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Hello All,
After having tried both the AirSense 11 and the AirCurve 10 S, DME has agreed that I could benefit from a different CPAP machine. Both provided better therapy results than the DreamStation 2. The AirSense 11 in APAP mode would be good if had more EPAP control and the AirCurve 10 S allows me to control the EPAP but I don't have auto adjusting IPAP. The issuse I had on DreamStation (constant waking at night, wake in morning with headaches, dizziness, everything really foggy and really tired) have lessened with both the new machines. The DME suggested 1 option, the AirCurve VAUTO but I am wondering about the AirCurve ASV because on my issues tolerating the higher pressures for any extended periods of time. My understanding of the VAUTO is that is uses a pressure support value so EPAP would be so many points below the IPAP value and ASV would ramp pressure up and down for the IPAP as needed and EPAP would be the set value. I am wondering if my understanding is correct and which machine would be best choice for me.
Here is some data, don't know if it helps but it can't hurt. If further info is needed please let me know.
Pressure in DreamStation set to min. 8.0 max. 10 with Flex of 3. - average AHI 3.80, CA no data
Pressure in AirSense set to min. 8.0 max. 10 with a Flex of 3. = average AHI 1.16, CA about 50% of OA
Pressure in AirCurve set to EPAP 4.4, IPAP 8.2 = average AHI 1.30, CA about 45% of OA
(07-16-2023, 01:02 PM)edyurgal Wrote: Hello All,
After having tried both the AirSense 11 and the AirCurve 10 S, DME has agreed that I could benefit from a different CPAP machine. Both provided better therapy results than the DreamStation 2. The AirSense 11 in APAP mode would be good if had more EPAP control and the AirCurve 10 S allows me to control the EPAP but I don't have auto adjusting IPAP. The issuse I had on DreamStation (constant waking at night, wake in morning with headaches, dizziness, everything really foggy and really tired) have lessened with both the new machines. The DME suggested 1 option, the AirCurve VAUTO but I am wondering about the AirCurve ASV because on my issues tolerating the higher pressures for any extended periods of time. My understanding of the VAUTO is that is uses a pressure support value so EPAP would be so many points below the IPAP value and ASV would ramp pressure up and down for the IPAP as needed and EPAP would be the set value. I am wondering if my understanding is correct and which machine would be best choice for me.
Here is some data, don't know if it helps but it can't hurt. If further info is needed please let me know.
Pressure in DreamStation set to min. 8.0 max. 10 with Flex of 3. - average AHI 3.80, CA no data
Pressure in AirSense set to min. 8.0 max. 10 with a Flex of 3. = average AHI 1.16, CA about 50% of OA
Pressure in AirCurve set to EPAP 4.4, IPAP 8.2 = average AHI 1.30, CA about 45% of OA
Any suggests or advice is appreciated, thanks.
Man I am confused with your question?, your comparing auto cpap vs auto bipap vs bipap asv machines
The ASV is not suitable for your condition and invariably fails for individuals sensitive to pressure changes that do not require therapy for central or complex apnea. Above all, your insurance is not going to approve ASV without an appropriate diagnosis and failure of both CPAP and BiPAP. It is not really an option unless you are buying out-of-pocket. We have never seen your results for the Airsense 11, so I'm not quite ready to write that one off. The Dreamstation was a real loser for you, but might have improved with positional and pressure correction. The Vauto remains your best option with controls for pressure support, trigger and cycle sensitivity as well as time of inspiration controls. The Vauto is capable of adjusting PS in increments of 0.2 and is ideal for treating your obstructive symptoms with the maximum of comfort. The Dreamstation was probably the worst option, and I have not seen your results on the Airsense 11, but the Vauto is the most capable of these machines. What I know of your CPAP data is that you have unresolved flow limitation which contributes to variable breathing which paralyzes a Dreamstation, and positional apnea (chin-tucking) that leads to clusters of obstructive events. on any device.
Questions like this require more background, and there is a lot to be said for keeping threads together rather than splitting them into a new thread every time you have a new question. https://www.apneaboard.com/forums/Thread...s-provided
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
In regards to your comment:
1.) I did start wearing (still do every night) a cervical collar, placed a pillow to stop me from rolling over on my back, and adjusted the pressures as suggested earlier. The DreamStation was still not acceptable. The sleep doctor said he was not familiar with variable breathing and the DreamStation's variable breathing controller. He is a very nice guy but I don't believe they are really up on the technology and that is why I come here for advice.
2.) I am providing a screen capture for the AirSense 11 and the AirCurve 10S for your review.
3.) Sorry I started a new thread, in my mind it was a new but I now realize it really is related. Should I try to consolidate them?
Also, it appears that whatever machine I choose may be on my dime, but we are discussing with the insurance.
If you have any further insights or need more info please let me know. Again thanks for your help.
I can merge threads if needed, but at this point, let's move on. I appreciate the updated charts from your Airsense 11 and VPAP S machines. Both show a significant improvement over your old Dreamstation. Your time in therapy is a bit short, but everyone has a reason for being under 7-8 hours of therapy. Going back to your original post, the answer seems obvious...buy my machine, the Vauto. You will get auto-adjustment of pressure, appropriate and consistent PS and controls of trigger sensitivity. I don't think you will need cycle sensitivity, but we might make use of Ti Max.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thanks again for the response Sleeprider! I notified my sleep doctor to move forward with the Vauto, so now I will wait to see what Medicare and my insurance have to say. One way or the other I will be getting that machine. I will let you know how it goes. Thanks!
Your therapy with the VPAP-S mode is really pretty good. The only thing missing is the ability to jump on flow limits, and increase pressure to stop the few remaining events. It's really close. The obvious solution is to use EPAP 5.0, IPAP 9.0 with your VPAP-S or move to Vauto to auto titrate up to pressure.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Figured I give you an update on how my therapy is going. I took your advice and stated to up the pressure to 5 Epap and 9 Ipap. With the 9Ipap I felt like my nose and head were swelling up so I had to back it down. Right now, I am at 4.6 Epap and 8.6 Ipap, I still get that swelling/pressure feeling but I am able to tolerate it better than at the 9 Ipap. Also, the OA's have dropped a little and CA's have risen a little, but overall the numbers are good, things have improved, and I am feeling much better.
Doctor says they are working with Medicare and the insurance company on getting the Vauto. I am hoping that will allow me to better control the Ipap pressures. Once I get that machine, I will let you know and seek your advise. Thanks for your help, Ed.
Received the ResMed AirCurve Vauto with the following settings, PS 4.0 over 4.0-15.0, and was wondering how these setting relate to AirCurve 10S settings, EPAP 4.6- IPAP 8.6. With the AirCurve Vauto at this setting the number of OA's, CA's and Hypopneas events have all increased. What should the settings in the AirCurve Vauto be when I am trying to duplicate the settings of the AirCurve 10S. Reason I am asking is I am trying to compare the two machines. Thanks for your help.
The PS of 4 is the same. You will need to bump up the EPAP minimum to 4.6. Doing this, and leaving the maximum pressure at the current 15cm, can provide a pressure range from 4.6/8.6cm to 11/15cm. EPAP+PS=IPAP. Then again, if you leave the settings as they are, will provide a pressure range of 4/8cm to 11/15cm.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
