Hi Banned SWS - I have done three days on the Vpap Adapt SV but am now back to the Bipap Auto SV.
These are the settings I ended up with & the data extracted from both machines seems to match very well (comparing the 3rd night on the Vpap SV with a typical night on the Bipap SV).
Bipap SV. Epap 11 & IpapMIN = 14.0 IpapMax=20 Risetime=3 BPM=auto
Adapt SV. EEP = 10 & MinPS = 3.4 & MaxPS=10 (which when compared,
is equiv to Epap 10 & IpapMIN = 13.4 IpapMax=20 on a Bipap Sv)
These settings are near to being the same (the Bipap SV differs by 1 CMS for epap & ipap from the Vpap SV at the mask & this reflects the use of proximal line on the vpap SV which means it measures pressure at the mask while the Bipap SV measures pressure at the machine & there is a known 1 CMS loss over a 6' hose at 10 CMS pressure. The data from both pretty well confirms the similarity of settings.
The trial of both has been a big eye opener for me but is not finished yet.
I have some different masks coming & also a reslink & already have an SpO2 module that attches to Reslink so plan to do further heavy hitting analysis of both machines.
Firstly I have to say that the
Bipap Auto SV is my current 'dream machine' - I look forward to using it & sleep long deep and well. I was not able to achieve that with the Vpap Adapt SV despite getting very close matching data from both machines after some tweeking. If you had asked me to bet on the outcome before I started either I would have willingly bet on the Vpap SV as delivering me the best nights sleep.
I note though that Banned is telling us he gets good results from his use of the Vpap Auto SV. We have traded PMs re some of the issues & the thing that does intrigue me is that the reasons I thought the Vpap SV wasn't working for me, seem to match Banned's condition. That is we both have severe nasal constriction. I found the Vpap Adapt felt very difficult unless I used the heavy hitting Otrivin spray & taped my mouth.
The Bipap SV seems to tolerate me breathing out my nose, my mouth, both (I'd swear it would let me breath out my ears if I had a mask that reached them )
The sleep I get with the Bipap Auto SV is deep restful and energizing & I love it.
The sleep I got from the Vpap Adapt SV was strained, shallow, but it was energizing in that once up & head cleared I had a good day, but after just one day debated if I would use it again right away, I decided I would (but had the Bipap SV ready & loaded in case I abandoned the Vpap SV quickly).
The Vpap SV data tended to show lots of leaks & my mask sure squeaked. On night 2 I used a new mask (Ultra Mirage FF) just to eliminate a weak seal.
After each night I download the data via serial link & stowed a copy on my web site. Anyone wanting to view my most recent detailed data can go to
http://www.internetage.com/cpapdata/ Choose items 1 or 2 to see each nights data - in the case of the Bipap SV, apart from a few lost nights (forgot card) I have 6 weeks of data. There was a short gap when I went to NZ & that daa is item 3 on the menu off an S8 Vantage in EPR mode. For the Vpap SV there is only 3 nights data.
The most recent nights data from each machine is very close in what the machine was doing. The av Ipap is close to the same (don't confuse what Resmed call the 'mean' Ipap with the average Ipap) , The number of times the machie went to max Ipap is typically the same.
So what do I think makes the difference ?
Firstly I found the Vpap SV too finely tuned for me. Like a formula 1 racer, the slightest breathing change & it reacted. It would 'pulse' me if my breathing slowed or stopped, each pulse got stronger. It seemed to be 'in my face' so to speak I am thinking that for what it was designed for it must be excellent. If I had a heart condition or some other breathing irregularity like Cheyens-Stokes, am sure it would be my lifeline.
The Vpap Adapt SV was soooo smooth in its operation. And it is soooo quiet my wife said the room was eerily quiet. The Bipap SV does have a steady drone but it never ever bothered me & later in the night seems to not be there. My wife did move rooms but has returned & is willing to get used to the Bipap SV based on it being the better therapy for my situation.
On the otherhand, the Bipap SV (unlike earlier trials with Bipap Pro II & Bipap S/T), never objected to my restricted nasal breathing nor my multi- mode breathing. It seems to have a lag in its responses & in my case that lag seems to give my symptoms a better run.
The Bipap SV is without doubt far more leak tolerant (certainly for me). I felt I never got my leaks under control with the Vpap Adapt SV. I have 2 more masks coming (the Quattro & Liberty) to trial with it & see if they help.
The Vpap SV is by far the simpler to set up. As Banned has told us before, just set EEP & stick with the defaults for all else. Then when ready to use run the mask training step. This is simple, you attach the mask, fill the H/H, then put the mask on the bed so it is unobstructed (you don't put it on) & run the training test. That test sends increasing pressures of air out the mask & I understand the proximal sensor feeds data back that allows the machine to calibrate to the air circuit. It has *nothing* to do with the mask leak holes as they only get exercised if the mask is worn. It has a lot to do with what H/H you are using & the type & length of the hose. & the air outlet (be it nasal prongs or F/F mask).
The Vpap Adapt SV will allow you to use a seperate H/H such as the F&P HC150, you just have to run the training circuit. The Bipap SV also let me use my HC150 & doesn't change its results in any way that I could tell.
With the Bipap Sv I sterted out with a F&P Hc150 H/H but switched to an integrated H/H - with the Adapt SV I only used the integrated H/H.
Each day after using either machine I was very alert. The major difference was what I saw as my quality of sleep. I felt I wasn't getting much with the Vpap Adapt SV & found myself reluctant to want to use it again. I really missed the 'delightful' sleep I feel I get from the Bipap SV.
The major thing that I see in the data from both machines is that both would go to max pressure between 10-16 times per night & that has to be because they both interpret my breathing as failing regularly. What I see in the data is what looks like responding to centrals except I have never shown a single central in any sleep studies (1990, 2005 & 2007).
So, one might ask, "are you having centrals because you are using SV (or bilevel) machines" - a fair question that I am posing to myself. My answer is, "I used cpap & after 3 months the benefits started to fade & I got alarmed & then despondent. It seemed that what I thought was a solution was slipping away". For work reasons & health reasons I became determined to search out more info on my issues.
Then I went Auto & got a bit of a lift for 3 months or so then again saw the improvement slipping away, that really bothered me. I figured there had to be an answer. Then I went Bilevel with a slow timed rate (BPM=6 - PB330 Knightstar) and I felt so much better and, lsot a load of weight, did loads of exercise - this continued for about 18 months - wife also said I seemed to sleep & breathe better. Then early this year started to feel like I wasn't getting enough air but my SpO2 data always seemed to show I was ! - I began to again feel things weren't right. Wife started saying to me "don't sleep on your back, your breathing goes funny".
I began looking into the SV class machines & I dub them tri-levels, they work at Epap (which needs to be set high enough to preempt outright obstructions when you breathe out), then they got to a set Ipap when you breathe in (just like a bilevel)
BUT these machines monitor your airflow & if they believe it is inadequate or your rate of breathing has suddenly dropped too much, will go from Ipap (min) to a higher pressure that can be as high as Ipap Max (or PS max), within 1 breath, & keep going higher until you start to maintain a reasonable airflow (thus they got to a third level of pressure & why I call them tri-levels).
Where the Vpap SV differs from the Bipap SV is that the Vpap SV starts 'pulsing' you to try & ventilate tyou at the rte it believes is needed whereas the Bipap SV just pushes more air into you to get your peak flow up & it doesn't (AFAICT) try the 'pulsing' that I felt from the Vpap SV.
SUMMARY:
Each of these machines offers a unique approach to irregular breathing & I am assuming that each targets a different SDB population (I know SWS & I think SAG have said this many times ) Well guys I did the suck-it-and-see test & you appear to be spot on.
So I would say both machines are innovators and high achievers in the cpap therapy stakes for people with special needs. Both concepts appeal to me but the physical machine that worked for my internal air circuits thus far, is the Bipap SV. But take it from Banned that the Vpap SV has sure given him the boost he needed - the pair of us are enthusiasts for SV technology
but I am in no doubt that these are highly specialized machines and require a very brave experimenter or someone with a researchers approach who can do enough tests to work out the what & why.
DSM
PS. Any legitimate cpap researchers have my permission to use my data extracted from the various machines asn part of their research. If you wish to use my name, please obtain that in advance.
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CPAPopedia Keywords Contained In This Post (Click For Definition):
resmed,
bipap,
mirage,
hose,
CPAP,
seal,
auto
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition):
resmed,
bipap,
mirage,
hose,
CPAP,
seal,
auto
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition):
resmed,
bipap,
mirage,
hose,
CPAP,
seal,
auto