UARS: AirCurve 10 VAUTO $500 vs Dreamstation APAP $400

[ragtopcircus]

The sleep study diagnosis was UARS and other sleep “architecture” issues, but there are Centrals in the accompanying data.

Sorry, I was looking at the old report. Nevermind.

The one in my signature is the latest most recent one (just a one month old, in lab one, September 2019), my bad it looks like I blacked out dates on those attachments.

Oops, I was in fact looking at the recent lab study. Nevermind the nevermind.

[slowriter]

Mostly the Flow rate chart, but look at other for signs of breathing irregularity.  This step is to identify disturbances.  The next is to validate them.  Then we can attack them.  Just trying to do this methodically.

Yes. It is odd the FL chart is so clean, given the UARS diagnosis.

[hombrecpap]

Night #3 (CPAP mode, fixed pressure "6", no EPR, establishing baseline, "mouthtaped")
AHI 5.09  CA 2.0

Finally lasted the whole night (7.5 hours) with the machine. I don't really remember waking up much if at all.
Still shopping for an IR camera and a USB enabled oxymeter.

[slowriter]

Just FYI, there's no need to change the mode. VAuto mode with PS 0 does the same.

As in, you could set VAutio mode at 0 (if you insist), and then slowly raise PS; 0.2, 0.4, etc.

[hombrecpap]

yeah, I was debating which way to go, for purity purposes chose to try pure CPAP mode...

Considering that I don't have OA events, I probably should keep EPAP at 6 and start working with only raising PS slowly.
I only need at least 6 for inhalation, I probably don't even need 6 for exhalation.

I see that "Exp. time" chart is not used around here, but mine looks weird as hell, pretty smooth for first two hours, then all over the place for the rest of the night.

PS. or maybe I should stick to 6 and PS 0 until I get the camera etc

[Sleeprider]

Your results with your Aircurve 10 Vauto are acceptable using CPAP mode at pressure 6.0, but you need the pressure support to treat the hypopnea. Pressure support will make your centrals worse. There are two ways around this, either treat centrals using ASV, or prevent them by using "Enhanced Expiratory Rebreathing Space" EERS. EERS is simple and inexpensive. Take a look at our wiki and see what you think. http://www.apneaboard.com/wiki/index.php...ace_(EERS)

[ragtopcircus]

He just acquired the Vauto, out of pocket I think. I’m going to assume that switching to an ASV may be difficult. If the Vauto was purchased used, it could probably be resold without losing much, and there is a used ASV available at a good price on another website for CPAP talk.

However, the EERS tube would certainly be cheaper to try first!

[slowriter]

He just acquired the Vauto, out of pocket I think. I’m going to assume that switching to an ASV may be difficult. If the Vauto was purchased used, it could probably be resold without losing much, and there is a used ASV available at a good price on another website for CPAP talk.

However, the EERS tube would certainly be cheaper to try first!

There's a few posts with a photo (linked from the wiki page that SR linked to) on my experiments with EERS. 

It's super easy and cheap to adapt a P10 style mask.

If you have UARS, I assume you need PS of somewhere +- 4 or so. EERS can be one thing to try to avoid a ton of CAs (though in my case is not needed; my CAs went away with time, even at PS over 5).

[Sleeprider]

He just acquired the Vauto, out of pocket I think. I’m going to assume that switching to an ASV may be difficult. If the Vauto was purchased used, it could probably be resold without losing much, and there is a used ASV available at a good price on another website for CPAP talk.

However, the EERS tube would certainly be cheaper to try first!

I'm not advocating ASV in this case, however it is one solution to the CA events that are much worse with pressure support.  We can see that other than CA, events are mainly hypopnea that correlate with flow limitation.  The solution to that is pressure support.  To enable pressure support it makes sense to try EERS which should also suppress CA.  I also think it woll be more comfortable, but hopefully my thoughts on this were clear.

[WillSleep]

Oct 30 ...  CA 2.0

Sleepstudy CA 1.1 

It's not like you need 'yet another' reply on CAs.  Lol. 

But is that gunna stop me? ...   looks like thats a no!  Lol.   


My input is not in conflict with any of the top quality advice on CAs you received above, just expanding on it. 

That is really a small number of CAs and unless you know it is may not really be a concern as CAs.
My advice today is that unless your experiencing long true CAs that are causing a desaturation (the Pulse-ox will make this crystal clear), if you are only seeing CAs driven just by short term high Minute Vent CO2 washout that have very little impact on your SpO2 levels then for now Ignore the term CA and just view them as a regular event, like a Hypopnea.


VAuto and ASV are both great machines both have pros and both have cons.   In this situation, so far,  I feel that by no means is an ASV better than a VAuto, its is just different.   

Eagerly ride get to know the really good horse (VAuto) you have in the stable now.   Post an overview and 2 min charts daily and let the group help you dial that machine in and CAs might just go away or not really be a concern at all.   Good starting inputs already from Slowriter.   

So far from what I saw above you may never need an ASV or EERS. If the Pulse-ox is screaming heavy destats at the point of events flagged as CAs then it becomes an entirely different game.
  
WillSleep