Self titration Aircurve 10 VAUTO HELP

[georgesadam]

I was diagnosed with severe sleep apnea (50 AHI) and prescribed an APAP machine (Lowenstein Prisma Smart MAX), which I used for two months. Unfortunately, I didn’t feel well due to high flow limitations and frequent RERAs. After reading multiple recommendations from this forum to switch to a BiPAP (AirCurve 10 VAuto), I decided to purchase one out of pocket. However, I’m still not feeling well, waking up with headaches every morning and feeling sleepy throughout the day.

One issue I’ve noticed is that when I wake up in the middle of the night, I have trouble falling back asleep. I experience difficulty exhaling and feel like I’m suffocating. This sensation doesn’t occur when I first start my therapy, but it becomes a problem later in the night( i dont use ramp).

I've reviewed several threads here for guidance on setting up the AirCurve 10 and found that most people recommend the following settings, which I’ve tried. Could you please take a look at my OSCAR data and suggest what I should do next? I really want to tune my machine and find what works best for me.

Settings:

• Mode: VAuto
  
• PS: 4
  
• Min Pressure: 4 / Max Pressure: 20
  
• Ti Min: 0.3 / Ti Max: 2.0
  
• Trigger: Medium
  
• Cycle: Medium
  
• Ramp: OFF
  

[SarcasticDave94]

With a median of 8.2, I'd consider turning up EPAP to at least 7.

[georgesadam]

AHI got lower but i still dont feel any better. I am really frustrated why i cant get rid of these OA.

[Deborah K.]

Your flow limits are pretty high. I would turn the PS up to 5.4 and see how you do.

[georgesadam]

Had a horrible sleep with PS 5.4

[SarcasticDave94]

In this latest OSCAR, there's the cluster pattern associated with chin tuck also known as Positional Apnea. Are you using thick pillows that promote your chin tucking towards your chest?

This type of Positional Apnea isn't the same as a doctor saying not to sleep on your back because Apnea increase.

[georgesadam]

I sleep on my side and use a thick pillow. Should I switch to a thin one?

[SarcasticDave94]

You can try it or at least tuck a pillow corner under your chin to attempt to block the chin from dropping to your chest.

[Phaleronic]

I would not have raised pressure support as you didn't need it (your 99.5 percent epap pressure was 10.6, and with min epap of 7cm and PS of 4 you were setup just fine up to 11cm, I would raise min epap to 9cm though please-you have OAs cropping up). Also, I didn't like vauto mode since it slides epap, I'd set it to s-mode and lock down min epap @ 9cm. And yes please switch to a flat single pillow under your head

[georgesadam]

I would not have raised pressure support as you didn't need it (your 99.5 percent epap pressure was 10.6, and with min epap of 7cm and PS of 4 you were setup just fine up to 11cm, I would raise min epap to 9cm though please-you have OAs cropping up).  Also, I didn't like vauto mode since it slides epap, I'd set it to s-mode and lock down min epap @ 9cm.  And yes please switch to a flat single pillow under your head

@SarcasticDave94 I had a horrible sleep again with PS 5.4, but this time I started using a flat, single pillow (attached OSCAR data).
@Phaleronic I'll try tonight with S mode, but could you please let me know if the settings below are correct, if I understood them correctly?

• Mode: S
  
• IPAP: 13 / EPAP: 9 (This will make PS at 4 again correct ?)
  
• Easy-Breathe : ON
  
• Ti Min: 0.3 / Ti Max: 2.0
  
• Trigger: Medium
  
• Cycle: Medium
  
• Ramp: OFF
  

Thank you ALL for the help , i hope i can reach something