[Pressure] Help with Settings -Resmed AirCurve 10 VAuto

[GrantT]

Hello all,

I am looking for some help in setting up my machine (Resmed 10 VAuto ASV).  I have owned it from new.  I have no DME support due to previous unsolvable issues with them - they kept telling me everything was great (S9 Auto) and yet I felt completely horrible.  Because I did not purchase the new machine with them, they will not provide support any more.  Where I am, the DME charges about 3x the cost of the machine, and then you get support "for free" afterwards.  Kinda of a scam.

Anyways, I have, in general terms, pretty mild Apnea from the original diagnosis - nothing remarkable at the time.  I can "almost" sleep without CPAP.

With the CPAP machine now, I'm continually waking up feeling like I have someone sitting on my chest, heart pumping, and feels the CPAP machine is suffocating me and overpowering my natural breathing and I'm fighting it...as soon as I remove the mask, I can totally relax, the feeling of chest pressure goes away, and I can easily fall asleep again, but then the snoring/apnea kicks in again and then I feel horrible when I wake up.  Vicious cycle.

Anyways, I purchase the ASV machine so I would have more available options.  I also have a Resmed S9 Auto (the original DME machine which they could not seem to get me properly feeling well on)  I realize I may not need the ASV's capabilities and perhaps could just use a different mode.  Anyways...here are some Oscar images of what is happening.

Really, would be happy just starting from scratch, trying any recommendations setting up some "baseline" settings for someone with mild sleep apnea to try, and moving forward from there....some help would be greatly appreciated as I feel I am at the end of my rope here getting a decent night's sleep.  Willing to try anything...

   

   

   

[SarcasticDave94]

Well, you can go nearly ASV Auto default at

ASV Auto mode
EPAP 5-15
PS 3-15
Then set mask type to whichever applies and your choice in humidifier and heated hose settings. I'd not use Ramp due to supposed CA in the current charts. Use and post OSCAR after 1 night as we need to see progress. Include your answer to "how do you feel?" which isn't OK, meaning we need some details, tired, fought ASV, well rested, etc.

[GrantT]

Thanks @SarcasticDave94

Greatly appreciate at least a starting point.  I am not sure I understand what you mean by PS 3-15.   Does that mean pick a value somewhere between 3 and 15?  If so, how does one choose (or adjust) that?  Is it better to start at a low value, and if there is problems, slowly increase the value (perhaps 1 per night) until things normalize?

i.e.  How do you know when to adjust PS?

Here is a snap of the current settings just as a sanity check...I did a factory settings reset, then set the following (plus adjusted for nasal pillows etc).

One thing I have noticed repeatedly is that the machine tends to "cut off" my inhale before my lungs actually think they are done....doing some reading, it seems that adjustments to Ti can adjust this....is it safe to start to adjust Ti Min/Max if i continue to get "cut off" in the inhale, and what values to adjust?

 
   

[SarcasticDave94]

OK forget the ASV info. This is a VAuto bilevel.

If it was sold as an ASV, you need to correct this with the seller. This is the ResMed AirCurve 10 VAuto. ASV is a whole different machine, made to combat Central Apnea. Again if you were intending on buying a PAP machine to combat CA, this ain't it. If you were intending to buy a BPAP/bilevel then that's the VAuto.

PS the VAuto has a single PS number that separates EPAP and IPAP. An ASV has 2 PS numbers, a Min. and Max.

[GrantT]

Sorry...did I have the machine name incorrect? Just my ignorance on the topic creeping thought...but the machine is what it is....was not purchased for anything specific.

So, sorry, are you saying ignore your total post...and keep looking?

[SarcasticDave94]

The ASV parts from my setting post wouldn't apply to your machine.

[Sleeprider]

As Dave pointed out, you have a Resmed VPAP Auto. This is an auto bilevel and a very good machine. I use the current version of it called the Aircurve 10 Vauto. I'm going to help you get some settings that should work better. You are currently in a fixed bilevel mode (VPAP-S) with EPAP 5.2 and IPAP 8.4 which is a pressure support of 3.2 cm. Your event rate has been lower in the past and increased between Dec 23 and Feb 6 when you experimented with higher pressure and pressure support settings. It appears you do better with steady pressure and a pressure support less than 3.

With that in mind, I'll give you two options. First, in Vauto mode where pressure is automatic, try EPAP min 4.0 PS 2.0 and IPAP max 9.0.
Alternatively, using your current VPAP-S mode, set EPAP 5.0 IPAP 7.0 In S mode, be sure Easybreathe is on.
If you see a Trigger Sensitivity setting in either S or Auto mode, turn that to High. I would prefer to see you use the Vauto mode. Good luck.

[GrantT]

As Dave pointed out, you have a S9 VPAP Auto. This is an auto bilevel and a very good machine. I use the current version of it called the Aircurve 10 Vauto.  I'm going to help you get some settings that should work better.  You are currently in a fixed bilevel mode (VPAP-S) with EPAP 5.2 and IPAP 8.4 which is a pressure support of 3.2 cm.  Your event rate has been lower in the past and increased between Dec 23 and Feb 6 when you experimented with higher pressure and pressure support settings.  It appears you  do better with steady pressure and a pressure support less than 3.  

With that in mind, I'll give you two options. First, in Vauto mode where pressure is automatic, try EPAP min 4.0 PS 2.0 and IPAP max 9.0.
Alternatively, using your current VPAP-S mode, set EPAP 5.0 IPAP 7.0 In S mode, be sure Easybreathe is on.
If you see a Trigger Sensitivity setting in either S or Auto mode, turn that to High.  I would prefer to see you use the Vauto mode.  Good luck.

Thanks for the feedback @Sleeprider.  I've set things up as you have recommended.

I'll try tonight in VAuto mode - EPAP Min 4.0 PS 2.0 and IPAP Max 9.0.  I've also set Trigger Sensitivity to High.

Just to clear up any confusion I created with my incorrect machine naming....my machine is the Aircurve 10 VAuto  (not the 9).  Just some background in case it makes any difference...I'm a mid 50s male, not really overweight, but have a thick neck, larger than average tongue, and poor sinuses which tend to get stuffy and cause air flow blockage as well.  My apnea was diagnosed as being mild originally and bad snore.  In 15 years, I've never had a great night sleep to be honest.  I'm not "fall asleep at my desk" tired during the day, but certainly need more quality sack time as I feel weak, tired, exhausted in general.

Report back on Monday after two nights testing - I have a Chromebook (without linux support) at home so can't get Oscar going.  I have it on my work PC though.

Thanks for stepping in to help me...

Grant

[SarcasticDave94]

OK that's a good plan. Don't worry about the name error, I was concerned on getting suggestions right which is machine specific.

If you'd like as the OP, we could ask a Moderator to edit the thread title. Just ask and it'll be done to avoid confusion.

[GrantT]

Yes, please.  I think it would be great to rename it to:  Help with Settings - Resmed AirCurve 10 VAuto    Could help avoid confusion with someone else looking at the settings suggested.


Just an FYI....I slept solid last night on the new settings and feel more rested today than I have in a very long time.  I'll post the Oscar graphs tomorrow morning.  Hoping for a repeat night again today!