[Pressure] Help w ResMed Aircurve 10 Vauto Settings

[BlueJay22]

KMHi 

I am new to the board and heard many good things. I was dignosed w sleep apnea just a few months ago. Since then I have used the Phillips DreamStation Andrea have just changed to the ResMed Aircurve 10 Vauto.

Question: how Can I figure out the right pressure ? 

Thanks in advance for your help 
Jason

[ajack]

This titration manual will help, It's for a s9, but the 10 is similar
how you would set the min ipap with the auto would be to have the epap 4cm lower than cpap pressure and the PS min 4 to give the min ipap. max PS would be the max ps available to start with. Then put up a sleepyhead chart for fine tuning. you could decrease or increase all settings as needed.
https://www.resmed.com/us/dam/documents/...lo_eng.pdf
page 34/35
VPAP Auto and VPAP S
Initial settings:
• IPAP = CPAP settings
• EPAP = 4 cm H2O below IPAP setting

[Sleepster]

I was dignosed w sleep apnea just a few months ago. Since then I have used the Phillips DreamStation Andrea have just changed to the ResMed Aircurve 10 Vauto.

What was the reason for making the change?

Question: how Can I figure out the right pressure ? 

That depends on why you made the change. There are three pressure settings, the minimum EPAP, the PS, and the maximum IPAP. If you want the IPAP to match your current range of 10 to 16, you would need to set the maximum IPAP to 16 and then choose a PS and a minimum EPAP such that their sum is 10. For example, if you follow the advice that ajack posted you'd set the PS to 4. Then you'd have to set the minimum EPAP to 6. But without knowing what condition you're trying to treat, that would not be much more than an educated guess.

[PaytonA]

For the Resmed Aircurve VPAP Auto in S mode or Vauto mode there is no PSmin or PSmax setting. There is just a PS (pressure support) setting. The factory sets PS at 4 and that is probably a good place to start.

In VAuto mode there are 2 other pressure settings that you need to deal with; max IPAP (maximum inhalation pressure and min EPAP ( minimum exhalation pressure). If your minEPAP is set at 8 and your maxIPAP is set at 18, your pressure will vary between these two pressures with your EPAP and IPAP always being 4 cm/H2O apart. If the machine decides you need EPAP of 10 then your IPAP will be 14. Your EPAP will never go below 8 and your IPAP will never go above 18. Looking at it in a different way your EPAP will be able to vary from 8 to 14 and your IPAP will be able to vary from 12 to 18. I hope that I have not made this too confusing.

Best Regards,

PaytonA

[BlueJay22]

Hi All,  I appreciate all the advise - as you can imagine being a newbie to this it can be rather stressful.  I have been like a zombie for months so I want to make sure I am getting the best treatment possible.  

To elabotrate , my AHI on this night was good, but I was tiered the next day

PS 3.0 over 10.0-14.0 (cmH2O)

EPAPExpiratory Pressure (cmH2O)
W-Avg: 9.65
5.22
10.00
10.66
11.00

PAPInspiratory Pressure (cmH2O)
W-Avg: 12.65
8.22
13.00
13.66
14.00

Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 8.05
0.00
7.75
11.88
29.75

Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 16.89
0.00
16.80
20.20
37.80

Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.00
0.00
0.00
0.00
0.64


I:E RatioRatio between Inspiratory and Expiratory time (ratio)
W-Avg: 50.72
0.00
51.00
64.00
124.00

Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.18
0.00
1.20
1.34
2.00

Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 2.35
0.00
2.34
2.88
7.92

Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 475.87
0.00
460.00
680.00
1740.00

[ajack]

ok, sorry I lead you astray, it's the epap that is variable on the auto, It's the second time I mixed that up. It would be PS:3 with the min epap below your cpap fixed pressure of 95% and the max above this 95%
with your current PS 3.0 over 10.0-14.0
W-Avg: 12.65
8.22
13.00
13.66
14.00
If 13 is your median, I would with the ps of 3 leave min at 10 for the time being, Later I wonder if you might be able reduce it to 9 and still be ok with the median number. It could be inflated a bit by the minimum 10 and ps3 and the median might reduce a bit.
I would lift the 14 because the 95% seems to be 13.66. I would raise max to 15
If those pressure numbers I guessed at are right. I would have 10-15 with PS:3

If these following numbers are right, you may need to talk with the doctor, the PS may need to be bigger because of the faster breathing rate, normal minute vent and low tidal volume. The machine can also misread and leaks can affect the number too. So it's a case of IF the machine numbers on BR TV and MV are right.

The I:E ratio is good. and I couldn't see the leak rate. It would help a lot of you post your sleepyhead chart.

[BlueJay22]

Hi Ajack and everyone, 

please see enclosed from Sleepyhead from last night 

- while I did not wake up multiple times, my AHI was more than it was on previous nights 

Question :  how would you make any adjustments to lower the AHI while trying to sleep through the night ? 

thanks in advance for your help

[BlueJay22]

Hi ajack,

please see a copie of the leak rate from the previous night as well 

thanks

[Gideon]

First realize that your numbers are good!!!.  Tweaking by making small changes yes, but the big question is how do you feel?

Why are you waking up?  Believe it or not your daily charts may help us understand  that.  Look at the 5 easy step link in my signature and pay attention to the organization portion.

Post the link as ordinary text but with a space (htt p://imgur,xxx.ing).  The events chart is very important because that tells us when things happen and allows us to gage how you and your machine react to it.

Fred

[trish6hundred]

Hi BlueJay22,
WELCOME! to the forum.!
Good luck to you with CPAP therapy, hang in there for more responses to your post.
You have come to the right place for guidance.