[Equipment] Noob questions about ResMed AirCurve 10 VAuto

[gwc2795]

Thanks very much for everyone's input.  I'll post a sleepyhead screenshot when I get home tonight, as I'm at work right now.  (Shift work stinks!)

I know I did it for 10 yrs.

[Fats Drywaller]

There's an option in the A10 clinical settings to tell the machine that an antibacterial (AB) filter is installed.  Is it a good idea to set that when using the HA filter also, because of the increased air resistance?

Fats really not a good idea and nothing like the effect Hojo was getting the hyperventilation was stunning.

But did you try it? Did you have "AB Filter" switched on in the clinical settings? Presumably that tells the machine to compensate for the increased resistance.

[nightshift]

Here are a couple of screenshots of "typical" nights.  Bear in mind I've been using the machine for less than two weeks.

[nightshift]

It's set to a CPAP of 12, ramp time of 20 min with start pressure 5, and full time EPR of 3.  I've started gathering data in sleepyhead but I want to give it a go with these settings for a while. I'll post screenshots and ask for input later, once I've settled in.  I seem to be adapting okay - I definitely feel more rested already.  I do have a few questions, though.

1. I've looked at the clinician manual but I'm still not sure what exactly the VAuto function would do if it were in use.  If I understand things correctly, my current settings on CPAP 12 with full time EPR 3 are essentially IPAP 12 and EPAP 9 whereas putting it on VAuto would give the machine dynamic control over those IPAP and EPAP values.  What could I expect in practice?  If you have one of these machines, do you use VAuto or do you set all the values manually based on your sleepyhead data?

2. I have seasonal hayfever.  Should I ask for the hypoallergenic filters?  Would they make the machine more noisy for my partner?

3.  I believe that after a month of compliance my DME will set me up with a permanent machine.  Which model should I go after?  Stick with the ResMed AirCurve Vauto or is there a better ResMed machine?  

Thanks in advance for any input.

The Vauto in CPAP mode does indeed provide EPR and your pressure settings are 12/9 (IPAP/EPAP) with a ramp from 5.  If you wanted to try the automatic mode, your settings would be:
Mode Vauto
EPAP min 9.0
PS 3.0
IPAP max 12.

That would provided the same fixed pressure you are getting now.  If you want to try auto-adjusting pressure, the the following settings may be tried:
Mode: Vauto
EPAP min: 8.0
PS 3.0
IPAP max 14

With more data feedback we could assess the effectiveness of those settings and suggest changes in pressures or pressure support.  You seem to have a good understanding of the function of the machine and your settings, and it's encouraging that you are feeling better with the therapy.

I'm not a big fan of the hypoallergenic filters, but they are available, and as long as you use OEM filters, the pressure drop should not affect machine performance.  We have seen some off-brand filters cause the machines to behave differently and record events that were not present with standard filters.

With pressure support at 3, the settings you are using with the Aircurve 10 Vauto can be duplicated with an Airsense 10 Autoset.  If you find higher pressure support is useful, then the Autoset is limited to providing EPR at 3.  The Resmed Airsense 10 Autoset or Autoset for Her is most likely what you will get for a permanent machine unless you have a need for something with more pressure support.  Do try the variable pressure so you can decide if a fixed pressure machine like the Resmed Elite CPAP is accptable based on your current trial, or if you prefer variable pressure as you will experience in Vauto mode.

This is all extremely helpful.  Thank you very much.  I'll ask my DME rep for a hypoallergenic filter next time I see her and I'll report back on how it works.  I have rotten hay fever.

I'm also going to give the variable pressure settings you suggested a try, maybe in a week or so.

As for the Vauto, i think it is the most flexible in features and does everything any machine can do except for backup rates. Unless you have complex, mixed, or central apnea issues, you have the top of the line machine in my opinion.

If you have further complications as stated above, the S/T and ASV machines are the choice, but that is strictly informational. I'm not implying you need those machines.

Thank you for the feedback.  I don't think I require the S/T or ASV machines.  I'll ask for a VAuto when my trial period is over.

[Sleeprider]

The screenshots of your current data look okay and you are getting decent results for CPAP at fixed pressure. Respiration statistics look very good and this looks like simple obstructive apnea, so CPAP or auto CPAP is appropriate. Although the summary says Ramp is off, it is going from a pressure of 5 to 12 over 40 minutes. I think you need to change that to either off, or set the minimum pressure to 7 if you can tolerate that, and set the ramp to Auto or 20 minutes tops. A 40 minute ramp from such a low pressure is not good.

I think you will find the automatic settings I suggested before will work well for you, and should avoid most of the obstructive events. There is a little bit of clustering on the OA events, and that may be a positional apnea from tucking your chin (too high pillow or poor head neck alignment). We can deal with it if it continues. Good luck.

[JesseLee]

If they give you the option of picking what machine you want then definitely go for the Vauto. Based on your charts, however, an auto CPAP machine is sufficient to handle your needs in my opinion. I hope that you will push for a Resmed if you can. Of the brands, Resmed machines are better and if you have any say in what you get, at the very least, no matter what mode, try for a Resmed.