(03-30-2013, 10:13 PM)BigD Wrote: I found a great deal on craigslist today and bought an S9 VPAP Auto. For now I just have it set up as a cpap with a 13 pressure setting like my old machine.
Can anyone give me tips for using the auto or bi-level functions? I've read a few posts about it but I'm not sure about the best way to set up the machine.
Hi BigD, welcome to the forum!
The S9 VPAP Auto is a great machine. I used one for nearly a year.
You can use ResScan to set the pressure and other options, but it is simpler and easier to use the on-screen Clinician Menu to select the settings and options. I assume you have downloaded the Clinician Manual from this site.
I would suggest setting the machine in Auto mode, with minimum EPAP pressure of 10 or 11 (2 or 3 lower than your previous CPAP pressure, though some may suggest even lower), and I would suggest setting the maximum IPAP pressure to 17 (4 higher than your CPAP pressure, though some would suggest lower).
I suggest starting with Pressure Support (PS) set to 1 or 2, which means whenever you are inhaling, the pressure will be increased by 1 or 2 above the current EPAP pressure. Actually, I think most people eventually find themselves preferring to use PS = 4, and a few end up prefering up to 7 or 8 for PS.
If your minimum EPAP pressure is 10 and PS is 2, and the maximum IPAP is set to 17, your machine would start with IPAP 12, EPAP 10, and could automatically raise itself as high as IPAP 17 and EPAP 15 if you have obstructive events which need higher EPAP pressure.
The EPAP pressure is primarily responsible for avoiding obstructive apneas, and PS helps to avoid Respiratory Effort Related Arousals (RERAs). I think RERAs may not show up in your Apnea Hypopnea Index statistics, but are important to avoid in order to have good sleep quality.
Keep an eye on how many (if any) Clear Airway apneas (or Central Apneas) are occuring. You may need to reduce the Pressure Support or even turn it off if you are having mostly CA events. But most people do not have that probem and prefer to use Pressure Support at 3 or higher.
Look at your data daily or at least weekly, and keep an eye on how long (in seconds) your apneas are lasting, and keep an eye on how your EPAP pressure is adjusting itself. If after a week you are staying close to the minimum EPAP pressure, or often max'ed out at the maximum IPAP pressure, then you may want to adjust the pressure by 1 cmH2O and watch for another week or so between adjustments.
Actually, I think ideally the settings should be left alone for about a month to get a very good average of how the settings are working, between making adjustments, but in the beginning I think adjustments may be made weekly to quickly get in the ball park.
Personally, I prefer the ResScan 4.2 version. I think ResMed is now recommending users upgrade to 4.2.
People say SleepyHead is easier to use. I like ResScan 4.2 because it has been very stable and does not have any bugs that I know of.
After installing the program (say no to installing any ResMed drivers), you will need to click on New Patient icon and set up a patient ID. I think you need to include at least a name and birth date in the patient profile, and you can add more info or edit the name, etc, later.
I prefer to open a patient before asking to download data from the card. If you click on download without a patient open, ResScan will prompt you to select a patient or set up a new one.
When you download the data, in the window which pops up there are two buttons to select the device and the data. On device tab, click on your device (SD card) and select OK, and in the data tab select all data and select the option for an equivalent amount of high rate data and select OK, then go ahead and select Download.
If the download fails (times out after a couple minutes), you can close the download window, reopen it, and try again.
After the first download, ResScan will notice there is already previously-downloaded data, and will ask whether you want to Overwrite (overwrite the previously-downloaded data with whatever is now on the card) or Discard (discard the new data on the card for days previously downloaded, taking from the card only new days which have not yet been downloaded). I prefer to select Discard, in order to be sure I am preserving the data from earlier downloads which might not still be on the card.
After downloading the data, close the download window and in the left-hand Navigation Pane, double click on the day (session) you want to look at. Select Statistics tab or Summary Data tab or Detailed Data tab to review.
When I look at the High Rate Pressure and Flow waveforms, I will use the lower window to zoom in until 10 or 5 or 1 minute fills the lower screen, so I can see exactly what is happening near any events.
Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
If you can't get the clinical manual from here then send me a message.
