[Equipment] Just got a Respironics DS960HS BIPAP Auto SV - now what?

[Peter_C]

Until recently, I have been using for years a VPAP Auto 25, then I finally got on Medicare, and was only able to get a S9 AutoSet (CPAP w/auto mode). I then a few weeks back had a new titration study and found due to too many CAs that I really should be on an ASV machine.

Today I went to my DME and picked up a new (still in the box) System One DS960HS with humidifier.

I've always had Resmed machines so this is totally new to me. Yes, I'll get the clinician's manual of course, and install Sleepyhead (which I've never used before).

Please feel free to offer any comments, suggestions, ideas, etc. As I've not bothered to read any threads pertaining to System One issues and stuff.

Out of the box the DME set it up in auto-mode. My sleep doc wrote a script of:

15/3/3

and is perfectly comfortable with me making adjustments. I've an APPT to see him again in bout 40 days.

I assume I ought to set the MIN EPAP to 15, and MIN Pressure Support to 3? But at this point I have no other clues.

[bwexler]

I would have, and did require the 960TS which includes the heated hose and 80 watt power supply instead of 60 watt.
I did receive the 950 manual. I am working on getting the 960. If you get it first let me know.
My settings currently are
Philips Respironics System One (60 Series)
BiPAP autoSV AdvancedModel 960P - P1245906725B9
PAP Mode: ASV (Variable EPAP)
Min EPAP 6.5 Max IPAP 17.1 PS 1.1-10.6 (cmH2O)

I am not smart enough to translate 15/3/3

Changing the settings is easy just turn the knob to setup, hold down the dial and the right hand button for 3+ seconds to get to the clinician menu. Then spin the knob to get to the setting you want to change, push down on the knob and spin to the setting you want and press the knob agen to set. Knowing what setting to choose is not always so easy, but others will be along with wisdom or at least their suggestions.

[PhyllisBalboa]

I assume I ought to set the MIN EPAP to 15, and MIN Pressure Support to 3? But at this point I have no other clues.

Well, that seems like an awfully high EPAP to me. I'm currently at around 4 EPAP, with a pressure range of 1-6. That usually puts me around 11 for IPAP. But I've had a lot of air swallowing, so am keeping it down for a bit.

Please make sure you know what that RX really means before setting it up. Someone more knowledgable than me will come along to help you, I'm sure. I am on the ResMed VPAP, which might be similar to yours, used for complex sleep apnea.

[racprops]

I have been on a 950 for a year when it seemly when bad and I was given a new 960.

I have been trying to learn as much as I can about these machines.

There are so many posts I have done and so many replies I would suggest you search for threads started by me to get a better over view.

I will try to check back or you can PM me.

Good luck.

RIch

[Whitewabit]

I have an ASV machine but it is the Resmend Adapt .. these ASV machines are used to treat complex sleep apnea and central apnea's .. my pressure like Phyllis's is much lower then the 15 you have suggested as a starting point .. .. Mine is set to 4-3-8 .. EPAP 4, Min Pressure Support 3, Max Pressure Support 8 .. it is running in the ASV Mode not auto !!

Higher pressure can contribute to central sleep apneas .. the higher the pressure given to me during my sleep studies greatly increased the number of Centrals while not decreasing my Hypopnea's or unclassified apnea's .. My Centrals are both caused by the pressure and also the narcotic pain medicine I take because of a back injury !!

[PhyllisBalboa]

I have an ASV machine but it is the Resmend Adapt .. these ASV machines are used to treat complex sleep apnea and central apnea's .. my pressure like Phyllis's is much lower then the 15 you have suggested as a starting point .. .. Mine is set to 4-3-8 .. EPAP 4, Min Pressure Support 3, Max Pressure Support 8 .. it is running in the ASV Mode not auto !!

Higher pressure can contribute to central sleep apneas .. the higher the pressure given to me during my sleep studies greatly increased the number of Centrals while not decreasing my Hypopnea's or unclassified apnea's .. My Centrals are both caused by the pressure and also the narcotic pain medicine I take because of a back injury !!

I second everything Whitewabbit is saying except for the pain meds part. He and I have both been dealing with significant high pressure issues, him with chest pains and me with air swallowing.

Be careful, Peter. High pressures have their own issues, especially when centrals are involved. Good luck in whatever you decide.

[Peter_C]

I have been on high (higher) pressures for years now. I have the numbers currently opened up so I/we (sleep doc) can see what the machine thinks over a longer period of time than a one night titration. The 'auto' mode refers to the ASV 'rate' - meaning let the machine decide rather than I setting a BRM rate myself.

MIN EPAP 10
MAX EPAP 15
MIN PS 3
MAX PS 10
BRM auto

And yes Rich, I've been reading many of your posts thank you

Prior to the pain meds I never used to get CAs, but with the pain meds (and age?) I have far more CAs than OAs. Having to sleep on my back (due to both knee, then shoulder surgery) isn't helping anything either.

The good point is I am sleeping through the night (again) now. Am not going to change any settings for a few weeks, then will tighten them up once I have the reports and see my sleep doc next month.

[Peter_C]

I would have, and did require the 960TS which includes the heated hose and 80 watt power supply instead of 60 watt.

I may well make that move. I was expecting to stay with Resmed, but was asked to try this machine first.

Dealing for all those years with the brick CPAP and BiLevel machines, it's easy for me to adjust to most anything. As my meds/doses get changed often, having an AVS machine with a backup breathing rate is a good thing - as apnea and pain meds don't always mix well.

[PhyllisBalboa]

Well, Peter, it sounds like you know what you're doing!

[Peter_C]

Who, me?? I doubt it. I've had the same sleep doc for bout 15yrs and I like him. I have more faith in our sleep machine's ability to adjust pressure as needed than I do in a one night titration. But I also won't do anything my sleep doc doesn't agree with. So, I have the ranges open, and will pull data for a few weeks, take it to my sleep doc and see what he thinks.

Lucky for me stuff like pressure changes, or going from CPAP to bilevel, and so on don't mess with my ability to sleep - that's *MY* problem, is if I stop breathing, chances are really good that I won't wake up on my own. I was that way long before pain MGNT - my blood O2 dropped into the low 60s during my original study without me waking...