Central Apneas Increase After Changing to Newer BiPAP

[upsman]

I have a friend who was being treated well with the ResMed S9 Auto25. 
She updated her machine to the AirCurve 10 VAuto using the same settings and her central events skyrocketed for some reason. 

I have attached a before and after screenshot of her charts. I don't know if anything further is needed to investigate this, but any help would be appreciated. 

[Gideon]

I Tried to look at your history and see why you have PS=8, This is why we encourage all your therapy posts to be in a single thread. I also don't know why the S9 didn't find any CA events

So why are you at PS=8? I did see you had other breathing issues.

Was this VAuto new or used? If used, Please do a factory reset then reset your pressure and PS settings.

Please check your Trigger and cycle settings. We want the Trigger setting to be high to start a breath (inhale) on a smaller indication. Cycle should be, for now, Med (default)
Based on the chart alone I would radically reduce your PS, to something that would resemble the Autoset (with EPR=3) then go from there, BUT we need to understand your other breathing issues first.

[upsman]

Thanks Gideon.

You didn't find any history because this isn't my issue. I have a friend asking me about this, and I'm transferring the info here for advice. Sadly, she is not very tech-savvy and it will be hard to translate instructions that she can use.

I'll pass along your suggestions and we'll see what happens.

[SarcasticDave94]

FWIW that After OSCAR would be reminiscent of my BPAP experience, with BPAP usage right after a diagnostic study showing Centrals at 124 and Obstructive at 24. Does your friend have her study results? She needs them for herself, but it can be posted or at least posting the event type and count table. Untreated CA is pretty common unfortunately. Just a maybe that is the CA spike cause.

[upsman]

Thanks, Dave. 

I guess her biggest concern, question is why did it spike all of a sudden when the only difference is a newer machine. Prior to changing she was having virtually 0 centrals. As far as I can tell, the settings are the same for both machines. 

 I had her lower the PS to 4 for tonight, so we'll see how that does for a couple of nights and go from there.

[Sleeprider]

Upsman, lets start really simple, and change her settings to EPAP min 7.0, Max IPAP 16.0 and PS 4.0. Set the trigger sensitivity to high. Lets compare results from those settings and I think most of this should be resolved. I suspect there were problems with the old S9 because it shows her median tidal volume was an extremely low 140 mL, but now on the Vauto she is 460 mL. I am certain she will do better with the lower PS. I also see an extremely low respiration rate and unsurvivable minute vent on the S9. Those respiratory number are impossible, so I'm assuming an error.

Now I see it. Update her Oscar version to the current 1.2.0 then take another look at the data. There are clearly errors, especially for the S9 we can't rely on version 1.0.0 beta2

[upsman]

Post edited. See below. 

[upsman]

Now I see it.  Update her Oscar version to the current 1.2.0 then take another look at the data.  There are clearly errors, especially for the S9 we can't rely on version 1.0.0 beta2

Ahhh, I didn’t catch that either. I’ll let her know about updating OSCAR.

THANKS.

[SarcasticDave94]

Yes a too high PS can certainly send things off kilter. If an edit to whichever culprit caused the high CA reporting, this may clear up immediately. Keep us updated.

[upsman]

 Keep us updated.

Thanks, Dave. 

I let her know to first update from Sleepyhead to the newest version of OSCAR and give me some new charts. 
She has also lowered the PS to 4, and I told her to let me know if it made any difference. 

She is in India so I'm not sure what the time difference is between there and Florida, but when she responds we'll see what happened.