S9 VPAP Adapt Settings

I need help with the settings on my S9 VPAP Adapt. I have a hand me down with low hours and want limit how much pressure the ventilator portion has. I regularly use an S9 VPAP Auto that I love. I want to use this as a travel machine or start using it as every night machine.

Exactly which model Adapt do you have...the 36007 or the 36037?

Exactly what settings are you using on the S9 VPAP Auto? All the settings...mode, PS and minimum and maximum, etc.

Answer those questions and we can see how close we can come to matching the settings.

Wow! Very excited that you replied so fast.

I have a 36037 with 1,412 hours on it. I want the settings to make it as much like my S9 VPAP Auto as possible. I cannot detect the same settings on both machines. I have been successful sleeping with the adapt but I have a harder time to get to sleep. If I stop to yawn or swallow I get a higher pressure gush of air.

These are my current settings.

VPAP Adapt in ASV Auto mode.
Min EPAP 4.0
Max EPAP 7.0
Min PS 3.0
Max PS 13.0

I see the error and fixed it. S9 VPAP Auto on next reply

The settings for the VPAP Auto seem to have not gone with the reply.

VPAP Auto

Max IPAP 14.0
Min EPAP 4.0
PS 4.0

Okay...keep the Adapt in AutoSV mode

Change your Minimum PS to 4....and see if the maximum PS will also equal 4...if it won't...try 5.

Keep your minimum EPAP at 4 but change the maximum EPAP to as high as it will go....this ends up forcing IPAP up similarly to what your VPAP does with its higher IPAP max. You probably won't ever go near the max but if you want or need to limit IPAP max you will have to do it with Max EPAP limit. Remember IPAP is a function of EPAP plus PS.

Probably what you find annoying is PS increasing while awake and not breathing regularly and the machine wants to try to fix it...only it doesn't need fixing while awake. So the PS is what we mainly need to limit.

If it won't let you change PS easily....go in and change the maximum EPAP first because sometimes if max EPAP is too low it won't let you do PS changes. I forget which setting comes first.

On your VPAP Auto....4 minimum and PS of 4 (and it won't vary)...that means in inhale you have 8 cm and on exhale you have 4 cm...and with max IPAP you can go up to 14 IPAP which means 10 EPAP. If you never hit the 14 IPAP...doesn't hurt keep things that way.

On the Adapt....4 minimum EPAP works out the same. So we also need PS of 4 both minimum and maximum if possible so that the PS can't vary. I think it will let you do PS minimum to equal max but if it won't then do PS max of 5..it's close enough and not so annoying with the bursts of air. This gives you the same 4 exhale and 8 inhale that you have on the VPAP. So should feel the same.
You need enough room in the maximum EPAP to let PS work and force IPAP up if you need it. I usually tell people to set max EPAP as high as it can go and not worry about it...the machine won't go up without a good reason.
If you want to limit it...max EPAP needs to be probably 11 or 12 so that your IPAP can equal your prior max of 14 or in that neighborhood.
Again...a lot depends on if you were hitting that IPAP max of 14 very often or not.

You were real close on your settings...it was your PS with the range that is likely the source of your discomfort. If you pause your breathing at all while awake the machine thinks you are having a central apnea and will increase that PS rather dramatically in an effort to force you to breathe. So if we set the PS to match...and limit the PS so it can't give you that burst of pressure...you should be real close to how the VPAP feels.

Give it a try and report back.

Oh...any other comfort settings like Ti min or max or others you might see...leave them at the factory defaults. They don't normally factor in except in special circumstances.

I so much appreciate your help and expertise .

I am having trouble with the Max PS. Setting the Min PS at 4 moves the Max PS to 9.0. I can set the min. PS to 0.0 and only lower the max PS to 5.0. When I raise the


min. PS up the max PS also increases and is always 5.0 apart. i.e. I set the min PS at 2.4 and the max increases to 7.4. Can I leave the min. PS at 0.0 or 1.0?

Crap... I was afraid of that...a limitation of the ASV and PS range. I couldn't remember for sure (it's been a few years since I used the 36037 model...and when I did I just left the PS open because the big bursts didn't bug me) if the machine would let someone use a tight PS range.

PS gives you the difference between inhale and exhale. You can use 0.0 or a lower minimum like 2.4 (with wherever it wants to limit the max PS) and stop the higher PS burst while awake but then you won't have the PS of 4 that you are used to. So it may feel a bit weird for you It won't hurt anything but it might not be all that comfortable for you because it may be or feel so different from what you are used to.
Maybe you could split the difference and use the minimum PS of 3 and max PS of 8 which might not be so bad.

Here's what is happening while awake and maybe once you get more used to it and how it works it won't seem like a problem...
while awake our breathing is irregular and often we pause our breathing or hold our breath and don't realize it. The machine takes a sort of running inventory of our breathing when we first start up the ASV machine and configures the auto breath rate algorithm...if I remember right it takes about 2 minutes to do this...then once that auto breath need is calculated and it takes longer for you to fall asleep and you don't breathe in a pattern that it calculated (based on that initial average) that adds up to so many breaths a minute then it thinks when you don't breathe enough to meet that rate ...that it needs to breathe for you and it gives you that big burst of PS to help you out. It's just doing its job. It doesn't know you are awake and just maybe holding your breath a little and you don't realize it.

Now you might also be able to force the machine to configure the auto breath rate to a lower number so it won't get in a panic when you don't breathe so fast and kick in with that burst of PS. What you do is when you first put the mask on and start the machine you make a concerted effort to breathe slowly and smoothly.
Example....maybe at the beginning of the session you were breathing rather quickly and and randomly and the machine ends up thinking you need to breathe 18 times a minute so it sets the auto breath to kick in if your breathing slows down to a point it where it is below 18 per minute. When your breathing slows down to a rate below 18...the machine kicks in because your rate is lower than the auto calculated rate. When it kicks in you get that big annoying burst.
So if you were to be very slow and deliberate with your breathing the first few minutes (2 minutes comes to my mind but it might be a bit longer) then the machine then would decide maybe you don't need so much extra help when you pause your breathing while awake. So it then sets an auto breath rate of maybe 8 per minute and it won't give you that burst of air until your rate drops below 8.

There is no way to set the auto breath rate on the 36037 machine that I remember so we can't manually override it, I don't think, but you could maybe fool the machine into thinking your slower breathing rate is just normal for you.
The auto breath thing gets a new calculation every time the machine gets turned on. It won't remember last night at all or what it figured earlier in the night if you would happen to turn the machine off in the middle of the night. It resets with every power interruption.

So you could try that with PS of 4 minimum and max of 9....and see if you still get the annoying bursts...slow deliberate breathing for a few minutes when you first start the machine.
Or you can use less PS if you are comfortable with it. Won't hurt a thing to use 2.4 min PS and 7.4 max PS....or anything in between as long as you are okay with less PS while awake.

Those bursts are just the machine doing its job...when it thinks you aren't breathing then it gives you that little annoying burst to jump start your breathing. That's how central apneas are treated...the machine essentially breathes for you. Annoying while awake for sure but that's the main job of the ASV machine when it comes to central apneas. It has zero way to know if you are awake and just pausing your breathing making it irregular or if you are asleep. It only measures air flow. In the machine's little mind it is thinking "OMG my human isn't breathing as fast as I calculated he needs to be so I have to help him out"...

So....very slow deliberate breathing so the machine thinks you need a low breath rate might be a way to fool the machine. He's a smart dude but maybe you can fool him.
Or you can just use a lower minimum PS if you are comfortable with lower.

Does this make sense? It's perfectly clear in my head but sometimes I can't always put what's in my head down on paper so that it is as clear to someone else.

When I used the 36037 (not because of centrals but because it was just nice to use) I never had the big bursts while awake but maybe I just was already so comfortable with it and went to sleep so easily that my breathing was so slow to start with the auto breath thing never got calculated to a higher rate causing it to want to need to kick in if I paused my breathing.
When I put the mask on and turned the machine on....I just normally would lay quietly and breathe nice and slow and fade away to sleep. Never took me long and I didn't toss and turn or fiddle with anything to cause the auto breath calculator to need to give me a higher rate. Now I would on occasion see it kick in after I was asleep...but I slept through it and never knew it...probably a random real central which is also normal.

Thank you for the detailed information. I believe that I understand. The machine worked quite well last night with these settings.

VPAP Adapt in ASV Auto mode.
Min EPAP 4.0
Max EPAP 7.0
Min PS 2.4
Max PS 7.4

It was a little weak before getting sleep. I changed the setting for tonight thinking that there will be more pressure at start up.

VPAP Adapt in ASV Auto mode.
Min EPAP 4.0
Max EPAP 7.0
Min PS 3.8
Max PS 8.8



My S9 VPAP Auto has always worked well and I have never explored changing the settings. It seems to also have a PS setting. If I think that I would want more pressure at start up should I try moving the PS to 5 or 6?

Max IPAP 14.0
Min EPAP 4.0
PS 4.0

This VPAP Auto machine currently has 14,190 hours. I am wondering if that is a lot of hours for this type of machine.

jwbwing wrote: ↑

Thu Jul 09, 2020 2:53 pm

It seems to also have a PS setting. If I think that I would want more pressure at start up should I try moving the PS to 5 or 6?

Be very careful with PS...too much PS can cause carbon dioxide wash out and trigger central apneas in some people.
I have a friend who gets about 15 centrals per hour with a PS of 4 but essentially none with PS of 3...
I have another friend using PS of 6 and no centrals to speak of.
So there is no hard fast line in PS limits...just be careful.
I had another friend who decided to try PS of 10...why she tried that I have no idea but she calls me up in a panic and said she was having a ton of centrals...what the hell kind of thing. She went back to PS of 5 and they went away.