Back from the Sleep Doc - VPAP Adapt SV

I am doing really well on the SV! Oh, I wish I had purchased this right away in November after my first sleep study. Enough with screwing around with insurance companies and wait periods. It is much, much more important just to get healthy!

I have been on the SV about 1 week now. I have had 2 nights in a row now of **no events** - AHI = 0 - now that I have it dialed in! Very happy.

I started on CPAP around December 20th (I bought a cheap machine off of Craigslist while waiting for the doctors, DME, etc.) I was on that for a little less than 3 months. I would rate my total improvement - improved memory, cognition, sleeopinees, etc. - at about 20%

I switched to a Bipap around March 9th and immediately started to improve! I had huge changes for the better in the first 3 days. Total improvement there was up to about 55%.

After I went on the SV last week I immediately started to feel better again. It took me 2 nights to back off on the PS max and get my mask leaks under control with a lower max pressure. I would rate the total improvement now, at 1 week, at about 80%.

I think the rest is just a matter of time. At my titration sleep study in December, I had a lot of centrals, and they flagged the need for a SV. One RT that I talked to said he was surprised that they didn't at least give me a Bipap right away, as I was not too well controlled at the titration with CPAP.

I am very resistant to the placebo effect after 12 years of chronic pain, etc. (which still exists, this is just part of the solution.) That can be a problem with any type of acute illness, as most people are going to get better no matter what they do. It is the problem of the "law of small numbers" and antecdotal evidence. ("I had my bedroom painted light blue and my back pain cleared up ....")

Happy happy happy. OK DD, get your butt in gear and get a machine!

One question: I had a few events flagged as "apneas" a few days ago. I didn't see any distinction, like "obstructive apnea" or "central apnea" that I saw in the examples from other machines. Does the SV need the ResLink to distinguish between the types of apneas?


Cheers!
Michael

unadog wrote:OK, how about making your own ResLink?

Is there a logic controller in the device? Or is it just a way to connect a data card to the 15 pin port?

If it is just the latter, it should be easy enough to make one. All you would have to do is trace the connection for each pin to the contact on the card reader/holder using an Ohm meter.

The 15 pin adapter is easy enough to get. I don't know how many contacts there are to the SmartMedia card adapter? Maybe 4 at most? Probably just two. So you would just need to solder up the existing wires on a normal SM card reader to a 15 pin adapter!!

My bet is that that all the logic is in the VPAP to drive that 15 pin port. The ResLink is just an "after market" way to connect a storage device. A way to update an old architecture to accept the Smart Media card until they were able to come out with the newer S9 machine architecture?

DSM, could you take a look at your ResLink and see what you think it might contain? Just the 15 pin, wires, and the card holder? I am not sure how fully they come apart.

But if they really do/did sell for only $180 to $200, I bet they are just a hunk of plastic to hold the SM card, knowing the markups in this industry! Do you have an Ohm meter handy? If you can tell me the pin-outs, I'll make my own ResLink to test this out .... After all, the cable they are using is just an off-the-shelf null modem cable.

Cool! We can start a small business - although the demand is likely to be low!

Michael

Michael,

I believe I have the required SpO2 units (several of them) but with the wrong plug. The ReslInk (& I am assuming the S9 SpO2 adpater) Use A 3-Pin plug. Restated: The Spo2 unit that plugs into the S7/S8/S9 Reslink/S9 adpator, use a 3-PIN PLUG (not a 15-pin plug). The 3 pins are serial signal, Positive voltage, Negative volatge & are TTL signals. (See Nonin's specs on the xPod 3012 device ).

Re the 15-pin connector, that is between the Reslink, which has a 15 pin plug, that mates with the 15-pin socket on an S7 / S8 (including the S7 shaped Adapt SV) machines but the SpO2 unit that connects to the Reslink (and presumably to the S9 SpO2 adpater) uses as stated above, a 3-pin plug. I purchased a Nonin experimental kit that supplied me with a Nonin 3011 + a serial adapter & allows me to connect the supplied SpO2 unit to a serial port on a PC & to capture SpO2 data inreal time. I paid $US 300 for that kit. I assumed it was the unit used by the Reslink but discovered it isn't. the 3012 is the correct unit.

If someone can find a supplier of the 3-pin plug that goes into the ResLink (& presumably the S9 SpO2 adapter), I can supply at least 10 people with the required Nonin xPod units that will work with the S8 Reslink or S9 SpO2 adapter. These would cost about $US 80 incl postage and incl the required cable if I can find one.

But let me say that I have spent 2 years looking into the Reslink & SpO2 & am certain I now know what units work & the lot always boils down to is that no one else uses the proprietary 3-pin plug as used in ResLInk (& am assuming S9 SpO2 adpater).

Restating, I have visted plug suppliers & manufacturers - showed them the ResLink module & NO ONE RECOGNISES the Resmed plug (remember too that I contacted Nonin & they also said they had no idea where the Resmed Reslink SpO2 3-pin plug comes from). Nonin merely supply Resmed who add their own proprietary plug to the Nonin XPod.

This is a very confusing area & believe me I will understand anyone new to the topic getting *utterly* confused by what model of what, connects to what , & with what plugs.

Cheers

DSM

Hi DSM!

That is all interesting. I have also read the other thread.

There are really 2 approaches. One is to fabricate (or find) a 3 pin plug to fit the existing ResLink. The other is to completely bypass the ResLink, and just wire to the pin outs on the 15 pin connector on the SV. Then we don't have to physically match the 3 pin, just wire to the same locations and inpiut values on the 15 pin.

I don't have a ResLink or an oximiter, so I am a little limited on engineering right now. I had better finish my taxes before I get too obsessed with this little project!

Send me the pics of the 3 pin when you get a chance, per the other thread. I do have a 15 pin adapter withcabling, and a card reader ready. If you have a meter and can get a chance to trace the pins of the 15 pin male (I think - from memory) pins on the ReslInk to where they connect on the SD card holder, I can try to wire those.

On the 3 pin, becase I don't have the unit itself, we would have to trace functionality - voltage, etc. - instead of just the physical wiring. No need to do that yet, as I can't test anything anyway.

It would be interesting to wire around the 3 pin. I know that some of the $120 oximiter units have a wireless sender/receiver. If we could patch that into the SV/ResLink, we could get the OXY data via wireless. That would be cool! Maybe - some days my brain works, some days not. Getting better though! One week on the SV now.

If you could trace the pins to the SD contacts using an ohm meter, that would be cool! I will try to fabricate the wiring for that first. No hurry.

Now I need to go buy a ResLink and oximeter I suppose. Wish I could get into a lab to test out some of their other device management software and hardware. A lot of opportunity here, but I don't want to buy all of the big bucks - and obscure - lab devices!

Best,
Michael

Wow - unadog. That is really impressive. I'm so glad it's working for you. It gives me great hope. I still have to wait to talk with my sleep doc on April 6th. I plan not to leave his office without a written prescription I can use on CPAP.com or somewhere else online, just in case I find something used and inexpensive.

Did you say what pressures your machine is set at? And how do those compare (if they can be compared) with how you set your BiPAP?

I've gotten a serial port adapter and a null modem cable. That should put me in good stead for trying out the VPAP Adapt SV.

I will likely also try the Respironics version BiPAP AutoSV Advanced I'm curious how loud the AutoSV is, and whether it makes that same nasty vacuum sound the M-Series Pro does during inhale.

DSM - I'm interested in learning more about an S9 oximeter. Are you saying all you're missing is a special three-pronged adapter? Is it proprietary, or is it something industry-standard?

DreamDiver wrote: It gives me great hope. I still have to wait to talk with my sleep doc on April 6th. I plan not to leave his office without a written prescription I can use on CPAP.com or somewhere else online, just in case I find something used and inexpensive.?

I hope you can get a machine right away! You have to do everything you can to get on one, so that you can see if it will help you. I really, really hope it does! I feel like I have been a zombie, just starting to wake up to a human life with spring.

Did you say what pressures your machine is set at? And how do those compare (if they can be compared) with how you set your BiPAP?

With the ResMed machine, the setup is fairly straightforward. The EEP, or exhalation pressure, is about the same as the exhalation on a regular BiPap or bi-level. On a Bipap, the exhalation is supposed to be set at the level that clears apneas. The inhalation pressure is then set higher to clear other events that happen during inhalation.

So on my Respironics BiPap Auto, my EPAP minimum (minimum exhalation pressure) was set at 8.0 It could float higher, and would go up to about 9 or 10. My IPAP - my minimum inhalation pressure - was set at 12.0 I think. My maximum inhalation was set at 14.5 - I didn't want it to go higher because of centrals.

I pasted all of that in my sig for now:

* ResMed VPAP Adapt SV: EEP 8.2, PS min 3.0, PS max 9.0: Mirage Quattro FF mask: ResScan 3.10
* Respironics BiPap Auto w/ Biflex: EPAP 8.0, IPAP min 12.0 IPAP max 14.5: Encore 2.2

There is not a lot to set up on the ResMed as compared to the Respironics. I started with my EEP – my exhalation pressure - set at around 9.4 or a bit more I think, because sometimes my auto would float higher. The default “PS min” - pressure support minimum, or minimum spread between exhalation and inhalation pressure, is 3.0. I just left it at that. So my minimum inhalation pressure was 9.4 + 3.0 = 12.4, similar to my BiPap.

The “PS max”, or maximum "spread" between exhalation and inhalation, defaults to 15.0. I started with that, which gave me a maximum pressure of 9.4+15=24.4, just under the machines maximum of 25.

I had a lot of issues with leaks the first night, as others have mentioned. So I pulled in the PS maximum, in a couple of steps, to the 9.0 that I have it set at now.

I also had few or no apneas, so I reduced the EEP in a couple of steps down to 8.2. I think I have had apneas in only 1 of the last 5 nights, and hypopneas in 3 of the 5. But my AHI has not gone above 1.0 on any night, and almost all of that was hypopneas. On two of those nights I had no events at all. So my apneas are quite well controlled at that pressure.

The EEP of 8.2 + PS max of 9.0 = 8.2 + 9.0 = 17.2 for my maximum pressure. That is fairly low for this machine, but all of my events seem to be well controlled at that level. Leaks are quite manageable, which makes the night much quieter and saner, and I don't have the feeling of the machine pressure being "out of control", as can happen when the pressures are up around 25 and you wake to noisy leaks and a torrent of air! I hate that, what a PITA, it is like waking up to total chaos!

So it really was fairly easy to dial in for me. The numbers that I wound up with – 8.2 exhalation, 11.2 minimum inhalation, 17.2 maximum inhalation – are not that far off what they were for my previous BiPap settings.

I will likely also try the Respironics version BiPAP AutoSV Advanced I'm curious how loud the AutoSV is, and whether it makes that same nasty vacuum sound the M-Series Pro does during inhale.

I actually liked the sound my Respironics BiPap Auto with made – the pre-M “tank” version. With my pressures set at 8 and 12, and a top of 14.5, there was not a lot of noise, and the patterns and sounds the machine made were peaceful and comforting.

My Respironics PR1 CPAP had a noise that was more similar to the ResMed Adapt SV. It is a bit of a spinning/hissing of the air in the tube, changing in piotch with inhalation and exhalation, at a higher frequency than the BiPap. The noise between the PR1 and the SV are pretty similar and about the same level. I do not find either annoying at all.

Perhaps most important for me is the newer version of the Mirage Quattro Full Face mask. It is **much** quieter than the older version that I have! The same is true for the Activa LT that I just got to replace an older Activa. These are the masks that vent above the forehead plate, instead of at the nose piece.

I really liked my Respironics BiPap. I like the breath flow and controls on those machines. So I also would like to try the BiPap Auto SV. But for right now, I think the real priority for us both, is just getting on effective therapy, and staying on it, and paying back that sleep debt, and repairing the brain damage, and healing!

Buy a machine, borrow a machine, get on a bi-level, do anything to start improving! You can worry about all the technical detail and analysis later.

Get going! If you are lucky, within a couple of weeks you won’t have any event data to analyze! I know you will be disappointed, but them maybe we can just get on with living instead!

Cheers! Let us know how it goes at the doc – only 3 more days! Any chance you can walk out with a “loaner” to try?

Best,
Michael

unadog wrote:Hi DSM!

That is all interesting. I have also read the other thread.

There are really 2 approaches. One is to fabricate (or find) a 3 pin plug to fit the existing ResLink. The other is to completely bypass the ResLink, and just wire to the pin outs on the 15 pin connector on the SV. Then we don't have to physically match the 3 pin, just wire to the same locations and inpiut values on the 15 pin.

I don't have a ResLink or an oximiter, so I am a little limited on engineering right now. I had better finish my taxes before I get too obsessed with this little project!

Send me the pics of the 3 pin when you get a chance, per the other thread. I do have a 15 pin adapter withcabling, and a card reader ready. If you have a meter and can get a chance to trace the pins of the 15 pin male (I think - from memory) pins on the ReslInk to where they connect on the SD card holder, I can try to wire those.

On the 3 pin, because I don't have the unit itself, we would have to trace functionality - voltage, etc. - instead of just the physical wiring. No need to do that yet, as I can't test anything anyway.

It would be interesting to wire around the 3 pin. I know that some of the $120 oximiter units have a wireless sender/receiver. If we could patch that into the SV/ResLink, we could get the OXY data via wireless. That would be cool! Maybe - some days my brain works, some days not. Getting better though! One week on the SV now.

If you could trace the pins to the SD contacts using an ohm meter, that would be cool! I will try to fabricate the wiring for that first. No hurry.

Now I need to go buy a ResLink and oximeter I suppose. Wish I could get into a lab to test out some of their other device management software and hardware. A lot of opportunity here, but I don't want to buy all of the big bucks - and obscure - lab devices!

Best,
Michael

Michael,

The problem with wiring around the 3-pin connector is that the Reslink has all the TTL logic and a processor chip in it to accept the data stream from the Nonin 3012. These Nonin SpO2 units deliver a high rate of data (100s of bytes per sec).

The 15 pin socket/plug on the S7/S8 & Vpap Adapt SV, is an interface between the processor chip in the Reslink & the processor in the S7 / S8 & Vpap Adapt SV.

In the S9 that processor in the Reslink got shifted into the S9. The S9 now only needs an SpO2 adapter that accepts the TTL signals from the Nonin 3012 & feeds them into the now internalized serial input processor. Anyone with an S9 does not need a Reslink, just the low cost SpO2 adapter that allows the Nonin 3012 to plug into the S9 machine. Anyone with a current Vpap Adapt SV, will need a Reslink plus the Nonin 3012 module. The trap being that only Resmed's version of the Nonin 3012 has the right plug. I know of no way to bypass the Reslink input socket because the processor chip in the Reslink is programmed to accept the 3012 data stream at the right rate & to write this data to the ResLink SM datacard.

The Vpap Adapt SV can tell if a Nonin 3012 is connected to the Reslink but the Reslink has all the smarts for handling & filing the SpO2 data.

The bottom line here is if we can find a souce of the Resmed SpO2 3-pin plugs or even someone who can make some. The effort to achieve this seems monumental.

DSM

dsm wrote: The problem with wiring around the 3-pin connector is that the Reslink has all the TTL logic and a processor chip in it to accept the data stream from the Nonin 3012. These Nonin SpO2 units deliver a high rate of data (100s of bytes per sec).

.....
The bottom line here is if we can find a souce of the Resmed SpO2 3-pin plugs or even someone who can make some. The effort to achieve this seems monumental.

Got it, thanks!

That is too bad. I was hoping all of the logic was built into the VPAP, and taht the ReslInk was just a wiring harness and hunk of plastic to retrofit the attachment points.

Well, semd me what you have of pictures of the 3 pin. I will think about fabrication. I'll also see if I can turn up anything close taht could be cut, modified, melted, etc. to get the right form. These damn little proprietaru parts are such a PITA! And it isn't like they actually accomplish anything, in terms of maintaing margins, etc. They are just a minor consideration in the whole architecture. SOB's!

Let me know if you find any ResLink available for sale. My first goal was to bypass them completely and build my own. I am curious as to whether that could still be done for recording machine data to the SD card? Now I am also interested in the oximeter question.

Of course, with no apneas or other events, I assume my oximiter data is pretty clean. I wish I had all these gadgets when I was up to my eyeballs in arousals, apneas, centrals, no REM sleep, etc.! What ugly, messy, black hole, cold, nightmare nights. Nice to have dreams and to sleep hours at a time!

Cheers!
Michael

unadog wrote:

dsm wrote: The problem with wiring around the 3-pin connector is that the Reslink has all the TTL logic and a processor chip in it to accept the data stream from the Nonin 3012. These Nonin SpO2 units deliver a high rate of data (100s of bytes per sec).

.....
The bottom line here is if we can find a souce of the Resmed SpO2 3-pin plugs or even someone who can make some. The effort to achieve this seems monumental.

Got it, thanks!

That is too bad. I was hoping all of the logic was built into the VPAP, and taht the ReslInk was just a wiring harness and hunk of plastic to retrofit the attachment points.

Well, semd me what you have of pictures of the 3 pin. I will think about fabrication. I'll also see if I can turn up anything close taht could be cut, modified, melted, etc. to get the right form. These damn little proprietaru parts are such a PITA! And it isn't like they actually accomplish anything, in terms of maintaing margins, etc. They are just a minor consideration in the whole architecture. SOB's!

Let me know if you find any ResLink available for sale. My first goal was to bypass them completely and build my own. I am curious as to whether that could still be done for recording machine data to the SD card? Now I am also interested in the oximeter question.

Of course, with no apneas or other events, I assume my oximiter data is pretty clean. I wish I had all these gadgets when I was up to my eyeballs in arousals, apneas, centrals, no REM sleep, etc.! What ugly, messy, black hole, cold, nightmare nights. Nice to have dreams and to sleep hours at a time!

Cheers!
Michael

Michael,

You are right when it comes to the S9 !. The smarts shifted to it & the SpO2 adapter *appears* to me to be a way of accepting the existing Nonin 3012 with 3-pin plug.

Re capturing the data - many of us have done that but I haven't come across anyone who knows how to convert captured SpO2 data into a form that ResScan would recognise. I went as far as trapping the serial data flow into Resmed machines & tried to analyse it for format but then realized it was too much effort with too little info. I used to capture my SpO2 data in XL & format it into a chart then strech the chart to match the charts from AutoSCan (the forerunner of ResScan).

I have enough into now to try to connect my 3012 / 3212 Nonin units to Reslink. Just lack the Resmed 3-pin plug & again will end up hand making some (a bummer of a process).

Cheers

DSM

dsm wrote:

dsm wrote:... If someone can find a supplier of the 3-pin plug that goes into the ResLink (& presumably the S9 SpO2 adapter), I can supply at least 10 people with the required Nonin xPod units that will work with the S8 Reslink or S9 SpO2 adapter. These would cost about $US 80 incl postage and incl the required cable if I can find one. ...

I have enough into now to try to connect my 3012 / 3212 Nonin units to Reslink. Just lack the Resmed 3-pin plug & again will end up hand making some (a bummer of a process).

Cheers

DSM

I'm interested, if we can get it to work with the S9. Can you post some examples of the 3-pin connector? Is it just a db9 with a 3-pin pinouy, or is it entirely different?

unadog wrote:... I am doing really well on the SV! ...

One question: I had a few events flagged as "apneas" a few days ago. I didn't see any distinction, like "obstructive apnea" or "central apnea" that I saw in the examples from other machines. Does the SV need the ResLink to distinguish between the types of apneas? ...

Glad to hear how much it helps. I doubt this is due to placebo effect. It is much more likely that it addresses the problem you face (as the numbers note).

No, the ResMed VPAP Adapt SV can not determine if the apnea occurs during a clear airway or not. It was developed in the early 2000 to 2002 time frame, if I remember correctly. It was not approved for therapy by the FDA until 2007 time frame. It just notes that you stopped breathing.

DreamDiver wrote:... I will likely also try the Respironics version BiPAP AutoSV Advanced I'm curious how loud the AutoSV is, and whether it makes that same nasty vacuum sound the M-Series Pro does during inhale. ...

The ResMed VPAP Adapt SV (though older technology) is quieter than the M Series units. And I am pretty certain it is quieter than the BiPAP AutoSV units. I don't find either too much of a problem. But I tend to compare it to the shop vac that I used to use ... Oh, wait. That was a CPAP unit.

JohnBFisher wrote:I doubt this is due to placebo effect. It is much more likely that it addresses the problem you face (as the numbers note).

I agree. I just have a healthy mistrust of all of the miracle cures so aggressively marketed on the Internet!

FWIW, according to ResScan, I have had 1 apnea in the past 7 days! As compared to about 99 events during my CPAP titration sudy - 80% mixed or centrals.

Yeah! Feeling better every day. Muscles are working again when I walk and stretch afterward. A new sense of peace and quietness when I lie down at night. Life again!

OK DD. I think you had an appointment yesterday. What's up? Moving forward?

Michael