Difference between S9 AutoSet and VPAP

My Dr said she would give me a bi-level if I wanted one. However I have been offered the ResMed S9 AutoSet by My DME as I only have the Escape, a cheap michine. Is it just as good. I do have CA's. What is the difference between the ResMed VPAP and the AutoSet.

The Autoset is an Auto CPAP, aka APAP. Discounting EPR, the in and out pressures are the same, but can change. The auto can vary the CPAP pressure over the night to where it's needed.

The VPAP is a Bi-level machine, the IPAP and EPAP can be set to different values. This is helpful for some people, aerophagia, and higher pressures.

There's a VPAP auto which is the bi-level difference in IPAP and EPAP, but it can adjust up and down as needed.

Xney, thanks for reply. I guess I don't need the bi-level from what you explained. The DME just ordered me the ResMed S9 AutoSet. They are tired of dealing with me. It has been brutal. They finally finally gave me my compliance status 84 days into my 90 day window. I have used my cpap 79 days out of 84 all night long so I have been very mad and have let them know it. When I started I did not know anything and this board had let me be able to fight them and win. And because of this board I am getting a better machine. I am thankful to all who have helped me and all the posts I have read. thank you all.

Now I have to learn how to do the software to read the data. I will do some searches and see what I can learn. Thank You. I am so happy at last.

MIght be too late. Can you get the VPAP for the same price to you, as the S9 autoset? Do you have a pressure above 11? Do you have a neurological problem? Do you have Aerophagia? Do you have any kind of a heart or lung problem? If your answer yes to any of these then you should get the more expensive VPAP.

For myself, if the doc said he felt a Bi-Level machine might be the way to go. I would have to ask, "Doc why do you think I might need a Bi?" before making a decision. The Sleep Doc would not say he was willing to write a script for a bi-level machine unless he had some kind of indicator that you need a bi-level machine over an S9 Autoset. What is that indicator to your doc?

The S9 AutoSet is an excellent machine.

The VPAP is ResMed's trademark for bilevel. Respironics uses the trademark BiPAP.

Bilevel machines allow a larger pressure difference between inhale and exhale pressure. They can also go to a higher pressure.

If central apnea is a problem, bilevel sometimes helps, but you may need an even more advanced type of machine called an ASV (Adaptive Servo Ventilator). Confusingly enough, ASVs are sometimes classified as "bilevel, VPAP, or BiPAP" as well.

Bilevel helps people who have trouble exhaling against the pressure, or people who get problems with gas. It may help or hurt central apnea, depending on who you ask.

Insurance may require you to "fail" CPAP before they'll pay for a bilevel, so be careful about prequalifying.

If you have too many CAs after trying the AutoSet, insurance will usually approve a more expensive bilevel or ASV if you need it.

By the way, a VPAP is not necessarily better than the AutoSet.

purple wrote:MIght be too late. Can you get the VPAP for the same price to you, as the S9 autoset? Do you have a pressure above 11? Do you have a neurological problem? Do you have Aerophagia? Do you have any kind of a heart or lung problem? If your answer yes to any of these then you should get the more expensive VPAP.

The Sleep Doc would not say he was willing to write a script for a bi-level machine unless he had some kind of indicator that you need a bi-level machine over an S9 Autoset.

My insurance pays for my machine with no cost to me. But I have not seen a sleep doctor. My doctor is just a medical doctor who wants me to be happy with what I get. I did a sleep study and my CA's and OSA was about the same. My pressure is only 11, I have none of the problems you listed and I have no problems breathing in or out with full pressure.

I think the AutoSet will be fine If it controls my CA's. Now that I have a data machine I will fine out, if it does not control my CA's I will get my doctor to write me a Rx for a ASV.

The DME was a nightmare to deal with as my doctor has been on vacation and my RX did not ask for a fully data machine. They have not been helpful at all. I ended up in a depression with all the problems I was having, and I had no help from them as to what was going on, let alone how to fix it. It was this site that got me on the right track and helped me with the problems. I am so thankful.

I still have a concern about not having any stage 3 or 4 sleep time. I am going to see if I can get a referral to a sleep doctor to talk to him/her about this. I am still real tired in the afternoon. My doctor does not know much about the sleep study data.

I would have quoted both of the last two posts but I don't know how. I am just learning how to use this board, But thanks to both of you.

lilly747 wrote:I think the AutoSet will be fine If it controls my CA's. Now that I have a data machine I will fine out, if it does not control my CA's I will get my doctor to write me a Rx for a ASV.

CAs can be a bear to eliminate, or they may not be a problem. If they are a problem on the AutoSet, you may need to see a "real" sleep doctor. Plus a "good" sleep doctor. Many sleep doctors seem to be clueless.

One warning, do not simply set the AutoSet to a maximum pressure of 20. Start it out with a narrow pressure range. If the pressure gets too high, it may cause CAs.

At least with the AutoSet, you will have a good clue whether you are having CAs or OAs.

Remember, the damage to your body is from having apneas. CAs are harder to eliminate, not necessarily more harmful.

The VPAP ASV was recommended to me when the APAP and the CPAP would not control the CA's.
One big difference is that I pay for my own machine.

My first machine was a Bi-Level/VPAP because I have asthma and because the initial pressure setting they wanted (17!) was too high for me to tolerate on straight up CPAP.

Though I should say when I looked at my sleep study, it should have been more like 113. I think they pulled that number out of their rear end.

Thanks to all for replies. I got my new AutoSet today and it is set to cpap with a pressure of 11. I will use it that way for a few days and then set it to Apap. So I guess the pressure 8 to 14 would be good????

Are you going to be using EPR?
See what you get at the 11 cm CPAP for a few nights. If the events are well controlled at 11 cm the 8 to 14 would be as good as any to start. If the events aren't well controlled at 11 cm then probably the minimum would need to be a little more than 8 cm.

lilly747 wrote:Thanks to all for replies. I got my new AutoSet today and it is set to cpap with a pressure of 11. I will use it that way for a few days and then set it to Apap. So I guess the pressure 8 to 14 would be good????

If you're comfortable with 11 and get good control of AHI, you might want to leave it alone. If you want to adjust it, since you seem to be comfortable with making your own changes, I'd suggest making small changes. Maybe even something like 1/2 cmH2O and then see what that does for a few days, then add a little bit at a time.