Trigger and Cycle Settings on a VPAP III ST

DrowzyDave · Post by **DrowzyDave** » Sun Jun 10, 2007 12:47 pm

First of all . . . thanks to christinequilts and Rested Gal for their explanation of Rise Time and a recommended setting range. I adjusted mine from 300ms to 500ms and it is much easier to go back to sleep if I wake up after the ramp time has expired. CQ made a great point that the machine has prescription settings AND comfort settings. I asked my RT about the Rise Time setting because when I first switched to this machine from a Respironics Bipap ST, it seemed like the change from EPAP to IPAP was very forceful. She didn't really say much, and since she took the clinicians manual with her, I did not have any resources. Thankfully, someone on this site told me the "magic key combination" to get into the clinical menu.

Now, here is my question, I noticed in the Settings Menu there are two parameters called Trigger and Cycle the values are High, Med., and Low. They are both currently set to Med. Does anyone know what these two settings are referring to?

Thanks.

Dave

christinequilts · Post by **christinequilts** » Sun Jun 10, 2007 9:13 pm

No clue...I can't remember hearing them before either (but I swear, everything I use to know about ST's is getting rustier by the month since switching to the Adapt )

How are you doing with your VPAP III ST? I was reading some of your past post and am I correct you are being treated for your CSA by your GP? Can I make a a not so subtle suggestion? Get thee to certified sleep doctor at a full service who has an interest in more difficult cases ASAP. Some people will say all of us with CSA should see sleep docs who are neurologist by training, rather then pulmonologist, but from my experience with my doctor, that is not necessarily true. GP's can sometimes coordinate treatment for uncomplicated OSA, but I would never expect one to for CSA...most don't know that CSA is something completely different then OSA, let alone what is required to treat it...or all the other issues that can come along with it.

If I had to rely on my GP to treat me based on my titration study, I would have never been put on a BiPAP ST to start with, as it was considered a 'failed titration' since it only reduced my centrals from 60+ to 30+ per hour. Well 30+ is more then anyone would want, its still 50% better, KWIM? BiPAP ST wasn't the perfect treatment for me by any means, but it did allow me to 'tread water' for 3 years until the Adapt came out. Without it, I would have kept sinking, and my head was barely above water as it was when I was Dx'd.

dsm · Post by **dsm** » Mon Jun 11, 2007 1:15 am

Dave,

You have a newer 'Enhanced Model' of the Vpap III (still not clear if you have an S or S/T model).

These settings were added in to provide some softening of the swiching from ipap to epep and from epap to ipap. They are user comfort settings.

DSM

christinequilts · Post by **christinequilts** » Mon Jun 11, 2007 11:05 am

dsm wrote:
You have a newer 'Enhanced Model' of the Vpap III (still not clear if you have an S or S/T model).

Thanks DSM...I was really starting to think my brain was subconsciously blocking out everything I use to know about the various BiPAP's & BiPAP ST's-lol
Glad to hear its it new info, not forgotten info for me

DrowzyDave · Post by **DrowzyDave** » Mon Jun 11, 2007 2:39 pm

dsm wrote:Dave,You have a newer 'Enhanced Model' of the Vpap III (still not clear if you have an S or S/T model).

It is an ST.

christinequilts wrote:How are you doing with your VPAP III ST?

Okay, I guess. For the last month, my AHI has been between 7 and 10. There was one night below 5 but I have not been able to duplicate that. I'm not sure if you read the whole RT Does 180 thing viewtopic.php?t=19685&postdays=0&postorder=asc&start=0 but the last oximetry report was very good according to my GP. (I actually see his PA.) They seemed very receptive to ordering a new PSG to titrate on an Adapt SV but said that since my last oximetry report showed I was in the 90% range 99% of the night, they didn't know if they could "qualify" me for a new study/machine.

My original PSG showed a huge reduction in centrals as the titration progressed. I still feel like I need a nap in the afternoon but I also need to lose about 40 pounds so I cannot blame all of my fatigue on sleep apnea. I am not nearly as tired as I was pre-bipap but don't seem to be as energetic as when I first started. But then maybe I have forgotten how tired I really was back then and my comparison is a little faulty. I am still experimenting with the F&P 432 trying to minimize leaks, etc. My leak rates have been in the low 40s which, according to info posted here is reasonable for my mask at my pressures -- unless the VPAP III ST subtracts the known leak rate and it should be zero. The machine does have a Leak Alarm that goes off 2 or 3 times a night, but overall it seems to work pretty well. One of the things about the Adapt that really interested me was "minimal support when you don't need it". When I wake up and am breathing normally, the switch from 10cm to 16cm is quite annoying -- not so much now that I have adjusted the rise time though.

I have an appointment with the PA on Monday. We'll see if there is any more discussion of a new PSG and titration on the Adapt.

Thanks for the feedback.

Dave

Guest · Post by **Guest** » Mon Oct 01, 2007 8:55 am

I sure would like to know what

rise time
trigger
cycle

...what they are? Ok they are "comfort settings" but that still does not tell me anything? How do they provide comfort, and how should they be adjusted?

You said someone had told you in previous post, but I was unable to find that post, so am still in the dark on the matter.

Guest · Post by **Guest** » Fri Nov 16, 2007 8:56 pm

Thankfully, someone on this site told me the "magic key combination" to get into the clinical menu.
[quoted from above]

I wish you would tell ME what the Magic trick is! How to get into the Adapt SV clinical menu.

DrowzyDave · Post by **DrowzyDave** » Mon Nov 19, 2007 3:23 pm

Anonymous wrote:Thankfully, someone on this site told me the "magic key combination" to get into the clinical menu.
[quoted from above]

I wish you would tell ME what the Magic trick is! How to get into the Adapt SV clinical menu.

Press and hold the down arrow and the key to the right (the red one) at the same time until the clinical menu appears. Since the Adapt is a very complex machine, I wouldn't recommend going in and experimenting with the settings. You can get more detailed efficacy info from the clinician's menu though.

Dave

rested gal · Post by **rested gal** » Mon Nov 19, 2007 5:29 pm

Guest wrote:I sure would like to know what

rise time
trigger
cycle

...what they are? Ok they are "comfort settings" but that still does not tell me anything? How do they provide comfort, and how should they be adjusted?

You said someone had told you in previous post, but I was unable to find that post, so am still in the dark on the matter.

That was a question from back in Oct 2007, but since this thread has come to the fore again, I'll add these links. They don't discuss "trigger" and "cycle" per se, but do deal with "rise time" and several other settings that are in bipap and/or bi-level S/T machines:

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viewtopic.php?t=21162

christinequilts discusses "backup rate" in an S/T machine.
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Jun 07, 2007 subject: Inhalation stops abruptly; please help a new bi-level user. christinequilts discusses "Rise Time" and other settings in a bipap S/T.

viewtopic.php?p=179771

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viewtopic.php?p=192217

Where to find the "Rise Time" setting in the M bipap.

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viewtopic.php?t=14359

StillAnotherGuest discusses what could happen if a person using a bi-level S/T machine for the purpose of treating centrals lengthens the "rise time" setting.

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