Help with Resmed S9 VPAP Adapt - it wont let me fall asleep!

[LuckyD]

Hi Everyone,

I've been using CPAP for 19+ years now. I was using a Respironics M-series Auto machine for the last 9.5 years, but a friend offered me his late father's newer (2014/2015) Resmed S9 VPAP Adapt. I had it checked by a technician, and properly cleaned. I thought that the leap in technology to the S9 VPAP adapt would give me a great night's sleep.

Started to use it last night, and had a terrible night's sleep.

Started on ASVAuto with no ramp. Every time I would start to drift off to sleep, the unit would suddenly and dramatically increase pressure for 1 second, drop back, increase again for 1 second, then drop back again. Happened every few minutes. The pressure increase was strong enough to cause a leak out the side of my Resmed F10 full face mask. Couldn't fall asleep because of it.

Tried changing to ASV mode to avoid the problem, but it kept happening. High pressure "jolts" every few minutes, keeping me awake. Fell asleep for a few hours. AHI was 0.7 when I woke after a few hours. Tried to get back to sleep, but the pressure jolts kept me from falling back asleep.

Eventually I had to change to CPAP mode. As I have been using an Auto machine for 9.5 years, wasn't sure what pressure to use. Went with 12, and that at least allowed me to get some sleep. When I woke (tired), AHI was up to 2.9! No issues with the mask - machine shows that the mask fit was good.

Is this normal, or is there a fault?
Why is it doing what it's doing?
Is there something that I should be adjusting to stop those pressure "jolts" under ASVAuto and ASV modes?

I really would like to enjoy the benefits of the ASV modes, but can't see how with the current pressure problem. Running the unit on CPAP mode seems like a waste.

Please help me out with guidance on this.

Thanks.

[jaswilliams]

The vpap adapt is a specialist machine for people with central apnea. It does what you describe to encourage you to take a breath.

The machine uses the last rolling 3 minute respiration rate  to set how often it wants you to breath. Often as you relax and fall asleep you breathing rate drops rapidly and the machine wants to you breath more, you can use a blow back technique blow hard against the machine and it will back off in it's attempts to make you breath for the next 3 minutes until it starts again.

The question is do you have central apnea and do you need the features of this machine if not get a reasonably priced auto pap and sell this machine.

Jason

[DeepBreathing]

G'day LuckyD. Welcome to Apnea Board.

I have to agree with Jason that unless you have central, mixed or complex apnea then the VPAP Adapt is probably not the right machine for you. If you have plain vanilla obstructive apnea then the best machine (in most cases) is the Resmed Airsense 10 Autoset.

The increased pressure you feel is the machine trying to force a breath as it thinks you've stopped breathing - this often happens during the wake -> sleep transition period. To overcome it, just blow back hard and the machine will back off. Alternatively, set the ramp for a longer period (but not too long).

[LuckyD]

Hi all,

Thanks for your guidance. I'm going to try and stick with the S9 VPAP adapt for the moment.

When the time is right (financially), I'll be looking at the S10 or Dreamstation, both in auto.

I tweaked the settings for PS based on advice received on another forum, and was able to sleep through the night without major disturbance. AHI was 1.7, and showed bad mask fit. Will tighten tonight and see how I go - never ideal with full face mask + beard.

Regards,
David.

[jaswilliams]

Hi all,

Thanks for your guidance. I'm going to try and stick with the S9 VPAP adapt for the moment.

When the time is right (financially), I'll be looking at the S10 or Dreamstation, both in auto.

I tweaked the settings for PS based on advice received on another forum, and was able to sleep through the night without major disturbance. AHI was 1.7, and showed bad mask fit. Will tighten tonight and see how I go - never ideal with full face mask + beard.

Regards,
David.

Pop up a chart either here or the other forum and we can then see if the PS changers have helped the downside of the s9 vpap is it does not differentiate between Clear airways and obstructive apnea. Normally it is fair to assume it has treated the clear airways apnea by using the pressure support but as you have set that to 0 it may not be the case.