SOS Urgent : Request for Analysis of My Data Please

[Anewser]

I finally have my new bipap machine “ResMed AirCurve 10 VAuto Setup Bilevel” since today, which I have the right to test for a little over a month. In addition i keep my CPAP prisma smart during the test.

I was supposed to have it last week + new mask, but the technician came empty-handed... (they had not received the doctor's prescription, but had not canceled the appointment).

He took the exact same pressure numbers as my prisma smart and transposed them to the new machine without doing any additional testing, just a swipe to see.

He confirmed to me that the only adjustment I have the right to make is the humidifier. But I'm clearly not going to bother changing the pressures myself since I don't intend to call them 300 times this month of testing (I found how to do it with tutorials on the internet).

So I went from:
CPAP prisma Smart → pressure 5-9, humidifier 3/5 → IAH = 4/h
to Bipap ResMed AirCurve 10 Vauto→ EPAP/IPAP 5-9, humidifier???/10

Already during the test it was unbearable, I felt like someone was pushing a rudby ball of air into my lungs every time I exhaled air. I will probably already lower the max IPAP.

If you ever have any advice or comments to make, I'm all ears. For example, would it be better for me to create a new topic since I might need new advice regarding settings/post Oscar results?

I will only test my new mask and cervicals collars when my settings are tolerable with this new machine.

[Dormeo]

What is the setting for pressure support? (This increases your pressure when you inhale by a set amount and decreases pressure when you exhale.) And did you have some kind of pressure support or pressure relief with the Prisma machine?

[Anewser]

"What is the setting for pressure support ? (This increases your pressure when you inhale by a set amount and decreases pressure when you exhale.)"

Sorry, I have no idea what this is "pression support" (i am french) and I'm just discovering this machine. I just know that the pressure epap = 4 and ipap = 9. I attached a photo, does this correspond to "AI" I saw a lot more options so it might be something else ? The technician just told me that there were 2 pressures with this machine, showed how to adjust the humidifier and said that there is a system for preheating the machine (and that's it). They believe that patients do not have to know more since they have to modify the other settings of the machine.

“And did you have some kind of pressure support or pressure relief with the Prisma machine?”

I tried this function on the prisma smart, but it's really poorly done. I talked about it in one of my previous posts, I will copy and paste my response concerning this SoftPap (EPR) function.

"I had tried SoftPap machine mode (EPR) several times, but it is literally unbearable. With each exhalation, I feel a very small knock almost every exhalation (CLAC! CLAC! CLAC!), even when breathing slowly. It's exactly like someone flicking my mask every time I exhale and it's impossible to fall asleep with that. A technician explained to me that this problem was due to the fact that the pressure on my machine was low for this function. greater pressures."

[AndyB]

You are getting expert guidance from Dormeo.

I would only add that an important objective of this forum is to teach members how to evaluate the efficacy of their therapy and adjust their treatment themselves. I would be surprised if there is a law or regulation in France that forbids you from changing your machine's settings; that is certainly not the case in the U.S.

The ResMed AirCurve 10 VAuto is an excellent machine. There are many threads on the forum that explain how the settings work and how to change them. We are all different, so you will need to experiment to see what works best for you -- after 9 years I still occasionally tweak my settings.

Good luck!

[AndyB]

On a VAuto sold in the U.S., "Pressure Support" (or just "PS") is the same as a French machine's "Aide Inspiratoire" (or just "AI"). So an AI of 4.0 means the machine will increase the inspiratory pressure ("IPAP" -- "inspiratory positive airway pressure" in English) by 4.0 cm of water from the expiratory pressure ("EPAP" -- "expiratory positive airway pressure"). So your current settings mean the machine will provide 5.0 cmH2O of pressure when you exhale and will add 4.0 cmH2O of pressure when you inhale, thereby increasing inhalation pressure to 9.0 cmH2O. Your current settings mean you will always get 5.0 cmH2O of EPAP and 9.0 of IPAP.

[Anewser]

Thank you very much for your explanations. So if I understood correctly, the PS (AI in French) is always equal to the Ipap-Epap = 4 for me (because 9-5 = 4). I did a test again and it’s obvious that the Ipap is too high.

With Cpap, I feel no problem when inhaling at 5, but always distress when exhaling above 5. I have the feeling that my body has to force too much to exhale part of the air from the machine and breathe against the current.

And I can't breathe normally during the day when I've used the machine for 7-8 hours in a row with the CPAP. It's as if I had a balloon constantly inflated with air blocked in my chest, and I force with each exhalation to release the excess air blocked in the upper chest. I also have to make an effort to speak without it being too obvious. I have never been able to get rid of this feeling despite 2 years of using my machine and already low pressures.

Are there people who have the opposite, that is to say an Ipap<Epap rather than an Epap>Ipap ? In this case, do you talk about a negative PS ? I always see the terms "inspiration aid", but never "exhalation aid" (I am aware that there must always be air blocked in the lungs to ensure opening respiratory tract).

[Dormeo]

First about your settings. My thanks to AndyB for pointing out that AI is what I was calling PS. Your minimum pressure when you exhale (EPAP) is 5; your maximum pressure when you inhale (IPAP) is 9, and your PS is 4.

Someone might have a min EPAP of 5, a max IPAP of 12, and PS of 4. Whatever their EPAP was, their IPAP would be that plus 4 -- but no higher than 12. But your settings constrain you to a constant EPAP of 5 and a constant IPAP of 9. (I use similar constraints myself, but with PS of 5, min EPAP of 5, and max IPAP of 10.)

Does this make sense so far? Let me know if it doesn't!

Breath by breath, your pressure increases when you inhale (breath in, or draw a breath), and it DECREASES when you exhale (breath out, release a breath). So in a way, PS is an exhalation aid, we might say. When you exhale, you are exhaling against a pressure of 5. You've described this as generally tolerable, so I'm uncertain why you're feeling a sense of breathing out against greater pressure than 5.

Try using the machine with these settings during the day or evening -- not when you're trying to sleep. Look at the screen when you start. You'll see a graphic representation of the pressure increasing as you breath in, then decreasing when you breath out. Notice how it feels. To me, I like the "support" when I inhale. It's just a little boost, really, but it makes inhaling easier. Then when I exhale, it feels completely easy and normal with the pressure dropped down to 5.

Tell us more about how this is all feeling to you and how you are understanding these settings. If we can get a bit more information from you, we might be able to suggest some changes to your settings for you to try out.