First night using VCOM

[VegasGMC]

I did a lot of research before using this and it didn't go as planned. I feel like I'm going to die today. Here are some Oscar screen shots. I don't know why there is a 5 hour blank spot.  I went to bed at 7:30pm. Woke up at 12 with dry mouth. I got up and took an Ambien and taped my mouth. Woke up at 3:30.            

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This is the night before without VCOM.

[Nightynite]

I don’t get the good reviews compared to logic. This device is basically slows down air volume.

If our machine’s are calibrated with hose size, mask has vent holes, machine has the ability to record data, such as pressure, and volumes. How come a restriction in the hose doesn’t throw off the sensors of the unit itself. I have read everything on their site. It still doesn’t compute.

Vegas post above is a good example. Look at the tidal volumes.

[cdplatt]

I don't really get it either.  As I understand it, they're saying the expiratory pressure is the critical parameter in maintaining airway patency, so inspiratory pressure can be reduced below expiratory pressure to increase patient comfort, while reducing leaks, CAs, noise and the necessity for chin straps or tape. They don't say (or I didn't see) how much inspiratory pressure is reduced below expiratory pressure.  If their hypothesis is correct, couldn't you get close to the same benefits by turning EPR off and reducing the max pressure to whatever your highest min pressure is during a typical night?

Anyway, I'm a sucker.  I purchased one because I'm curious.  Waiting for it to be delivered.

[Nightynite]

Cdplatt, I agree, I couldn’t stand it and also purchased one. At a good price of $22.81 lefty lanky shop with a 30% discount now.  I just had to know if this works.

[djont57]

Add another sucker to this list; I actually tried for 2 nights. FAIL! They wont't let me return it!

[JoeP]

Partially obstructing your CPAP tubing with a piece of plastic? How does this help with APAP or BIPAP. Must throw off all statistics recorded by the machine since it is always reading pressure data upstream of the obstructive object. 

If the VCOM inventors are right, and that may be so, then current APAP machines have completely incorrect therapy goals. Because the machines could be capable of making inspiratory pressure less than expiratory pressure easily through the algorithm if that truly was the correct goals for therapy -- without blocking the tube with a resistor. But that is not implemented generally. 

How reliable are the stats for AHI, CA, leaks, volume, pressure after sticking this into your tube? I'd say not reliable at all since the computer in your machine is not calibrated for the obstruction. How reliable is the APAP software going to dynamically adjust things based on not really knowing what is going on at the mask end of the system? In fact, people often have a hard time when plugging in the wrong tube diameter data into their machines because the algorithm is calculating everything incorrectly and delivering the wrong levels of pressure based on the sensor data -- let alone a partially blocked tube.

[VegasGMC]

I didn't know the thing could be returned. I have to look for it. I threw it across the room after I woke up feeling like crap.

[Bluesv6]

I looked at the vcom and luckily it's  not in Canada so I researched and looked into it.  As mentioned above how does restricting a hose help ?  As well I question if running in apap how well a machine would respond and read pressures to know to increase pressures what not with a restriction in the hose.  Plus I feel that if it was the thing to do resmed , fisher paykel , Philips and whomever else would engineer into their machines. 

I found some reviews such as Jason ak  Lefty lanky  on YouTube.   It's hard to take someone's word on how well it works when someone has coupon codes and they get a kick back for every unit sold.  

I personally don't feel this item works more so a hindrance . However if your interested in trying the VCom people please do your due diligence and research and find some people that review with real data.  People that are reviewing it aren't either the manufacturer or people getting a kick back from every piece they sell . 

Be careful ! We are all here adjusting our own pressures as we don't trust the clinicians or feel that our pressures could be better set ! Why take advice from YouTubers or manufacturer to their own words ?

[cdplatt]

It isn't intended to be used in APAP mode.  It should only be used in CPAP mode so the machine delivers constant pressure.  Then, according to their white paper, the V-Com will drop inspiratory pressure below expiratory pressure - which may increase comfort.  I wouldn't expect the machine pressure algorithms to respond properly with that device in the airflow.

I tried mine, one night after setting CPAP mode, and did it without mouth tape.  I had continuous leaks through my mouth during the night, so though I wasn't uncomfortable and my AHI at 1.5 was within my normal range, I didn't draw any conclusions about the device.  Instead, I decided to get the best results I could over several nights in CPAP mode without the device and then reinstall it for a few days to see what, if any, difference it makes in comfort.  The only thing I've discovered so far is that I may sleep better with CPAP than with APAP.  Maybe all the APAP pressure variations are disturbing my sleep more than I realized.

I found this very interesting article in Sleep Review from last year that discusses the potential for decreasing inspiratory pressure: 

https://sleepreviewmag.com/sleep-treatme...e-mistake/

[enjoysleep59]

Equipment Used
ResMed AirSense 10 AutoSet
Standard Tubing
ResMed AirFit P30i Nasal pillow mask (medium)
V-COM w/ Tape
Ice Cube head pillow
Knee Cube with Ice Cube Cooling Cover

What the Report Revealed
The sleep report from last night was okay (AHI 1.19), but there is an added resistance to the breathing circuit that is uncomfortable. There were also spikes in the Flow Limit graph that seem more common with the VCOM than without. Tried several different pressures (10, 11, 12 cmH2O), and a few nights I used EPR, and a few nights in APAP mode, but overall, I think the AirSense 10 does a superb job without this device.

Conclusion
The VCOM might have it place for small number of users, but in my case using the machine in APAP mode with a pressure setting of 10-12 cmH2O and the EPR setting of two is comfortable and produces equivalent or better results without the add-on equipment (VCOM).