[Equipment] What machine is a step up from VPAP Autoset 25?

[Easygoingal]

I have an old VPAP auto 25, and am looking for an upgrade. Can someone recommend one? The s9VPAPs look nice, but they are very expensive.
Thanks

[trish6hundred]

Hi Easygoingal,
WELCOME! to the forum.!
I've read quite a few favorable posts about the S9VPAP Auto or the Respironics bipap, (I don't know the model,)
Hang in there for more suggestions and a better explanation and best of luck on your machine decision.

[diamaunt]

the next step would be the S9 VPAP Auto, REF# 36006.

the VPAP S is a fixed bilevel.

[PaytonA]

Hi easygoing, welcome to the forum.

I will tell you what I know, which is not a whole lot. I too have a VPAP Auto 25 and I find it very acceptable. If I had my druthers, I would like to have an S9 VPAP Auto which has some capabilities that I would like to have. The S9 shows flow data when data is downloaded which I would find useful and has the ability to differentiate types of apnea and respond appropriately. The differentiation is not perfect but it is better than the old assumptions. The Philips Bipap Auto which actually goes by a different name that is an equivalent machine which is a little stronger in some areas and a little weaker in others. I am told that the Philips machines are a little less expensive than the their Resmed counterparts.

If I remember correctly, Robysue did a comparison of a Resmed and a Philips machine. Yup. Here is the link. http://www.apneaboard.com/forums/Thread-...1#pid49331.

She also did a synopsis of the 4 most common types of machines. http://www.apneaboard.com/forums/Thread-...5#pid53845

Best Regards,

PaytonA

[archangle]

The S9 VPAP Auto is the obvious answer in terms of being the newer model that does the same job as the VPAP Auto 25.

The advantage of the modern machine is mostly better data collection and access. Especially in terms of airflow waveforms. The SD card is easier to get data off of.

There are a number of other improvements in the newer machine. The technology has improved a lot in the years between the release of these two machines.

[Sleepster]

I would think then that there's a big improvement in the pressure-adjusting algorithm, too.

[robysue]

I would think then that there's a big improvement in the pressure-adjusting algorithm, too.

The only real difference in the pressure adjustment algorithms between the Resmed S8 machines and the Resmed S9 machines is due to the FOT Central Apnea Detection algorithm.

S8 machines: No FOT CA detection algorithm means the S8 AutoSet machines are programmed to respond to all Apneas scored when the pressure is below 10cm. And the machine responds to NO apneas scored when the pressure is AT or ABOVE 10cm. I suspect that on the S8 VPAP Auto, line between responding and not responding to apneas is at EPAP = 10cm.

S9 machines: The FOT CA detection algorithm classifies each apnea as either an OA or a CA. If the apnea is an OA, the machine responds regardless of the pressure setting. If the apnea is a CA, the machine does not. This allows the S9 machines to respond to OAs that occur above the 10cm pressure line and ignore the CAs that occur below the 10cm pressure line.

But the speed at which the S9 and S8 increase the pressure in response to apneas, hypopneas, flow limitations, and snoring is pretty similar, and the rate at which the two machines decrease the pressure once the breathing is stable is about the same.

[Sleepster]

I've been watching the way my new S9 VPAP auto adjusts the pressure. I noticed the other night that it raised the pressure during the first few minutes of use even though I was still awake.

I interpret this as the algorithm adjusting the pressure upwards in response to my breathing pattern. No events were scored.

Trying to outsmart it I thought I'd start using the ramp feature in the following way. I set the starting EPAP equal to the Min EPAP, and the ramp time to 20 minutes. The next day I check the data and sure enough for the first 20 minutes the EPAP stayed at the Min EPAP. But immediately afterwards, within just a few seconds, it raised it up to almost its highest possible value.

What the heck is going on here?

[diamaunt]

I've been watching the way my new S9 VPAP auto adjusts the pressure. I noticed the other night that it raised the pressure during the first few minutes of use even though I was still awake.

I interpret this as the algorithm adjusting the pressure upwards in response to my breathing pattern. No events were scored.

Trying to outsmart it I thought I'd start using the ramp feature in the following way. I set the starting EPAP equal to the Min EPAP, and the ramp time to 20 minutes. The next day I check the data and sure enough for the first 20 minutes the EPAP stayed at the Min EPAP. But immediately afterwards, within just a few seconds, it raised it up to almost its highest possible value.

What the heck is going on here?

were there flow limitations? I assume it didn't think you were snoring, though, if there are snores recorded, it may be picking up some noises and thinking it's a snore. FL causes leads to rapid pressure increases.

[robysue]

Without looking at the graphs, I'd put my money on flow limitations. Loosely a flow limitation is anything "funny looking" in the inspiratory part of the flow rate curve. Some folks wake breathing is full of funny looking patterns and the S9 responds pretty aggressively to them.

And then there's also the fact that when we're awake we'll hold our breath (sometimes without realizing it) for several seconds when concentrating on doing something as simple as turning over in bed with a hose attached to our nose. And even if the machine doesn't score it as an apnea, the breathing around it can look flow limited to the dang machine. And the pressure is increased.