Air curve 10 and Sleepyhead software

[sleepyOttawaSteve]

I will wait a little while to see how these settings work out and then possibly adjusting slowly

[PaytonA]

Well I finally got my new bi-level Aircurve 10 V Auto. I have just had it for 2 nights so far and all is going well. I have had sleep apnea for over 15 years and had various machines over the past. Anyway todays question is that when I do my download into sleepyhead software not all parameters are being either downloaded or accessible. The one that I am concerned with is that I cannot see my daily pressure graph in the overview window . All my previous daily bar graphs are there from my air sense 10 that I had as a loaner or my old S9. All the other bar graphs do download just fine it is only the Pressure chart that is not showing the air curve results. Just wondering if this is unable to be fixed until there is an update on sleepyhead or whatever other reason?

Thanks in advance
Steve

A10 Vauto displays a wealth of info but you have to turn on the display.

go into clinical mode by pressing both home/round button down for a few seconds

second line down is mode: options will be .. Cpap .. S .. Vauto

scroll all the way down to options: switch essentials to plus. this will display a slew of info without going into clinical mode.

press home, then exit clinical mode. then scroll to sleep reports: all sorts of critical info is now displayed.

Aircurve 10 Vauto will auto titrate pressure settings in Vauto mode. but note it only auto titrates max ipap only. min ipap is determined by PS setting. for example Vauto determines 11.8 ipap or what ever is needed, with default PS setting of 4 .. you would get 11.8 ipap with 7.8 epap

PS controls pressure difference between ipap/epap.

another recommended tweak is to change Ti max settings. default is 2.0 seconds .. take a split second stop watch and time your max breathing cycles. this will reveal your baseline. then with default 2.0 seconds setting .. breath normally during rampup and observe if your breathing cycle length matches airflow coming out. you want to set Ti max to match your breathing cycle length.

Ti max and min do not control your breathing cycle, they limit the time that the machine spends with the inhalation pressure. The machine will follow your normal transitions from inhalation to exhalation and vice versa but, for instance, if the Ti max is set for 2.0 seconds and you are still inhaling at the end of 2.0 seconds the machine will go to EPAP anyway. If that were to happen to you a lot, it would probably be a good idea to raise your Ti max. In ResScan under statistic there is one called "Spontaneous Cycled Breaths". It is a percentage. If this is not close to 100%, it means that what I have described above is happening. I can not think of anything untoward that would happen if your Ti max was higher than necessary.

The factory setting for Ti max is 2.0 seconds. Most people do not need to change it. You can check your inspiration time on the Insp. graph if you are interested and you will probably see that it is well within the 2.0 seconds. If I were to set my Ti max to my breathing cycle time (that is one inhale plus one exhale equals a breathing cycle), I would need to set my Ti max to almost 4.0 seconds which is the max.

Best Regards,

PaytonA

[sleepyOttawaSteve]

Thank you for the great information.. I was wondering exactly what the inspiration and exhalation info meant and now I have a better understanding.. I will keep that in mind if I need to adjust anything

Steve

[_cy_]

Well I finally got my new bi-level Aircurve 10 V Auto. I have just had it for 2 nights so far and all is going well. I have had sleep apnea for over 15 years and had various machines over the past. Anyway todays question is that when I do my download into sleepyhead software not all parameters are being either downloaded or accessible. The one that I am concerned with is that I cannot see my daily pressure graph in the overview window . All my previous daily bar graphs are there from my air sense 10 that I had as a loaner or my old S9. All the other bar graphs do download just fine it is only the Pressure chart that is not showing the air curve results. Just wondering if this is unable to be fixed until there is an update on sleepyhead or whatever other reason?

Thanks in advance
Steve

A10 Vauto displays a wealth of info but you have to turn on the display.

go into clinical mode by pressing both home/round button down for a few seconds

second line down is mode: options will be .. Cpap .. S .. Vauto

scroll all the way down to options: switch essentials to plus. this will display a slew of info without going into clinical mode.

press home, then exit clinical mode. then scroll to sleep reports: all sorts of critical info is now displayed.

Aircurve 10 Vauto will auto titrate pressure settings in Vauto mode. but note it only auto titrates max ipap only. min ipap is determined by PS setting. for example Vauto determines 11.8 ipap or what ever is needed, with default PS setting of 4 .. you would get 11.8 ipap with 7.8 epap

PS controls pressure difference between ipap/epap.

another recommended tweak is to change Ti max settings. default is 2.0 seconds .. take a split second stop watch and time your max breathing cycles. this will reveal your baseline. then with default 2.0 seconds setting .. breath normally during rampup and observe if your breathing cycle length matches airflow coming out. you want to set Ti max to match your breathing cycle length.

Ti max and min do not control your breathing cycle, they limit the time that the machine spends with the inhalation pressure. The machine will follow your normal transitions from inhalation to exhalation and vice versa but, for instance, if the Ti max is set for 2.0 seconds and you are still inhaling at the end of 2.0 seconds the machine will go to EPAP anyway. If that were to happen to you a lot, it would probably be a good idea to raise your Ti max. In ResScan under statistic there is one called "Spontaneous Cycled Breaths". It is a percentage. If this is not close to 100%, it means that what I have described above is happening. I can not think of anything untoward that would happen if your Ti max was higher than necessary.

The factory setting for Ti max is 2.0 seconds. Most people do not need to change it. You can check your inspiration time on the Insp. graph if you are interested and you will probably see that it is well within the 2.0 seconds. If I were to set my Ti max to my breathing cycle time (that is one inhale plus one exhale equals a breathing cycle), I would need to set my Ti max to almost 4.0 seconds which is the max.

Best Regards,

PaytonA

some of above is good information, but gotta disagree with Ti setting on A10 Vauto not controlling breathing cycle. perhaps I should have gone into more detail in my post above. please note my comments are based on experimenting and observing how A10 Vauto behaves.

Aircurve 10 Vauto detects both obstructive and central sleep apnea. CSA is detected by forced oscillation technique. which adds 1 cm pressure @4hz when an apnea is detected, then results are interpolated to measure airway patency.

there are times where A10 Vauto acts very much like a ventilator and takes over breathing cycles. Ti max setting determines length of breathing cycle when that occurs.

A10 Vauto has a setting to adjust sensitivity of trigger. once intake cycle is detected, A10 Vauto can either follow your breathing cycle length or deliver a full length intake cycle determined by Ti max setting.

more clarification is needed for my comments about using a split second stop watch. this is only to set a baseline, NOT to determine Ti setting. for instance my max breathing length is 3.75 seconds .. you would NOT want to set Ti max to 3.75 seconds. you want to observe how long a comfortable breathing cycle takes. for instance 2 seconds default was a bit short and left me needing more air during ramp up. increasing Ti max to 2.2 second from default 2 second solved the problem.

A10 Vauto will track your average Ti max which is 1.4 seconds for me. there are times where A10 Vauto will deliver pressure below levels needed to for an effective splint. my take is A10 Vauto has determined no apnea events are going on based on flow volume and/or forced oscillation technique. A10 Vauto then goes into lowest air pressure settings. for me that would be 4 min with PS at 4 which results ipap of 8. if my nasal passage ways are clear with no apnea events, I'm seeing 4.4 epap with 8.4 ipap with settings: Ti max 2.2, epap min 4, ipap max 14.8, PS 4

my conclusion is A10 Vauto is a very_intelligent machine! that sometimes works very different from other cpap/bi-level machines.

[PaytonA]

some of above is good information, but gotta disagree with Ti setting on A10 Vauto not controlling breathing cycle. perhaps I should have gone into more detail in my post above. please note my comments are based on experimenting and observing how A10 Vauto behaves.

Aircurve 10 Vauto detects both obstructive and central sleep apnea. CSA is detected by forced oscillation technique. which adds 1 cm pressure @4hz when an apnea is detected, then results are interpolated to measure airway patency.

I do not see what the last paragraph has to do with Ti min or Ti max!!

there are times where A10 Vauto acts very much like a ventilator and takes over breathing cycles. Ti max setting determines length of breathing cycle when that occurs.

Ti max setting only limits IPAP time. It has no control over the entire breathing cycle. The following is a quote from the A10 Vauto clinician manual on page 6.

Unique to ResMed bilevel devices, TiControl™ allows the clinician to set minimum and maximum limits on the time the device spends in IPAP. The minimum and maximum time limits are set at either side of the patient’s ideal spontaneous inspiratory time, providing a ’window of opportunity’ for the patient to spontaneously cycle to EPAP. The minimum time limit is set via the Ti Min parameter and the maximum time limit is set via the Ti Max parameter.

A10 Vauto has a setting to adjust sensitivity of trigger. once intake cycle is detected, A10 Vauto can either follow your breathing cycle length or deliver a full length intake cycle determined by Ti max setting.

Trigger is not part of Ti max and does not affect it.

more clarification is needed for my comments about using a split second stop watch. this is only to set a baseline, NOT to determine Ti setting. for instance my max breathing length is 3.75 seconds .. you would NOT want to set Ti max to 3.75 seconds. you want to observe how long a comfortable breathing cycle takes. for instance 2 seconds default was a bit short and left me needing more air during ramp up. increasing Ti max to 2.2 second from default 2 second solved the problem.

A10 Vauto will track your average Ti max which is 1.4 seconds for me. there are times where A10 Vauto will deliver pressure below levels needed to for an effective splint. my take is A10 Vauto has determined no apnea events are going on based on flow volume and/or forced oscillation technique. A10 Vauto then goes into lowest air pressure settings. for me that would be 4 min with PS at 4 which results ipap of 8. if my nasal passage ways are clear with no apnea events, I'm seeing 4.4 epap with 8.4 ipap with settings: Ti max 2.2, epap min 4, ipap max 14.8, PS 4

I do not know what all of this has to do with Ti max and Ti min.

my conclusion is A10 Vauto is a very_intelligent machine! that sometimes works very different from other cpap/bi-level machines.

i agree that the A10 Vauto is a very intelligent machine but it does not work all that differently from other Resmed machines

Best Regards,

PaytonA

[_cy_]

some of above is good information, but gotta disagree with Ti setting on A10 Vauto not controlling breathing cycle. perhaps I should have gone into more detail in my post above. please note my comments are based on experimenting and observing how A10 Vauto behaves.

Aircurve 10 Vauto detects both obstructive and central sleep apnea. CSA is detected by forced oscillation technique. which adds 1 cm pressure @4hz when an apnea is detected, then results are interpolated to measure airway patency.

I do not see what the last paragraph has to do with Ti min or Ti max!!

there are times where A10 Vauto acts very much like a ventilator and takes over breathing cycles. Ti max setting determines length of breathing cycle when that occurs.

Ti max setting only limits IPAP time. It has no control over the entire breathing cycle. The following is a quote from the A10 Vauto clinician manual on page 6.

Unique to ResMed bilevel devices, TiControl™ allows the clinician to set minimum and maximum limits on the time the device spends in IPAP. The minimum and maximum time limits are set at either side of the patient’s ideal spontaneous inspiratory time, providing a ’window of opportunity’ for the patient to spontaneously cycle to EPAP. The minimum time limit is set via the Ti Min parameter and the maximum time limit is set via the Ti Max parameter.

A10 Vauto has a setting to adjust sensitivity of trigger. once intake cycle is detected, A10 Vauto can either follow your breathing cycle length or deliver a full length intake cycle determined by Ti max setting.

Trigger is not part of Ti max and does not affect it.

more clarification is needed for my comments about using a split second stop watch. this is only to set a baseline, NOT to determine Ti setting. for instance my max breathing length is 3.75 seconds .. you would NOT want to set Ti max to 3.75 seconds. you want to observe how long a comfortable breathing cycle takes. for instance 2 seconds default was a bit short and left me needing more air during ramp up. increasing Ti max to 2.2 second from default 2 second solved the problem.

A10 Vauto will track your average Ti max which is 1.4 seconds for me. there are times where A10 Vauto will deliver pressure below levels needed to for an effective splint. my take is A10 Vauto has determined no apnea events are going on based on flow volume and/or forced oscillation technique. A10 Vauto then goes into lowest air pressure settings. for me that would be 4 min with PS at 4 which results ipap of 8. if my nasal passage ways are clear with no apnea events, I'm seeing 4.4 epap with 8.4 ipap with settings: Ti max 2.2, epap min 4, ipap max 14.8, PS 4

I do not know what all of this has to do with Ti max and Ti min.

my conclusion is A10 Vauto is a very_intelligent machine! that sometimes works very different from other cpap/bi-level machines.

i agree that the A10 Vauto is a very intelligent machine but it does not work all that differently from other Resmed machines

Best Regards,

PaytonA

I respectfully disagree with most of your above post. all I'm doing is reporting how my A10 Vauto reacts to certain conditions.

[PaytonA]

Sorry, I thought that we were having a discussion and I must apologize to the original poster for hijacking the thread.