Switched to AirCurve 10 VAuto

[jtech1]

I decided not to wait around for Philips to fix/replace my Dreamstation APAP, so I bought an AirCurve VAuto.  It was working well for me, but I had always struggled/fought with syncing myself to the DS, and some nights would just get frustrated and not use it.  After one night on the VAuto, it is already clearly much more comfortable.  Just the extra notch of exhale relive (PS=3) and the ability for it to sync with my own breathing is so much better.  I left the EasyBreath enabled and did not have to adjust any of the sensitivities... As this is my first experience using a VAuto myself, I am hoping you can all help me with some easy questions...

1) I did notice my throat was a bit dry during the night.  I never had that problem with the DS.  Humidifier was set to Auto, which I believe is level 4... am I correct that changing to manual and level 6 is a good next test, or do people just go right to 8?

2) Am I correct that EasyBreath is essentially "auto" mode for the entire rise/fall waveform (or is it just the rising part), and is non-linear to model actual changes in rate over full rise/fall?  Whereas, disabling EasyBreath, allows me to set rise time which would then just be a linear rise at the rate set?

3) I use Dreamwear pillows.  I noticed today that I left it on nasal and not pillow setting last night... I assume that is only telling the unit what to expect for acceptable leaks and not affecting treatment?

So far, I am very happy with this, and appreciate all of the info on here that pointed me to it.  Now I guess I can only hope that Philips, or more likely a class action, will help me recover a small fraction of what I had to spend out of pocket to replace a 3 year old machine.

[Crimson Nape]

1. You are getting a real 3 cm-H2O pressure difference.  The DS can not achieve this much pressure difference, even when it is set to flex-3.
   
   
2. Easy-Breathe samples your breathing patterns and adjusts the rise and fall of the pressure.   For me, it is so natural that I have to feel the exhaust port to see if my AC10 is on.  You will be in for a culture shock if you turn it off.
   
   
3. I would set it to the "Pillows" setting.  Since each mask type has a different volumetric area, this setting could also monitor the air compressibility for a particular mask.
   

[GuyScharf]

ResMed uses EasyBreathe in all their AirSense and AirCurve models. It is only in the AirCurve-S or the VAuto in S-mode that EasyBreathe can be turned off. And it is pretty unbearable when turned off!

You can set the humidity level to whatever is comfortable for you. I have mine set to 4.

[SarcasticDave94]

Rise time and the other timing settings are best kept at default until or unless a specific reason crops up. I'm not saying never to adjust, but if you spin these settings randomly, you could be giving yourself headaches. Figuratively that is.

[jtech1]

ResMed uses EasyBreathe in all their AirSense and AirCurve models. It is only in the AirCurve-S or the VAuto in S-mode that EasyBreathe can be turned off. And it is pretty unbearable when turned off!

You can set the humidity level to whatever is comfortable for you. I have mine set to 4.

My father has an ST, and if I remember correctly, it does not have EasyBreath... and I had to adjust the ramp time manually to make it more comfortable.

Sounds unanimous, that if it what you have has EasyBreath, it should be left on, and is the most comfortable config.

[Geer1]

Yup. There is a reason easybreath is the standard waverform on every machine except for ones meant to treat serious breathing issues that require more powerful/invasive pressure waveforms.

[jtech1]

I am doing well with the AirCurve... one issue.

With the DreamStation, I NEVER had any condensation in the heated hose.  With the AirCurve, the first few nights I felt a little dry, so I took the comfort off Auto and set the humidifier to 6.  I left the hose temp at 81.  I have tons of condensation in the hose now.  NOT while I am using it... all though the night, it seems fine... but the next night, before I use it, I can pour it out of the hose...  first few times I started using it and could hear the water gurgling in the hose... then poured it out, and the rest of the night was fine.  What am I doing wrong with the settings?  Why such a big difference from NEVER having any water in the hose of the DS?

[SarcasticDave94]

Why the difference? I'm only guessing but maybe the ResMed humidifier is putting out more moisture.

Try turning up your heated hose a few clicks or drop the humidity a click or two. Also get a hose hanger to allow the hose to angle up from the PAP to the hanger then down to the mask. That angle should make moisture drain back to the humidifier tub.

[jtech1]

I am narrowing things down.  Going back to auto and hanging the hose have helped with the moisture.

On DS I just used fixed pressure (since the auto never did much for me except create discomfort)... I have been experimenting again with Auto mode in VAuto.  My problem is that I tend to have registered events as I am falling asleep.  Mostly central with a few obstructive.  At a fixed pressure, once I am past this 10-15 min period, I have few events all night.  In auto mode, the ResMed ramps up the pressure based on these and then slowly comes down over hours... problem is, that at the higher pressures I swallow air.  I don't use ramp mode, but I am wondering if I were to enable ramp over 15 min for only a very low increase... 1 or less... would the ramp mode get me past the falling asleep junk and keep Auto mode from jumping to max pressure?  During the ramp period, is the Auto increase algorithm ignored?

[Dormeo]

The pressure won't rise in response to CAs, so the cause for the pressure increase lies elsewhere. Do you see any correlations with your flow limitation graph? You might want to post a chart for a typical night when you saw the pressure increase.

Central apnea is a known sleep-transition phenomenon. There are some complex neurochemical "hand-offs" that occur as respiration controls shift while we fall asleep. Sometimes pauses in breathing will occur during this transition. If these CAs aren't making it hard for you to fall asleep, I'd say you shouldn't really worry about them.