - but I'm digging deeper to see if we can tweak that high-pass filter without adversely affecting the ResMed analog resistor-sensing circuitry.

What we don't (yet) know is whether there is any voltage on the middle pin of the ResMed unit when it is powered up.
Here are the calculations, for example, "assuming" that there is 24VDC on that middle pin (inside the ResMed CPAP device):
[*] http://ladyada.net/library/rccalc.html


Since those calculations above depend on knowing whether there is a voltage on the middle pin of the ResMed unit, I simply ask if anyone here knows the answer to this question:
[Q] Is there an internal voltage on the ResMed middle pin when the unit is powered up?