Bilevel machine - advice needed

[LookingForward]

Quick update:

I finally had my appointment today at the DME. I do indeed have a ResMed AirCurve VAUTO with a ClimateLine hose. They didn't have the big selection of masks I was told would be there to choose from. I'm not surprised. I brought home a ResMed AirFit N20.

The machine is currently set at Standard with the pressure settings of 18/12, as per the prescription.

I'm trying to decide how long I should leave it at standard to make may doctor happy. I have little knowledge of SleepyHead. That's my next project. I'm sure those numbers will help me decide how quickly to switch over.

I have other questions regarding changes to setting to the machine but wasn't sure if I should start a new thread with symptoms I've had using mom's older RedMed H4i or just give it a few nights with this machine and then ask and make changes then.

Thanks again for the knowledge gained regarding pushing for the Auto instead of the Standard machine.

[Walla Walla]

The settings you mentioned sound like you have a AirSense 10 Autoset. The VAUTO doesn't have a standard setting. When you get a chance go ahead and post a sleepyhead chart and I'm sure you'll get input on which setting to use.

[Stom]

My doctor got upset and told me that I was wrong and the Auto machines are very intricate and way more expensive. He said I don't need it, my sleep study was only done under the standard setting and he would not write the script for it.

As far as I can tell, the auto bipap is the *exact same machine* with the exact same sensors and mechanical parts as the fixed bipap, just with additional software modes enabled to reactively control pressure levels.

Given the large amount of data home machines provide I'd think that *weeks and weeks* data from an auto machine is more telling that a single, non-representative night of PSG testing when it comes to titration.

[Walla Walla]

OK I think I know what your saying now. What you call standard I know as fixed pressures. So you have a VAUTO but he has it set to fixed pressures so it doesn't adjust for events. Go can go ahead and use the pressures he has it set for for a few days than post a sleepyhead chart here. A couple of days data at the set pressures should give an idea of what changes you'll need to make. You also could change to VAUTO setting and set minimum pressure at 11cm and pressure support at 6cm. Than set maximum pressure at 25cm. That should be close enough for Auto settings to see what you need. It's up to you though.

[LookingForward]

The settings you mentioned sound like you have a AirSense 10 Autoset. The VAUTO doesn't have a standard setting. When you get a chance go ahead and post a sleepyhead chart and I'm sure you'll get input on which setting to use.

My machine is an AirCurve 10 VAuto. It's silver like the other BiLevel AirCurves. And the little decal on the front of the machine says "AirCurve 10 VAuot. I think all the AirSense are black. When I go into clinical settings it shows the choices of CPAP, S, and VAuto. At the moment it's set at Standard. I would guess my pressure of 18 to 12 shows the BiLevel rate. 

I see that you also have the AirCurve 10 VAuto. Do the modes in your clinical settings say the same?

Hopefully this evening I will start watching SleepyHead YouTube videos. I have it downloaded to my computer already. I'll be very interested to see the results in the morning.

Thanks for your help. I'm looking forward to the help with pressure settings and learning how to use SleepyHead.

[trish6hundred]

Hi LookingForward,
WELCOME to the forum.!
Iwish you good luck with CPAP therapy.

[jaswilliams]

The S on a vauto stands for Spontaneous Mode ie BiLevel with fixed pressures.

[LookingForward]

OK I think I know what your saying now. What you call standard I know as fixed pressures. So you have a VAUTO but he has it set to fixed pressures so it doesn't adjust for events. Go can go ahead and use the pressures he has it set for for a few days than post a sleepyhead chart here. A couple of days data at the set pressures should give an idea of what changes you'll need to make. You also could change to VAUTO setting and set minimum pressure at 11cm and pressure support at 6cm. Than set maximum pressure at 25cm. That should be close enough for Auto settings to see what you need. It's up to you though.

I did a lot of studying this morning in the use of SleepyHead and I'm still a beginner with much more to learn!

But I did manage to view my results on SleepyHead. I was really surprised to see that there were 51 Centrals and 13 Obstructives. I probably should have waited a day or two but I went ahead and sent a message to my doctor requesting that he look at the results and possibly recommend a pressure change. Hopefully he won't be too mad at me for getting the Auto or that I requested he look at the results so soon. Should I post the screenshot on this threat or start a new one  since the topic is now changing to one with results?

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The S on a vauto stands for Spontaneous Mode ie BiLevel with fixed pressures.

Thanks for the info. I made the assumption that S meant Standard so I'm glad you let me know. Now I have to remember that   I tend to be forgetful sometimes.

[Walla Walla]

You can post the chart here. I can tell you right now though your going to want to reduce the pressure support down to 4cm or 3cm and see if that reduces the clear airway events.

[Sleeprider]

The VPAP S mode is fixed pressure, and at 18/12, your pressure support is 6-cm. I think you'd probably benefit from the Vauto mode which would allow you to use a lower pressure, and it would automatically adjust upward according to your needs. For example, you could set it in Vauto mode at EPAP min 10, PS 6.0 and IPAP max 18 and be very close to your current fixed pressure prescription, but a bit less aggressive as you fall asleep and unless you need the higher pressure. When in VPAP-S mode be sure the Easy-Breathe comfort option is selected. It makes a big difference in comfort.