Questions regarding System One BiPAP AutoSV (DS960)

[DeepBreathing]

Mark, there is a discussion on ResMed v Philips here: http://www.apneaboard.com/forums/Thread-...ght=holden

I found the ResMed a lot easier to live with than the Philips, but other users have found the opposite. The Philips seems to have a lot more configurable options.

[markbking]

Thanks again to everyone for their comments and support!

Well, the DME is dodging me but maybe that turned out for the best. Last night was much better than the previous night and I had no leak alarms. After reading the thread posted by DeepBreathing, and considering Peter_C's advice, I am thinking that I will probably stick with the Respironics after all. I still may press the DME to update the firmware though. Being an IT guy it would seem to me that the best business practice for a DME would be to ensure each system they sell has the latest firmware before giving it to the client.

Wow, getting used to therapy is tricky enough, but making difficult decisions in a short amount of time about complex and expensive equipment that we rely on so heavily is no simple feat. Thanks for helping me make an educated decision.

[bwexler]

As you are discovering, it takes a few days (weeks) to get used to ASV.
After 2 months I sometimes feel I have to check to be sure the machine is on.

On rare occasion it will fight me when I am still awake. I find deep breathing whips it back into shape in a few breaths.

[Peter_C]

Just a thought? In my many dealings with 'DME's, I've found them to be knowledgeable about many things, but IT type stuff is not one of them. They may not even know what firmware is or what it does. So honestly, good luck with that. Remember, if it was a critical issue being fixed, a recall would happen. I suspect that updated firmware is simply trying to fix small issues while introducing new small issues.

I'm in the if it ain't broke, don't fix it camp myself.

[vsheline]

After reading the thread posted by DeepBreathing, and considering Peter_C's advice, I am thinking that I will probably stick with the Respironics after all. I still may press the DME to update the firmware though. Being an IT guy it would seem to me that the best business practice for a DME would be to ensure each system they sell has the latest firmware before giving it to the client.

The S9 VPAP Adapt is certainly less customizable, with very few settings. It is sort of a "One Size Fits Most" machine.

By the way, I suggest anyone who is getting the S9 VPAP Adapt should insist on the new model manufactured starting Nov 2012. On the older S9 VPAP Adapt (if in USA models 36007, 36017 and 36027), the EPAP pressure setting was fixed and did not auto-adjust; only the IPAP pressure (or Pressure Support) auto-adjusted itself.

The Clinician Manual (available from Apnea Board) will tell you what settings can be adjusted to affect how early or late the machine traditions from inhale to exhale, and from exhale to inhale, and which settings affect how abrupt or smooth the transition will be.

Below are listed a few of the settings available on the 2010 model PRS1 BiPAP autoSV Advanced. The 2013 model (DS960 if in USA) may have additional settings.

• BPM - This screen allows you to modify the Breaths Per Minute setting. You can choose between Off, Auto, or 4 through 30 in 1 BPM increments.
Note: This setting only displays if PS max is greater than zero.

• Ti - This screen allows you to modify the Inspiratory Time setting. You may adjust the setting from 0.5 to 3.0 seconds in 0.1 increments. This setting only displays if PS max is greater than zero and BPM is not set to Off or Auto.

• Flex type - This screen displays the comfort mode setting. You can select None or Bi-Flex.

• Bi-Flex - You can modify the Flex setting (1, 2 or 3) on this screen if you enabled Bi-Flex. The Bi-Flex comfort feature allows you to adjust the level of air pressure relief that the patient feels when exhaling during therapy. The setting of “1” provides a small amount of pressure relief, with higher numbers providing additional relief.

• Rise time - Rise time is the time it takes for the device to change from the expiratory pressure setting to the inspiratory pressure setting. This screen allows you to adjust the rise time so you can find the desired setting. A setting of “0” is the fastest rise time, while “3” is the slowest. This is only available if Flex type is set to None and PS max is greater than zero.

Take care,
--- Vaughn

[markbking]

Update:

Well, after a couple of weeks on the Respironics the DME offered to let me try the RESMED VPAP Adapt. It was my lucky day!

From my perspective (and I know everyone is unique) the Respironics seemed to blast me with a startling jet of air to combat my central apneas. My wife told me that it was doing it while I was sleeping when in her opinion I was already breathing normally. I was sleeping very poorly on this device and it just wasn't working for me.

Once I switched to the RESMED I noticed the difference immediately and my sleep improved significantly. In my opinion the RESMED is much more comfortable in the way that it ramps up the pressure to combat central apneas. Rather than an immediate strong jet of air (like the Respironics) it kind of smoothly ramps the air pressure so that it is not startling. I find this works MUCH better for me. Plus I am now able to check my data using Sleepyhead once again!

I think that after three months of struggling with apnea treatment I have finally gotten where I needed to be and it feels like I can check the box and get the worry of all of this off my plate now (except for periodic data checks of course).

I just wanted to pass along the update for anyone else who may be in my position and also to once again thank everyone here for their support.

Mark

[p7staxc]

Update:

Well, after a couple of weeks on the Respironics the DME offered to let me try the RESMED VPAP Adapt. It was my lucky day!

From my perspective (and I know everyone is unique) the Respironics seemed to blast me with a startling jet of air to combat my central apneas. My wife told me that it was doing it while I was sleeping when in her opinion I was already breathing normally. I was sleeping very poorly on this device and it just wasn't working for me.

Once I switched to the RESMED I noticed the difference immediately and my sleep improved significantly. In my opinion the RESMED is much more comfortable in the way that it ramps up the pressure to combat central apneas. Rather than an immediate strong jet of air (like the Respironics) it kind of smoothly ramps the air pressure so that it is not startling. I find this works MUCH better for me. Plus I am now able to check my data using Sleepyhead once again!

I think that after three months of struggling with apnea treatment I have finally gotten where I needed to be and it feels like I can check the box and get the worry of all of this off my plate now (except for periodic data checks of course).

I just wanted to pass along the update for anyone else who may be in my position and also to once again thank everyone here for their support.

Mark

Now I am confused. What you are saying seems the opposite of what I read elsewhere on this site that: "The S9's rapid pressure increases disturb some folks and wakes them up. Those rapid pressure increases can also trigger leaks." while "The System One is much slower to respond to clusters of events. Judging from the pressure curves I've seen it appears that the System One will raise the pressure in 1-2 cm increments once a minute in response to snoring, flow limitations, OAs, and Hs. And then it waits to see if things clear up before it increases the pressure again by a 1--2 cm increase."

I am currently trying to decide which one to buy and would prefer the one with the smoother ramp up rather than the sudden burst. I thought that would be Respironics but Mark has experienced the opposite, so maybe its ResMEd???

[Whitewabit]

Update:

Well, after a couple of weeks on the Respironics the DME offered to let me try the RESMED VPAP Adapt. It was my lucky day!

From my perspective (and I know everyone is unique) the Respironics seemed to blast me with a startling jet of air to combat my central apneas. My wife told me that it was doing it while I was sleeping when in her opinion I was already breathing normally. I was sleeping very poorly on this device and it just wasn't working for me.

Once I switched to the RESMED I noticed the difference immediately and my sleep improved significantly. In my opinion the RESMED is much more comfortable in the way that it ramps up the pressure to combat central apneas. Rather than an immediate strong jet of air (like the Respironics) it kind of smoothly ramps the air pressure so that it is not startling. I find this works MUCH better for me. Plus I am now able to check my data using Sleepyhead once again!

I think that after three months of struggling with apnea treatment I have finally gotten where I needed to be and it feels like I can check the box and get the worry of all of this off my plate now (except for periodic data checks of course).

I just wanted to pass along the update for anyone else who may be in my position and also to once again thank everyone here for their support.

Mark

what was the mode and settings for the Adapt that your using ??

I am using the Resmed Adapt in the ASV Mode and after getting the setting adjusted from the max down to a usable 4-3-8 and finding a comfortable mask for me I find it to be it to be comfortable after getting use to it which took several weeks .. but am now using it for over 7 hours a night ..

haven't used the other brand ..

[PaytonA]

Update:

Well, after a couple of weeks on the Respironics the DME offered to let me try the RESMED VPAP Adapt. It was my lucky day!

From my perspective (and I know everyone is unique) the Respironics seemed to blast me with a startling jet of air to combat my central apneas. My wife told me that it was doing it while I was sleeping when in her opinion I was already breathing normally. I was sleeping very poorly on this device and it just wasn't working for me.

Once I switched to the RESMED I noticed the difference immediately and my sleep improved significantly. In my opinion the RESMED is much more comfortable in the way that it ramps up the pressure to combat central apneas. Rather than an immediate strong jet of air (like the Respironics) it kind of smoothly ramps the air pressure so that it is not startling. I find this works MUCH better for me. Plus I am now able to check my data using Sleepyhead once again!

I think that after three months of struggling with apnea treatment I have finally gotten where I needed to be and it feels like I can check the box and get the worry of all of this off my plate now (except for periodic data checks of course).

I just wanted to pass along the update for anyone else who may be in my position and also to once again thank everyone here for their support.

Mark

Now I am confused. What you are saying seems the opposite of what I read elsewhere on this site that: "The S9's rapid pressure increases disturb some folks and wakes them up. Those rapid pressure increases can also trigger leaks." while "The System One is much slower to respond to clusters of events. Judging from the pressure curves I've seen it appears that the System One will raise the pressure in 1-2 cm increments once a minute in response to snoring, flow limitations, OAs, and Hs. And then it waits to see if things clear up before it increases the pressure again by a 1--2 cm increase."

I am currently trying to decide which one to buy and would prefer the one with the smoother ramp up rather than the sudden burst. I thought that would be Respironics but Mark has experienced the opposite, so maybe its ResMEd???

Actually, what I think you are referring to is the pressure increase for APAPs, not necessarily SVs. With an SV it would be more important to incerease the pressure rapidly than for an APAP. In fact, for pressures over 12 the Resmed Autoset does not respond to apneas but the servo ventilators need to do so. I suspect that Resmed has found a pressure curve that makes the rapid pressure rise time less bothersome to us human beings. As an example when I have "Easy Breathe" turned on my bilevel Resmed machine, it is difficult for me to detect when the machine has changes from EPAP pressure to IPAP pressure and I think that it has to do with the pressure rise curve.

Best Regards,

PaytonA

[bwexler]

After a year with the 960 and reasonably good numbers I still can't decide if I would have been happier with the Resmed. My DME just replied my noisy 960 with a new one. They refused to even consider a Resmed.