Respironis CPAP Auto to Resmed S9 VPAP Auto

I am currently on a Respironics M series Auto set at 7cm. My new one that is coming up will be set at 15/11. I will be picking it up on 4/1. This is my question: will it hurt anything for me to gradually raise up the pressure so that I will be ready to use the 15/11 settings? Comments?

I can't think of anything that it would hurt to increase the current machine's pressure but it really won't be needed.
If you do want to try it..go up slowly and don't go over 10...it won't be needed.
15/11 the way the bilevel pressures are delivered will be likely easier than you think. Even the higher pressures are so much easier to tolerate because of the pressure support (difference between EPAP and IPAP) and the way it is delivered.

Probably not. I would suggest that you increase the pressure no higher than the 11 cmH2O of the new prescription and do it about 2 cmH2O every couple of days to make the transition gradual.

Did you have a new sleep study that indicated the new pressures?

BTW your equipment selection indicates a ResMed machine and not the Respironics M series you currently have.
Are you indicating the new equipment to be delivered?
Its helpful if you click on the text display in the equipment selection 'cause too many ResMed and PR machine look identical in the pictures.

JDS74 wrote:Probably not. I would suggest that you increase the pressure no higher than the 11 cmH2O of the new prescription and do it about 2 cmH2O every couple of days to make the transition gradual.

Did you have a new sleep study that indicated the new pressures?

BTW your equipment selection indicates a ResMed machine and not the Respironics M series you currently have.
Are you indicating the new equipment to be delivered?
Its helpful if you click on the text display in the equipment selection 'cause too many ResMed and PR machine look identical in the pictures.

Oh, I see part of my mistake here. My old equipment and that which I'm currently using is the "Respironics Remstar Auto M Series." It has two modes: CPAP and Auto. I'm using the 'auto' mode. The new one I'm getting is the one that is now shown in my pictures here, the Resmed S9 VPAP Auto. So, currently on my old equipment, I'm at 7cm and a high of 9cm.

As a BiPAP user I have to agree with Pugsy... BiPAP at 15/11 is not at all like cpap at 11. I don't see it doing you any harm to increase your pressure if you are being moved to 15/11, but I don't think it will acclimate you for BiPAP either.

djhall wrote:As a BiPAP user I have to agree with Pugsy... BiPAP at 15/11 is not at all like cpap at 11. I don't see it doing you any harm to increase your pressure if you are being moved to 15/11, but I don't think it will acclimate you for BiPAP either.

Interesting comment here. On another forum that I'm a member of I get the same sort of answers. In fact, a therapist told me NOT to do an increase for it would increase my CSA's. I wish I understood what technically is the difference between these two types of therapy. If anyone knows and can explain it detailed but simply english, I would love to hear it.

Basically the difference is that Obstructive Apnea is when the airway is blocked and you can't breathe because of it. The positive pressure holds the airway open like blowing into an envelope to open it up a bit.

Central Apneas are when your body just doesn't tell you to breathe. In this case your airway isn't blocked you just don't remember to breathe.

Since our breathing is based on CO2 drive and not O2 drive by increasing the PAP we perfuse more O2 from the air and therefore it lowers the CO2 and that in turn tells the brain that we don't "need" to breathe.

Of course it's more complex than that, but that's the simple answer. And that doesn't take into account people with COPD who have switched to O2 drive.

Bama Rambler wrote:Basically the difference is that Obstructive Apnea is when the airway is blocked and you can't breathe because of it. The positive pressure holds the airway open like blowing into an envelope to open it up a bit.

Central Apneas are when your body just doesn't tell you to breathe. In this case your airway isn't blocked you just don't remember to breathe.

Since our breathing is based on CO2 drive and not O2 drive by increasing the PAP we perfuse more O2 from the air and therefore it lowers the CO2 and that in turn tells the brain that we don't "need" to breathe.

Of course it's more complex than that, but that's the simple answer. And that doesn't take into account people with COPD who have switched to O2 drive.

Thanks for taking the time to respond. However, I see that I didn't make myself 'clear' enough in order to get my answer. Maybe I should have said: Whats the difference between "CPAP Auto" of which I'm currently on and "BiPap/VPAP Auto" of which I will be going to? Do these two types of therapy differ all that much? Do they function differently?

DAG wrote: a therapist told me NOT to do an increase for it would increase my CSA's.

The "would" should have been replaced by "could" because higher pressures don't always increase the chances for Centrals.
Higher pressures only cause centrals in maybe 15% (generous estimate) of the population of cpap users.
BTW when it does happen it can happen with as little as 5 cm pressure...so it really is cpap pressure in general more than it is "higher" pressures.
When on APAP I often went to near 20 cm and never had a central at all. So while higher pressures CAN cause centrals...it's not a given absolute that higher pressures ALWAYS cause centrals. The people who have that happen are in a very small minority and if you are being given a machine that is going to do 15/11 pressure...it must not be causing a problem with centrals or they wouldn't be giving you that machine would they???

DAG wrote: Maybe I should have said: Whats the difference between "CPAP Auto" of which I'm currently on and "BiPap/VPAP Auto" of which I will be going to? Do these two types of therapy differ all that much? Do they function differently?

In your situation and the machine you will be given there really isn't all that much difference in how they work except you get 2 pressures instead of one pressure. If you were using EPR at 3 (if not using Respironics machine)...that's sort of like what it feels like to use a bilevel pressure machine. One pressure for inhale and another for exhale. The timing is slightly different but in general that's how it feels.
Your Flex relief available on your current machine doesn't feel anything like EPR or the drop in pressure you are going to feel with the bilevel machine. So even at max of 3...not the same feeling. First time I ever tried bilevel (it was me trying a machine that was going to a friend of mine) withing 15 seconds I said "I gotta get me one of these" as I had been using a PR S1 APAP machine with AFlex at 2. I was just making sure it was a working machine and used it for 3 nights...sent it off to my friend and told her that if she didn't like it I would be real happy to take it back...once she got it her response was "over my dead body"....so I had to go find my own bilevel machine and that's how I ended up with a PR S1 BiPap Auto and my journey through bilevel machines began. Sheer comfort while awake breathing..sleeping better/longer with the bilevel machine (still don't know why I sleep longer with it) which translated to feeling better in general over how I felt on APAP even if AHI was actually worse to start with on BiPap.

Auto adjusting part of it..works the same but 2 pressures go up and down as needed. If the machine senses that more EPAP is needed then it pushes IPAP up with it. If it senses more IPAP is needed then IPAP drags EPAP up. Please don't ask what the criteria is for determining exactly why the machine does its changes. All I know is that in general EPAP is looked at for Obstructive Apneas and IPAP for Hyponeas. So the flow reduction associate with either OA or hyponea drives the machine.

When using APAP machine..it is still the flow reduction that drives the minimum pressure up..be it Hyponea or OA.

So the basic function on how it deals with apnea events remains the same..it just goes about it with dual pressures instead of a single pressure and is more comfortable doing it that way.

DAG wrote:Thanks for taking the time to respond. However, I see that I didn't make myself 'clear' enough in order to get my answer. Maybe I should have said: Whats the difference between "CPAP Auto" of which I'm currently on and "BiPap/VPAP Auto" of which I will be going to? Do these two types of therapy differ all that much? Do they function differently?

For the sake of the explanation I am going to ignore the effect of comfort options like EPR / C-Flex / A-Flex which technically alter pressure as you breathe.

CPAP machines deliver Constant Positive Airway Pressure. Your current CPAP blows a single constant pressure as you breathe. Because you are on auto that single pressure can range up and down over the course of a night, but over the span of a single breath the pressure stays constant.

BiPAP machines deliver Bi-level Positive Airway Pressure. The new BiPAP will deliver two alternating pressures for every breath. As you inhale the machine will deliver 15cm pressure (your IPAP pressure). When you stop inhaling the machine will drop to 11cm pressure for your exhale (your EPAP pressure). When you stop exhaling the machine will switch back to the 15cm IPAP pressure for your next inhalation, then back to 11cm for your exhalation, and so on....

Air wants to flow from areas of high pressure to areas of low pressure... that is what causes the wind. When you have 15cm pressure air in your lungs from your inhale and suddenly there is only 11cm in your mask when you start to exhale, the air wants to go out. When you have 11 in your lungs at the end of an exhale and the mask now has 15cm at the start of your inhale, the air wants to go in. In a crude sort of analogy, BiPAP is like power steering for your breathing...

Increasing your CPAP would acclimate you to breathing out against the harder resistance of higher incoming pressure... but that is completely different than the "power assist" effect that occurs when the BiPAP drops the pressure significantly on exhale.

I think I'm getting "it" and want to thank all of you who have taken the time to post.