CPAPtalk.com

ozij wrote: ↑

Sat Jul 13, 2024 1:13 am

According to last nights OSCAR, you're still letting your machine go lower that the 18 IPAP you need - it rarely stays long beneath that 18, and every time it drops too low, you snore, probably wake up, and the pressure obligingly return to 18.

Last question on this please. Since my AHI is ~3, should I not be concerned about this, or are we targeting since I am feeling so lousy?

Thanks!

chuck29 wrote: ↑

Sun Jul 14, 2024 12:32 pm

Last question on this please. Since my AHI is ~3, should I not be concerned about this, or are we targeting since I am feeling so lousy?

How you feel is a lot more important than a nice low AHI. What if your AHI was 0.0 and you still felt like crap?

In the S9 model line the term "VPAP" was just denoting bilevel pressure availability.
VPAP S just means it is a fixed bilevel machine meaning it never could auto adjust.. If it had offered auto adjusting bilevel pressures the model would be the S9 VPAP Auto instead of VPAP S.

ResMed is now using the term "AirCurve" instead of "VPAP" as a way of denoting bilevel pressure machines.

chuck29 wrote: ↑

Sun Jul 14, 2024 12:30 pm

As far as machine history (I think that is what you are asking), I had that S9 BiPAP for years.

I was actually asking about you Rx - why you were given such a large difference between EPAP and IPAP

You have to understand the difference between Fixed and Auto mode, and what they mean on a bi-level machine.

A bi-level machine, supplies two pressures: An Exhale pressure [EPAP] and an Inhale pressure [IPAP]. All bi-level machines switch from EPAP to IPAP how they switch depends on what you tell them. In Spontaneous mode, the machine waits for you to stop exhaling, and starts raising the pressure to the IPAP. And when you finish inhaling, it drops to EPAP. The timing depends only on your spontaneous breathing, and the IPAP and EPAP remain at their fixed level.
Please reread robysue's explanation about how an Automatic bi-level machine functions and what its setting mean:

viewtopic/t188516/How-Long-To-Feel-Bett ... l#p1457861

When you set up an Auto bi-level machine, you tell the machine to vary the IPAP pressure it supplies and the EPAP pressure it supplies, depending on its interpretation of your breathing. You define the minimum EPAP and the maximum IPAP.
You also define a constant difference between the two - that's the pressure support.
Resmed machines do not let the difference between EPAP and IPAP vary.

You were using a fixed bi-level machine with a very large difference beween EPAP and IPAP (8), and a constant, stable, unchanging pressure of 18 for your inhale, 10 for your exhale. Apparently, this served you well for some time.

However it now seems, from what you've told us of your machine history, that you've been having CA's - Central Apneas for a long time.

In response to your very first post

Pugsy wrote: ↑

Mon Jul 08, 2024 3:01 pm

Fixed bilevel at 10 exhale and 18 inhale.....that's 8 PS and pretty much going to trigger a boatload of centrals at that setting. Unless of course you have some sort of respiratory or lung disease issue going on besides the sleep apnea.

This happens sometimes, after year of successful PAP therapy people can develop Treatment Emergent Centeral Sleep Apnea.

You got rid of those CA's by lowering the PS, narrowing the difference between EPAP and IPAP - that's good.

But the minimum EPAP you're giving your machine it too low for you to sleep comfortably, because it frequently drags down your IPAP.

Please re-read robysue's post, look at your machine and tell us what your Minimal EPAP is, and why you think it should be there.

Pugsy wrote: ↑

Sun Jul 14, 2024 12:57 pm

How you feel is a lot more important than a nice low AHI. What if your AHI was 0.0 and you still felt like crap?

In the S9 model line the term "VPAP" was just denoting bilevel pressure availability.
VPAP S just means it is a fixed bilevel machine meaning it never could auto adjust.. If it had offered auto adjusting bilevel pressures the model would be the S9 VPAP Auto instead of VPAP S.

ResMed is now using the term "AirCurve" instead of "VPAP" as a way of denoting bilevel pressure machines.

Understood Pugsy, thank you!

ozij wrote: ↑

Sun Jul 14, 2024 11:55 pm

You have to understand the difference between Fixed and Auto mode, and what they mean on a bi-level machine.

Please re-read robysue's post, look at your machine and tell us what your Minimal EPAP is, and why you think it should be there.

Thanks for explaining the differences between Fixed, Spontaneous, and Auto modes, I think I understand these now.

My minimal EPAP is now set to 12 from 10 based on recommendation from user in forum.

Thank you!

bump

Pugsy wrote: ↑

Sun Jul 14, 2024 12:57 pm

How you feel is a lot more important than a nice low AHI. What if your AHI was 0.0 and you still felt like crap?

In the S9 model line the term "VPAP" was just denoting bilevel pressure availability.
VPAP S just means it is a fixed bilevel machine meaning it never could auto adjust.. If it had offered auto adjusting bilevel pressures the model would be the S9 VPAP Auto instead of VPAP S.

ResMed is now using the term "AirCurve" instead of "VPAP" as a way of denoting bilevel pressure machines.

Just some additional information that I find interesting:

Manometer:
I purchased a manometer, and found that my pressure was fine. I decided to check my old ResMed S9 VPAP S, which I was told was blowing at 8 per a supplier (I asked him to turn off ramp). Turns out, it is working fine. This is BiPAP set at 18/10. Note: I tested 18 pressure on both machines and S9 blows stronger. I put both in CPAP mode to test.

Central Apneas:
Now, my AHI was 60, with CAs in the 50s if I recall, on the S9 for months, but I did not feel as bad as I do on S11 in VAuto. Also, manometer showed pressure is a bit better on the S9 (although S11 was showing above setting). I used S9 last night and changed Trigger from Medium to Very High, for the 1st time. My AHI was 6.5 with CAs below 1.

S9 Noise:
Problem is that machine is very noisy now also the mask (even though it is the same I use on S11) was very noisy, so I only got about 5 good hours of sleep, so still not feeling wonderful, but maybe a tiny bit better. Will try the same setting on S11 tonight.

S9 Ramp not working:
Another interesting note is that I have Ramp set to 30 minutes on S9, but within seconds its blowing 18/10. So if that is not working (machine has 22,000 hours on it), what else may not be...

As noted, tonight, I will be using S11 in S Mode WITH Trigger set to Very High, to see if feel ANY better.

I've attached OSCAR dashboard from S9 last night in case anyone would like to see that.

About the S9 report from last night.....The number of OAs points to maybe needing a little more EPAP. The 10 cm EPAP isn't quite preventing those OAs as well as we would want.
Maybe some are positional like you were on your back part of the time or maybe tucking your chin or maybe in REM stage sleep where our OSA can worsen and need more pressure.

I am with you when it comes to some function on a machine not working like it should.....sure makes me question everything else it does.

Let's see what happens with the AirCurve 11 tonight.

BTW....ResMed quit using the "S" nomenclature with the advent of the AirSense/AirCurve 10 machines. So the "S" ended with the S9 models.
There are no S10 or S11 models....just AirSense or AirCurve.

Sounds like a plan. I can set IPAP to 12 in S Mode on AirCurve 11 tonight.

Thanks for explaining that "S" was stopped with ResMed S9, got it!

Also, I ordered an oximeter which I will be able to use Friday night. I mentioned somewhere in this post (can't find at the moment) that I had this feeling before when using nasal pillow one time, and I woke up in the AM with my mouth was open (air blowing out of mouth, not seeming to be going anywhere else), and I felt like a truck hit me and was in bed all day. So want to see what SpO2 looks like throughout the night.

Pugsy wrote: ↑

Thu Jul 25, 2024 12:11 pm

Let's see what happens with the AirCurve 11 tonight.

(posting here and then will just respond to just one thread)

Pugsy, FYI:

ResMed Aircurve 11:
Mode: VAuto
IPAP: 18
EPAP: 12
PS: 4
Trigger: Very High

Within these last few weeks, I was on these settings for 4 consecutive days.
Results:
AHI: ~3
CA: 0

Still felt crappy.


Last night, 7/26:
ResMed Aircurve 11
Mode: S
IPAP: 18
EPAP: 12
Trigger: Very High

AHI: 3.4
CA: .3

I will stay on this for the next few nights.
I am on trying S Mode because the S9 I used for years was in S Mode where I felt decent.

ALSO, I see that I am waking up earlier than I'd like, 6:00 AM, and trying to go back to sleep without much success. Bedtime will now be 9:30 PM EVERY NIGHT!

Thanks!