AirCurve 10 VAUTO vs MY Machine

[3rdMarDiv]

I Recently obtained above machine model # 37051 and I am asking for a comparison of this machine against my machine. (please see my machine specs in my bio).

Currently, my machine is set at fixed E & Ipap and that's it. No deviation, no changes.

This one, correct me if I'm wrong, looks like it can drop or raise cmH20 based on an individual "As Needed" basis.

This is an interesting prospect that I would like to explore further.

I'm kinda looking at my machine as a old dial phone and this one as new Smartphone.

Any insights or thoughts would be appreciated.

[Sleeprider]

Your Dreamstation BiPAP ST30 is a fixed bilevel machine with the capability to trigger IPAP by responding to spontaneous effort or a timed trigger if spontaneous breathing does not occur. At a pressure of 18/14 you are using a 4.0 pressure support (PS). Your machine delivers a mostly square-wave of pressure modified by BiFlex or rise-time settings. This machine has a pressure capability for up to 30 cm and is mostly appropriate for treating restrictive pulmonary conditions such as COPD or obesity related hypoventilation.

The Resmed Aircurve 10 Vauto is an auto bilevel machine that automatically adjusts EPAP and IPAP pressure within a set range, while maintaining a fixed pressure support. The Vauto triggers IPAP strictly on spontaneous effort and there is no timed backup. Pressure delivery on the Vauto is modified by the EasyBreathe™ algorithm that follows respiratory effort in a smooth wave pattern that can be viewed in OSCAR as mask pressure. In addition to pressure settings, the Vauto can be fine-tuned with trigger and cycle sensitivity, and minimum and maximum time of inspiration. This machine has a pressure capability for up to 25 cm, but will only reach about 22 cm in Vauto mode.

You're in for a treat. I will suggest the following settings to start:
EPAP min 9.0
Max pressure 18.0
PS 4.0
Ti Min 0.3
Ti Max 2.0
Trigger and cycle Medium.

[3rdMarDiv]

Thank you so much sleeprider I really appreciate this information. I’m going to start doing more research into this machine as to its basic operator usage. It won’t be long and I will fire it up and I take it for a ride. I will use the same thread to make updates… Thanks again, Gary

[ragtopcircus]

Just to reiterate one of Sleeprider's comments, your Dreamstation S/T is capable of initiating a breath for you if you do not. The Vauto is a great machine (it's what I use), but it will not initiate a breath for you. This is not a problem UNLESS you have a diagnosis of Central Apnea or Complex (Obstructive and Central) Apnea (which is unusual but possible).

[Sleeprider]

Ragtopcircus, just a bit of correction. I said ST could trigger IPAP on a timed basis, and the Vauto triggers only on spontaneous effort. I never suggested the ST could "initiate a breath". The ST-A can get there, but in my opinion the ST is a machine looking for a job that another machine doesn't already do better. It's basically a VPAP-S or BiPAP S with a backup rate...useless.

[3rdMarDiv]

Ragtopcircus, just a bit of correction. I said ST could trigger IPAP on a timed basis, and the Vauto triggers only on spontaneous effort. I never suggested the ST could "initiate a breath".  The ST-A can get there, but in my opinion the ST is a machine looking for a job that another machine doesn't already do better.  It's basically a VPAP-S or BiPAP S with a backup rate...useless.

Thanks for the additional information. I tried the triggered/timed breath with my PR machine and it was not for me. I felt like I was trying to breath and so was it. Terrible.! For me anyway. Spontaneous is perfect. My PR machine is in Bi-Level S mode. Looking forward to using the V-10.

I have connected the F-30 Mask with the F&P Simplus Headgear to my PR machine and will use it until I am accustomed to it. To me the mask is a big part of using any machine. It feels really comfortable compared to the PR set up I have been using.

[3rdMarDiv]

Your suggestions with comments/questions:

SleepRider Wrote:
You're in for a treat. I will suggest the following settings to start:

EPAP min 9.0
Set

Max pressure 18.0
- There was no setting for “Max Pressure” found on this machine so I set the IPAP at 18. This machine has no Min & Max pressure settings, but instead has IPAP and EPAP settings.

PS 4.0
-There was no setting for “PS” found on this machine that I found. Today upon reviewing my first nights OSCAR data I see OSCAR shows the PS at 4.0

Ti Min 0.3
Set

Ti Max 2.0
Set
Trigger and cycle Medium.
Set

Additional:
Under “Mode” I set the machine at “S”. I did notice that there are also “CPAP” and “Vauto” modes available. “CPAP”& “S” Modes I understand, but question if “Vauto” Mode should be chosen?

Completed my 1st night of use and really like the smoother breathing it offers. I found it to be much more natural. It was like I was not even on a machine.

I liked everything about it actually, except, the motor noise is very different. I believe I can overcome this by incorporating sleep sound noise into my nightly sleep regime. I'm sure right now the difference in noise is due to conditioning with the PR noise. I was reading another post and found this comparison spot on.

RE: Does anyone prefer Dreamstations to Resmed? The only thing I liked better about the Dreamstation was the character of the noise. I don't think it was actually more quiet than the Resmed Airsense/Aircurve 10 series; it may have even been louder. The Dreamstation just sounded more like a strong wind outside, while the Air* 10 machines have a faintly wheezy character.

That comment hits the nail on the head..!

I am including some screenshot info from OSCAR daily and hope you can review for any mistakes I made or have suggestions for improvement.

Q: Is the ResMed a lot more sensitive or accurate about events. My PR reports have been under 2 AHI for a very long time. I haven't had a 16 AHI since I first started using a CPAP machine. Not a big deal as I am past freaking fretting over an AHI number. 

   

   

   

[Sleeprider]

Um, sorry, you should have done this setup in Vauto mode. S-mode is strictly fixed pressure and did not allow the machine to access the pressure up to 18/14 that may have been needed for obstructive events. We can now see why that is important. The clustering of events looks extremely positional here, and has me thinking of the soft cervical collar.

Now that I have seen 13/9 at VPAP -S I am pretty sure that is too low. I think I will revise upward as follows:
Mode Vauto
EPAP min 12.0
Max pressure 20.0
PS 4.0

In Vauto mode, this will provide a pressure between 16/12 and 20/16 which is plus or minus 2-cm from your current settings. I think this should be a bit better that that last disaster.

[ragtopcircus]

Note that in S mode, with the pressure set at 18/9, that means Pressure Support was 9. That is a pretty big change from 18/14 (Pressure Support 4). No wonder AHI jumped up! That actually is a big deal, and it makes sense. It's not a matter of Resmed reporting events differently; it's a clear indication that 18/9 is, as Sleeprider called it, a "disaster".

[3rdMarDiv]

Um, sorry, you should have done this setup in Vauto mode.  S-mode is strictly fixed pressure and did not allow the machine to access the pressure up to 18/14 that may have been needed for obstructive events.  We can now see why that is important.  The clustering of events looks extremely positional here, and has me thinking of the soft cervical collar.

Now that I have seen 13/9 at VPAP -S I am pretty sure that is too low.  I think I will revise upward as follows:
Mode Vauto
EPAP min 12.0
Max pressure 20.0
PS 4.0

In Vauto mode, this will provide a pressure between 16/12 and 20/16 which is plus or minus 2-cm from your current settings.  I think this should be a bit better that that last disaster.

No problems at all. Every time anything is changed there are always challenges.

My apnea is extremely positional (Like 100%). A few minutes on my back and and the AHI increases.

Using the new machine introduced a big change in sound and caused an interrupted sleep for my wife and I both. Trying to fool with the machine and get back to sleep was a pain. Like the original machine, time will hopefully eliminate the disruption.

Right now the change in sound is the only obstacle to overcome.

As you can see by the Usage report I have almost eliminated supine sleeping with an occasional transgression.

For now I'd like to replicate my current PR Max and Min, IPAP/EPAP, pressures until I get past the sound change.

Based on the enclosed data pics what settings would you recommend to replicate my 18.5/14.5 settings in the VAuto Mode?