I got a ResVent 30STA Bilevel

[TechieHippie]

I couldn't figure out which forum to put this in, mods feel free to adjust as needed.

With my doctor's approval I got a ResVent bpap30sta on 30 day trial from Supplier #40 (just under $1k). It's a Bi-level device with CPAP, S, Auto S, ST, Auto ST, EVAPS, and more.  I think it's basically a combo of Bi-level and maybe ASV; I haven't explored what all of the modes mean.

I'll update more as I get to know it better but here are my first impressions.  Overall, I'm pleased - especially since my oxygen jumped almost a point higher average, AND let me sleep in positions that I normally get immediate flow limitations in with the other machine - even on very similar pressure. Time will tell if it's just observational effect, of course.

Pros - comfortable, quiet, lots of modes and settings for fine-tuning, really nice touchscreen display, very little offgassing (using with existing hose and mask). Smooth operation, auto detect of water levels, saves data to the SD card even if you put it in after waking up, all the features I would expect.  Includes "iPR" which refines the curve of pressure support but I don't fully understand it yet.

Cons - The really big con I see is that settings and modes are quite complex and don't map exactly to those I see here. The defaults felt strange to me. 

It's the same exact housing / humidifier / power as the APAP but with a larger touch-capable screen that gives live graphs of pressure and flowrate. 

Note: I know this is an off-brand device but I've been very happy with the APAP version. (I also bought a used Vauto a few weeks back, but it was filled with room freshener scent even after many hours of running, it is louder and whinier than my ResVent, and the brand new (non-smelly) humidifier leaked even after replacing the air outlet, etc.  A friend is using it while waiting for the interminably slow process that for some reason she has been going through. )

Oscar imported my data with only a few strangenesses; here is last night, my first full night with it. 

[SarcasticDave94]

On what machine you've got, it's likely loosely similar to a ResMed AirCurve 10 ST-A. In that case, it can use a mode delivering a version of AVAPS which is a ventilator mode.

AVAPS is what I need myself due to lung disease. Yes, it's related to ASV, but they're not similar enough to be interchangeable. ASV is a ventilator focused on Central Apnea, ST-A focused on lung disease breathing issues. Just a pared down to minimal basics comparison not into details of settings.

In ResMed pecking order, there's CPAP, AutoSet, etc., then BPAP, VAuto, etc., then the specials, ST, ASV, ST-A. I would think ASV and ST-A are top of the class, however again different needs.

You can buy whatever you want, myself though will only get ResMed. I'm not certain what your buying options are, it looks like both ResMed ST-A and the ResVent 30STA are available refurbished, used, and of course new. I've seen a ResMed ST-A refurbished at about $1,800, with the ResVent being about that area on price.

[Sleeprider]

Did you by any chance get a clinical manual with that machine?

[TechieHippie]

SleepRider: I've requested the clinical menu from the supplier and they said they will get back to me Monday. If they can't get it, I'll call ResVent directly.

Dave: I really only need Auto S / (Vauto) mode at this point, this was just the only model ResVent Bilevel I've seen for sale. I figure I'm one of the only ones at a place where I'm able to try it, and it would be good to have someone with experience of it as well as data for OSCAR, though if I like it once I get to know it, I'll probably keep it. I'm a "canary" and hypersensitive to chemicals and it's rare for me to be able to use something like this after running it a few hours (I did still taste the offgassing slightly and had an irritated nostril but very minor). It uses a German foam though I've not found more detail than that.

Lisa

[SarcasticDave94]

You have to do what's best for yourself, so I'm not bashing your choice of machine. Something that works for you is better than not having it. Even so, I inject opinions here and there.

I think it's part of my ongoing effort in upholding my reputation of treating everyone equally bad.

PS a Mr. Google search found ResVent CPAP (models 20 and 25 I think) with a clinical manual at manualslib but only user manuals regarding the ResVent 30STA.

[TechieHippie]

No offense taken! I think your advice is right on, I may just be an outlier

[TechieHippie]

I'm doing really well on the new machine, the ResVent bi-level with Auto S, Auto-ST and other modes.  (With a coupon for joining the mailing list I got it for $899.) I used Auto-S mode until recently, getting very low AHI and some 0s even. I tried Auto ST with similar settings, plus Ti 2.8 and a really low backup setting of 6bpm. It makes a big difference in my flow limits, and my perception of sleep is subjectively better.  I see less "noisy spots" in the graph when I go 3 minutes at a time. The auto ST feels very comfortable and not pushy at all with the slow rate, and if I vary my (conscious/awake) breathing rate it's still smooth and follows my pattern. 

I feel "greedy" for using the advanced Auto ST mode to address flow limits with almost perfect AHI, but the difference in how I feel is palpable. I want to make sure I'm not messing myself up or overventilating, though. Is there a reason not to just have the machine trigger a breath for me in ST mode rather than letting it get to an arousal?  

Here are my current settings and a night with Auto S mode and another with Auto ST mode, with some wave forms. Sorry I didn't get the scale the same but you can see the shapes.

I welcome your thoughts, input, and questions.

Auto S: (Feb 3)

EPAP min 4
IPAP max 13
PS 3.7
Rise Time 500ms
VT Off
Ti Control Off
I-Trigger Auto
E-Trigger Auto
iPR 3 



Auto ST: (Feb 1)
Same as above, with Ti 2.8s and F 6bpm, Auto F Off

[Sleeprider]

Results look excellent. Your device is providing a fixed pressure support with minor variations of EPAP pressure. I don't see timed breaths here but the results are very good. How is the comfort of this algorithm for you? We can see it is a modified square-wave pressure delivery:

[MVoltaire]

I'm doing really well on the new machine, the ResVent bi-level with Auto S, Auto-ST and other modes.  (With a coupon for joining the mailing list I got it for $899.) I used Auto-S mode until recently, getting very low AHI and some 0s even. I tried Auto ST with similar settings, plus Ti 2.8 and a really low backup setting of 6bpm. It makes a big difference in my flow limits, and my perception of sleep is subjectively better.  I see less "noisy spots" in the graph when I go 3 minutes at a time. The auto ST feels very comfortable and not pushy at all with the slow rate, and if I vary my (conscious/awake) breathing rate it's still smooth and follows my pattern. 

I feel "greedy" for using the advanced Auto ST mode to address flow limits with almost perfect AHI, but the difference in how I feel is palpable. I want to make sure I'm not messing myself up or overventilating, though. Is there a reason not to just have the machine trigger a breath for me in ST mode rather than letting it get to an arousal?  [...]

I am not on a CPAP machine yet but just ordered the Löwenstein 25 ST. From your experience, do you think it makes sense to jump titration experiments on auto CPAP and start directly with ST mode using conservative settings?

[TechieHippie]

It feels comfortable (as someone described in another thread, sometimes in the night it feels like it's not doing anything because it feels natural) and gives my best sleep so far at altitude. This gives me great o2 results with average SPo2 96-97 and not a lot of drops.

I think the modified square is from the iPR setting, a proprietary setting which in CPAP mode works as EPR but in bi-level mode, rounds the curve. At first I didn't use it because it felt a little weird, but now it feels normal. I can see the square graphs from when it was off, let me know if you would like to see an example for curiosity's sake.

I couldn't find any obviously timed breaths either, but I can feel it gently kicking in if I pause breathing. I tried a little while last night on auto F and it was strange, as much as I relaxed my breathing I couldn't get it to allow the slow breaths and longer pause after exhale that I prefer.

Another interesting thing about the bi-level is that even though none of the settings will go below 4 the manual says that it has a lowest effective pressure of 3. The effect of this is that I don't feel a little hiccup when the algorithms dip the epab slightly below four. With the APAP, I had to raise minimum to just a little higher, e.g. 7.2, to smooth this out when it dropped EPAP by 3. It was subtle but it was like it would fail to trigger inhale for a microsecond and then catch itself.

Another interesting thing about this machine is that it has a touch screen that shows the waveform and pressures in real time and allows settings to change on the fly. In the graph I can see the IPR taking the EPAP down under my minimum sometimes (a quick test awake shows EPAP 3.4 at times) and each breath is a little different, so the algorithm isn't forcing it to be exact. I don't know if that's bad or good, but it seems to be quite comfortable. I have little else for comparing in the CPAP world, but as a software engineer it feels like a high end machine to me.


Lisa