New Guy needing VPAP III Pressure Settings Help

[Jobo82]

Hi all,

My name is John. I've been a BiPAP user for a number of years now. Namely due to a disability I was born with. When I was first given my Resmed VPAP III, it was after I almost died from Pneumonia. The pressure settings I was started on were spot on perfect. Then 3 weeks later I was sent for my first ever sleep study. Ended up with Bronchitis 2 days later because the night of my test it was pouring outside and the sleep tech had the AC cranked all night, lol. Following that, a representative came to my house and said my respiratory doctor wanted her to change my settings. To which I made complaints that while the pressure was "ok", my sleep wasn't as great as the original incoming pressure settings.

Kept insisting to me that was not the case and that the lower settings were the proper pressure settings, but if I really insisted I could have him order another sleep study again to make sure and prove my point. I asked about just changing it myself, to which he told me it was against the law and I could get into serious trouble with the law for messing with my machine. So with fear instilled, I sucked it up and learned to deal with not as good incoming pressure settings for a number of years now.

I've done decently for a number of years, however I've noticed the pressure settings (namely the incoming pressure) is not working as well as it use to on my VPAP III. A huge portion of this is due to unfortunate weight increase due to dealing with a lot of bad depression and dealing with a lot of stress from both a lot of fake friends and even worse family members for the past few years now off and on. So for awhile I was starting to lose grip and give up on life, and as usual junk food because a factor. And with my disability, increased weight is a big no-no in general. So I've noticed my setting isn't helping much due to the, um.... excess baggage.

So I've been having a bit rougher nights and feeling tired after a 8-9 hour sleep. I went back to my family doctor and deal with them just to get them to give me a referral (due to my crappy medicaid). Went to see my doctor, sat there for waiting for an hour just for him to come in and tell me they do not accept medicaid anymore so all he could do is give friendly advice in the way of--"well you got fat, so work on losing it and find another doctor to send you for another sleep study to get the incoming pressure raised a bit more" and left the room.  

Needless to say, I was both hurt and majorly P*ssed off. But unfortunately these are the type of doctors I often get stuck with due to so many here outright refusing to accept me and my coverage. 

So I've been watching TheLankyLefty27 for awhile now, and was a tremendous help in realizing the truth when it comes to people trying to instill fear that they could be imprisoned just for upping their pressure settings a tiny bit more. I know my body, and if I know my incoming pressure setting use to be far superior than my current, then I should be able to raise it up a tiny bit. It's not like I'm trying to commit suicide by BiPAP or something, lol. Basically my plan is to go into my VPAP III, write down every setting and value first, then go and increase the incoming pressure a tiny bit just to get a little more help until I can start getting a lot of this weight back down which will definitely help a lot. However I have two questions I really need help on firstly, which I hope someone could aid me with:


1) I am unsure how to get into the clinic menu. I have one .pdf manual that covers both the VPAP III (my model) and VPAP III ST. But there's nowhere I've seen that states how to get into those settings. Everything in the pdf just says things like "VPAP Detailed Menu Series (if enabled by your clinician)". So does anyone know how to get into the VPAP Detailed Menu?

2) Once in and I boost my incoming pressure a tiny bit, does it eventually revert back to Patient Menu mode on its own, or do I do the same method originally used to get into the Clinic Mode to set it back to Patient mode? (sorry if I just confused anyone here, haha)

Any help would be super greatly appreciated. Because at this rate it's either this or ending up spending literal months back and forth with crappy doctors who don't really care about what I am trying to explain to them as someone who has lived in this body for 35 years and knows how he feels more than what they do. And will only end up constantly doing testing so they can make my insurance pay out just so I can have someone drive to my house and do the same damn thing and leave. 

So again, any help would be greatly appreciated! 

-John

[jaswilliams]

Hi John,


Welcome to Apnea board


To get the clinical manual for you machine go to this page https://www.apneaboard.com/adjust-cpap-p...tup-manual and follow the instructions to get the manual by email. From there you can read and change the current values of your machine.


Jason

[OpalRose]

John,

Order the Clinicians manual here:

https://www.apneaboard.com/adjust-cpap-p...tup-manual

The ResMed VPAP III is listed in Section Three.

Follow the directions and list the “exact” name of your machine.

You can also do a quick Google search. Search by typing “ResMed VPAP III”. You will find some direction on accessing the clinician menu.

[Sleeprider]

The first thing I'd like to suggest is that you start now to source a new replacement VPAP. That is of the S-8 generation, and is definitely at or beyond the end of its service life. The current models are Resmed Aircurve 10, and I think you need the ST-A. If I had your experience with this medical group, I would be looking to change doctors and find a group that wants to work cooperatively and listens to my needs. Regardless, you need to begin the search and request a new VPAP. You should have copies of all of your sleep tests and prescriptions for your personal records. Insurance will cover a new machine every five years, and all you have to say is you think the old machine is not maintaining pressure properly and is about 10 years old and serviceable. If you had the copy of your tests, your could have quantitatively argued how effective settings are by comparing the blood oxygen saturation (SpO2) at new vs old settings. You can even get a recording oximeter for your use for well under $100 and this would give you a great basis for arguing or defending changes. One big advantage to the new machines is that they will provide useful data on everything from AHI to respiratory rate, tidal volume, minute vent, spontaneous breathing percent and other important information needed to optimize your therapy.

When you find out what your machine settings are, we can probably help you to interpret them and suggest what change would better meet your goals. Your machine has two pressures, inhale (IPAP) and exhale (EPAP). It may also have a backup rate where EPAP is triggered on a timed basis (Breaths Per Minute BPM). EPAP is generally set to keep the airway patent against obstruction, and it is IPAP that relieves the effort of breathing by providing "pressure support" (PS), which is the difference between IPAP-EPAP=PS.

Good luck and don't worry about being your own advocate to get a new machine or making changes that work better for yourself. You deserve a newer machine that will let you make informed decisions based on the data.

[Jobo82]

Thanks all for all the help! Really, really appreciate it!