S8 Vantage Resmed Auto

sleepyhead63 · Post by **sleepyhead63** » Wed Mar 21, 2007 10:15 am

I have the S8 vantage and it seems to be set in auto mode and I have a problem with exhaling. Now if it was programed to be put in EPR mode would this give me relief. Also I heard in EPR mode it becomes a straight cpap, can someone explain what would be the advantages and disadvantages of this. I am going to the doctors soon to have the pressure adjusted because its too high at 14 and would like to know what I am talking about when I go. One more question am I limited with which manufacturer of masks with this machine or could I purchase anyone I choose. Unfortunely the tech programed the machine for me explained how to turn it off and on and sent me on my way, in retrospect I am very annoyed

bdp522 · Post by **bdp522** » Wed Mar 21, 2007 10:50 am

In apap mode you will stay at the lowest set pressure until you have an event, then the apap will increase the pressure to treat the event, then it will decrease the pressure after the event. This should allow you to spend a good part of the night at a lower pressure, leaving you more comfortable. So, if the machine is set for 6-14, you may spend most of the night at 6 or 7 and only go to 14 when an apnea event triggers the machine.
In cpap with EPR you will spend the entire night at 1 pressure with MOMENTARY pressure relief on exhale. This will make it easier to exhale but will not fluctuate as events happen. So, if the machine is set at 14 you will be at 14 all night except on exhale when the pressure drops for just a moment, then goes right back to 14.

Brenda

snoregirl · Post by **snoregirl** » Wed Mar 21, 2007 11:25 am

Resmed machine can't use EPR in auto mode. So if you want EPR you will need to use it in CPAP mode and it will blow 14 all the time.

That is why I prefer my Remstar Auto. I can use cflex AND Auto mode with my pressure of 13.

As far as I know masks are interchangable. There is some CYA disclaimer in some of the machine manufacturer's instructions to only use their masks, and as far as I know that is exactly that CYA and to sell more of their stuff.

If you want exhale relief in auto mode ask for your doc to write a new prescription for a Respironics Remstar Auto and get your DME to swap out your current machine (or Auto M series) and you can use both features.

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, resmed, cflex, CPAP, DME, Prescription, auto

Wulfman · Post by **Wulfman** » Wed Mar 21, 2007 11:41 am

sleepyhead63 wrote:I have the S8 vantage

Your profile is showing the "Compact" model.....not the Vantage. The "Compact" doesn't even have EPR......let alone the capabilities of a pressure range. You might want to take a closer look at it.....and/or change your profile if it IS a Vantage.

https://www.cpap.com/productpage-advanced.php?PNum=2004

https://www.cpap.com/productpage-advanced.php?PNum=1954

Den

sleepyhead63 · Post by **sleepyhead63** » Wed Mar 21, 2007 12:02 pm

Thanks wulfman I made the change. I like the idea snoregirl came up with changing to respironics remstar auto with c-flex but what are the chances my doctor would write a new presciption for it and can the vantage be swaped for the remstar without problems with my medical insurance. I suspect I have good coverage because the cpap was fully covered.

Wulfman · Post by **Wulfman** » Wed Mar 21, 2007 12:13 pm

You won't know till you ask......

I suspect several factors will be in play.
How long you've had your existing machine, dealing with your insurance provider (and if there's a contract), where you get your equipment (if your DME is a ResMed ONLY supplier that might present problems unless you can change DMEs).......AND your doctor.

Can't answer any of them for you.

Best wishes,

Den

dsm · Post by **dsm** » Wed Mar 21, 2007 3:11 pm

snoregirl wrote:Resmed machine can't use EPR in auto mode. So if you want EPR you will need to use it in CPAP mode and it will blow 14 all the time.

Hi Snoregirl, Some clarification re EPR & Cpap Mode.

EPR it is *not* plain cpap mode, far from it, EPR is a BiLevel mode and is set to work at two pressures (ipap & epap) just like a BiLevel. The main difference to a normal BiLevel though is that EPR can only set a maximum epap to ipap gap of 3 CMS but it can also be set to 2 cms or 1 cms if the user wishes. Normal BiLevels offer a wider ipap/epap gap range but 3 cms is a very optimal value for people with SA who don't have copd or other lung complications.

BiLevel is arguably the best form of cpap (debate welcome ) - Auto is great for people who like to play around & can tolerate the constant changing of pressures that Autos are famous for (many people find that this changing pressure regime, over time, causes them problems (incl: mask issues, breathing issues, excessive arousals, undetected SpO2 drops due to flow limitiations/hypops not being adequately treated) & end up switching to cpap mode). Autos are great for setting a baseline for therapy then sticking to it. One other reason Autos became very popular is that Autos did 3 things that older cpaps didn't (points 2 & 3 now no longer apply to modern cpap only machines, only point 1 is the differentiator now) ...

1) They adjusted the therapy pressure based on detecting patterns of events

2) Because of their added pressure & flow sensing detection, the Autos provided a form of exhale relief in that as the sleeper breathed out the machine detected the back pressure and lowered its pumping effort thus holding the exhale pressure constant rather than allowing it to rise up while the machine tried to pump air in and the sleeper tried to breathe air out.

Until recently many cpap only machines had no pressure sensing detection & merely pumped the air out at a constant preset pressure which when combined with the sleeper's breathout pressure, caused the combined pressure to go high & this added pressure was a typical cause of mask failures (leaks, squeaks etc:). But now most cpap machines have the pressure transducers fitted & also have enhanced pump controllers so can now maintain a constant breathout pressure.

3) VERY IMPORTANTLY: They once were the only xpaps that provided detailed nightly data that could be downloaded (now most cpaps do this as well so that great incentive to go Auto is now a lot less than it was)

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So Autos are great for doing home titrations but arguably are not ideal for normal therapy once baselines are established. But if some cpap seller can make more money by selling Autos over cpaps you can bet they will use every persuasive argument they can to convince you you *must* have one but the reality is it is a bells & whistles luxury now that cpaps have pressure sensors & adjustable speed blowers and can record nightly data.

Back to EPR,

1) nup it is *not* plain cpap mode
2) Also on another theme, it is not comparable to cflex any more than any BiLevel mode is

You *do not need* EPR mode in Auto mode - this is a fallacy repeated constantly here by people who clearly have picked up the mistaken statement from someone else & are merely repeating it, unfortunately without any comprehension of what it means or how it works.

"blow 14 all the time"

*nup* in EPR mode it could be set to blow 11 on exhale & 14 on inhale - that is a big difference to "14 all the time". This 3 cms gap bilevel mode is arguably the better form of pressure relief available. It provides a constant and steady set of pressures in an xpap environment and that people are more likely to adjust to than fluctuating (roaming) pressures be it the benefit of a steady mask environment or the elimination of arousals brought on by roaming pressures due to other causes or the decline in well being that so many Auto users report after 3-6 months of regular use.

The smart way to use a Vantage machine is to use the Auto mode to get your baseline. Then when that is done use the titration value that gave optimal benefit & switch to EPR mode using that cms setting & choosing an EPR setting of 1, 2 or 3 (3 would be my preferred EPR setting as that would set my titration as ipap 13 and an epap of 10). This machine is a very well thought out and versatile design. A real innovation.

Cheers

DSM

#2 I see TXKajun just posted his own experience in switching from Auto to Cpap mode - this is a common experience among some of us ...

viewtopic/t18405/Switched-Back-To-Straight-CPAP.html

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, CPAP, auto

Rabid1 · Post by **Rabid1** » Wed Mar 21, 2007 5:04 pm

DSM,

Nice post. I just bought a Vantage to back-up/replace my Remstar Auto BiPAP. Can't wait to give it a go.

Rick

bdp522 · Post by **bdp522** » Wed Mar 21, 2007 5:36 pm

Wow, DSM! The EPR lasts for the entire exhalation? The resmed site it will last up to 15 seconds but doesn't say what triggers it to go back to the regular pressure.

Brenda

sleepyhead63 · Post by **sleepyhead63** » Wed Mar 21, 2007 5:47 pm

Thanks dsm I feel alot better after reading your post, this is all new to me and my doctor really wants me to stick with the vantage, he also highly recommends it! Also he told me to knock it down to 12 instead of 14 on EPR mode so I am looking forward to the change tonight, thanks again it sets my mind at ease.

dsm · Post by **dsm** » Wed Mar 21, 2007 6:03 pm

[quote="Rabid1"]DSM,

Nice post. I just bought a Vantage to back-up/replace my Remstar Auto BiPAP. Can't wait to give it a go.

Rick

dsm · Post by **dsm** » Wed Mar 21, 2007 6:09 pm

[quote="bdp522"]Wow, DSM! The EPR lasts for the entire exhalation? The resmed site it will last up to 15 seconds but doesn't say what triggers it to go back to the regular pressure.

Brenda

bdp522 · Post by **bdp522** » Wed Mar 21, 2007 8:10 pm

Thanks DSM. I'm always glad to learn something new!

Brenda