S9 Adapt pressure support cutting in and out

Hi everyone,

I have S9 adapt that I've been on for 5 years for complex sleep apnea and I know this is a "feature" of the Resmed ASV machines, but I've never gotten used to it. Almost every time it drops abruptly or cuts the minimum pressure support down to zero I start hyperventilating or miss a breath completely because I feel like I'm suffocating. It happens all throughout the night whether I'm awake or asleep. I've tried the Respironics SystemOne ASV many years ago, I don't remember if it had the same issue, I just remember that I didn't like it at all. Is anyone else extremely bothered by it? How are you coping with it? I should be getting a new machine soon and I've read that Aircurve S10 for Her has a feature where this is smoothed out, but I can't find that machine for sale anywhere.

Also, does my breathing wave look ok? It seems to be always out of sync with the pressure support. Just as I've finished exhaling, the pressure support is still not down completely.
Thanks for your input.

To my knowledge, there is no AirCurve 10 "for her" models...only Airsense 10 Autoset "for her.

kmkz58 wrote: ↑

Mon May 20, 2019 3:40 pm

Hi everyone,

I have S9 adapt that I've been on for 5 years for complex sleep apnea and I know this is a "feature" of the Resmed ASV machines, but I've never gotten used to it. Almost every time it drops abruptly or cuts the minimum pressure support down to zero I start hyperventilating or miss a breath completely because I feel like I'm suffocating.

If you don't like 0 ps, then raise the MinPS setting.

But that's the thing, it will still go below it no matter what the pressure support is set to. Right now I'm on EPAP 9 with PSmin 5 and PSmax of 15. I've tried many different pressure combinations including the PSmin at 1 and PSmin at 6. I've seen this on other people's graphs as well, it cuts pressure support for a few seconds.

kmkz58 wrote: ↑

Mon May 20, 2019 5:12 pm

But that's the thing, it will still go below it no matter what the pressure support is set to. Right now I'm on EPAP 9 with PSmin 5 and PSmax of 15. I've tried many different pressure combinations including the PSmin at 1 and PSmin at 6. I've seen this on other people's graphs as well, it cuts pressure support for a few seconds.


PS cut.png

Without a proper graph, I can't tell anything.

Flags (big enough to see), flow rate, mask pressure, leaks, flow limitations. No other strip charts.

The only flags are flow limit that sometimes follows the pressure cuts. Other times there are no events anywhere near it.

kmkz58 wrote: ↑

Mon May 20, 2019 11:46 pm

The only flags are flow limit that sometimes follows the pressure cuts. Other times there are no events anywhere near it.


PS cut.png

Please remove the pressure line, as requested..

I see no place in that screenshot where your PS drops.

I seem the same effect in my pressure line on my S9 vpap adapt that the PS has disappeared but when I look at the mask pressure the PS is still there it seems to me to be a reporting defect of the low resolution pressure graph ie a defect in the Resmed software (the drop in pressure line is show in the the data on the SD card) i do not feel a ps drop and i sleep great, so i shrug my sholders and move on. If I was replacing my ASV machine after 5 years I would stick with the Resmed Aircurve 10 ASV

I definitely feel it and it's like breathing using a straight CPAP without any exhalation relief for a second. Then it goes back to normal. I can see it on the machine screen as well, the PS goes bellow minimum sometimes (the same way it does when you first start the machine before the pressure support ramps up), then it goes back to normal. I do see that the mask pressure on the graph remains at minimum as it should. I think the issue (or one of the issues) is that my breath is out of sync with the machine. The machine is sometimes late when I start my breath, but even when it starts on time, it doesn't get to the peak until after my breath is done. Looking through my graphs - every breath is like that.

Here is an example of the machine being late to start pressure support on inhalation. This looks like the culprit.

There are no flags here, only the leak from me being disturbed in my sleep, feeling like I'm not getting enough air. As soon as pressure support goes down abruptly, the machine is late on the first breath, even later on the 2nd one shown in the graph below, and on the 3rd erratic breath it's 0.5 seconds late.

kmkz58 wrote: ↑

Tue May 21, 2019 12:26 pm

Here is an example of the machine being late to start pressure support on inhalation. This looks like the culprit.

There are no flags here, only the leak from me being disturbed in my sleep, feeling like I'm not getting enough air. As soon as pressure support goes down abruptly, the machine is late on the first breath, even later on the 2nd one shown in the graph below, and on the 3rd erratic breath it's 0.5 seconds late.


late PS.png

Where? put the green line on the start of inhalation, to line up the pressure increase.

The Resmed ASV primarily is timed by *YOUR* breath, it doesn't have a set backup rate.

It's in the image above, the green line is lined up with the very start of the pressure increase.

kmkz58 wrote: ↑

Tue May 21, 2019 1:16 pm

It's in the image above, the green line is lined up with the very start of the pressure increase.

And it's also at the start of your inhalation.

Yes, there's a tiny amount of apparent inhalation showing before the start of your actual inhalation, but that's not an inhale.

I'm not seeing this lateness you're talking about.

palerider wrote: ↑

Tue May 21, 2019 3:25 pm

kmkz58 wrote: ↑

Tue May 21, 2019 1:16 pm

It's in the image above, the green line is lined up with the very start of the pressure increase.

And it's also at the start of your inhalation.

Yes, there's a tiny amount of apparent inhalation showing before the start of your actual inhalation, but that's not an inhale.

I'm not seeing this lateness you're talking about.

This small amount is very noticeable and it happens frequently. That is definitely an inhale because I've tested it and immediately checked the OSCAR graph when these happened. I've also found this thread and it makes sense now, I remember trying an earlier model S9 years ago and it was so much faster/more responsive compare to my current S9. It had a breathing rate so much faster that I thought the algorithm from the loaner unit was stuck like that from the previous user and it wasn't normal. I guess that's why Resmed turned it down, but they turned it down way too much.

viewtopic/t115905/Resmed-S9-and-10-VPAP ... nged-.html

kmkz58 wrote: ↑

Tue May 21, 2019 4:55 pm

palerider wrote: ↑

Tue May 21, 2019 3:25 pm

kmkz58 wrote: ↑

Tue May 21, 2019 1:16 pm

It's in the image above, the green line is lined up with the very start of the pressure increase.

And it's also at the start of your inhalation.

Yes, there's a tiny amount of apparent inhalation showing before the start of your actual inhalation, but that's not an inhale.

I'm not seeing this lateness you're talking about.

This small amount is very noticeable and it happens frequently. That is definitely an inhale because I've tested it and immediately checked the OSCAR graph when these happened. I've also found this thread and it makes sense now, I remember trying an earlier model S9 years ago and it was so much faster/more responsive compare to my current S9. It had a breathing rate so much faster that I thought the algorithm from the loaner unit was stuck like that from the previous user and it wasn't normal. I guess that's why Resmed turned it down, but they turned it down way too much.

I would not call that tiny amount of air flow an inhalation, your inhalation starts where the green line is, if you look, you'll see that the timing for it is consistent with the breaths before it.

Machines don't trigger on very slight fluctuations in air, because that would result in complaints of the machine forcing air into people before they were ready to inhale.

You've changed from saying that the PS is zero (which I haven't seen any indication of) to saying that the PS is *late* (also no indication so far of that).

kmkz58 wrote: ↑

Tue May 21, 2019 4:55 pm

viewtopic/t115905/Resmed-S9-and-10-VPAP ... nged-.html

I think you're misinterpreting the message there.