ResMed AirCurve 10 S ?

[monkeybusiness]

I’ve been on a high CPAP pressure of 17 for the past 2 years.  It has been an ongoing battle to breathe against this pressure.
 
I recently underwent another sleep study to see if BIPAP therapy would be appropriate.  I won’t know the results for another 2-3 weeks.
 
When I did the sleep study they started my pressures at 14/10.  During the whole study I was amazed at how easy it was to breathe both in and out!  A far cry from the constant pressure setting I’ve been enduring for so long. 
 
In anticipation of the study culminating in purchase of a BIPAP device, I’ve started nosing around for a good machine.  It appears that the ResMed AirCurve 10 S is highly thought of by many  people on this forum.  Is this the ‘ultimate’ BIPAP machine or are there others I should consider?

Thanks for any input you can provide.

[Gideon]

BiPaps tend to handle specialized conditions.  The VAuto is the ultimate IF you do not have Central or Complex Apnea.  The ASV if you have Central Apnea not handled by the other choices.  The VAuto has the manual "S" mode in addition to "VAuto" mode.

I have used high pressures (18+) for over 10 years. With the Vauto I am currently using an EPAP of 9 with a PS of 4 (IPAP of 13) and typically getting an AHI of <= 0.5


Here is a summary of the different models.

The AirCurve 10 line includes:

• AirCurve 10 S: A bilevel device ideal for patients who need extra pressure support or find it difficult to adjust to therapy on a fixed pressure continuous positive airway pressure device. It features two different adjustable pressures that can help make therapy feel more comfortable.
  
  
• AirCurve 10 VAuto: An auto-adjusting bilevel device for patients who need greater pressure support to treat their obstructive sleep apnea. It uses the comfort of both the proven AutoSet algorithm and Easy-Breathe waveform in its VAuto algorithm.
  
  
• AirCurve 10 ST: A bilevel device with backup rate that provides exceptional patient-ventilator synchrony, reducing the work of breathing so patients remain comfortable and well ventilated.
  
  
• AirCurve 10 ASV: A bilevel device for central breathing disorders such as Cheyne-Stokes respiration, central sleep apnea, or obstructive events. The AirCurve 10 ASV targets the patient’s own recent minute ventilation. By treating central breathing disorders with auto-adjusting pressure support, and upper airway obstruction with auto-adjusting expiratory positive airway pressure, the device works to rapidly stabilize breathing.
  

Features include:

• TiControl: Found in AirCurve 10 S, AirCurve 10 VAuto, and AirCurve 10 ST, TiControl lets providers set minimum and maximum time limits on either side of the patient’s ideal spontaneous flow cycling, creating a window of opportunity for the patient to spontaneously cycle the breath and timely intervention during challenging conditions.
  
  
• Trigger Sensitivity: Adjustable trigger and cycle sensitivity settings TiControl, found in AirCurve 10 S, AirCurve 10 VAuto, and AirCurve 10 ST, can be used to optimize synchrony between the device and the patient’s own respiratory efforts.
  
  
• Vsync: Advanced leak management technology, Vsync helps provide patient-ventilator synchrony. Vsync is available in all AirCurve 10 devices.
  
  
• HumidAir: Integrated heated humidification that affords simpler therapy, with fewer parts to set up and manage.
  

Fred

[monkeybusiness]

Thanks for your informative summary, Bonjour.  (I noticed in your profile page that you use nasal pillows.  Perhaps there is hope for me to also get off a FFM at these pressures one day). 
 
My sleep doctor did mention that he didn’t think an ST machine is needed.  I have CHF, so the AVS device is also out.
 
Sounds like the 10 S  or the 10VAuto would work. 
 
I now have a plan going forward in working with my DME depending on the results of the sleep study.      

[Matt00926]

The AirCurve 10 series is great--you can't go wrong. The VAuto is worth getting if you can get it supplied, as it can do variable IPAP and EPAP in the VAuto mode, and it also has the S mode in case you want to do straight pressures.

[Sleeprider]

Another Vauto user here. As said above, the automatic pressure adjusting will work to give you the lowest possible bilevel pressure, but will increase if you need it. The cost differential is not very much, so try to have your doctor specify the auto-bilevel. It is has the same advantages an auto-CPAP has over fixed CPAP.

Hopefully your insurance is good, and your costs for this will be fairly low, but if insurance is not covering most of the cost, there are significant discounts on the Vauto available if you go online.

[monkeybusiness]

Two weeks have expired since I initiated this thread.  Results of the sleep study have come back with a prescribed pressure of 16/12.  One thing puzzles me.  The report indicated that oxygen levels dipped below 89% for 5.7 minutes during the study.  Not sure if that is significant or not.
 
I take delivery of a AirCurve 10 VAuto Bilevel machine tomorrow afternoon. 
 
I’m anticipating some easier breathing (and less broken sleep patterns) this weekend.
 
I appreciate everyone who has responded in this thread.  Without your help I would have most likely purchased an inferior device.

[Walla Walla]

It's common for O2 levels to dip down during the study due to apneas. Your machine will prevent that from happening.

[monkeybusiness]

Walla Walla

I took possession of the Aircurve 10 VAuto this afternoon. 
 
My final bipap sleep study prescription pressures turned out to be 17/13.  In running a test, the pressure change inhale and exhale seemed uncomfortably abrupt.  I noticed the DME had set the therapy mode to ‘S’.  I’m afraid the abruptness is going to interfere with sleeping.
 
Is there some way I can utilize the ‘auto mode’ (or some other settings I’m unaware of on this machine) to maintain the necessary pressures but allow for slower changes between epap and ipap?

[Sleeprider]

Mode Vauto, EPAP min 10, EPAP max 14, PS 4 will give you an auto range of 14/10 to 18/14 . That brackets the prescription and allows lower pressures. The auto mode will cover anything you need higher. If you find pressure support is disruptive or causes excessive CA events, reduce to 3 temporarily.

[Walla Walla]

There's a TI Control setting that adjusts the length of the inhale time. You really need to download the clinic manual for the VAUTO. Go to private files and you can download it there. Make sure you read about the settings before you start changing them.