Wrong machine? AirCurve 11 - can it do S/T mode?

[timmytoo]

I've been using a Respironics BiPAP Pro 660P for a decade. The SDCard slot will no longer write data. My pulmonologist wanted to see 30-days of sleep data so I bought a AirCurve 11.

I think I bought the wrong type of machine. A friend who is a respiratory therapist came over to look at the machine settings. She said I likely need a machine that as a timed mode, a S/T machine. This machine is not returnable, so I'm checking to see if I can get settings close to a timed mode.

I've tried both S mode and VAuto. I was able to use it for four nights, but now I'm back on my old machine.

Are there settings I can make to get close to the way my old machine works?

[StuartC]

VAuto does not have ST mode.

S mode on VAuto may have a setting called Backup Rate that is effectively ST mode but you cannot adjust the backup rate.  It is either 10 BPM or off.

You need an AirCurve 10 ST or ST-A (ST-A has iVAPS in addition to ST mode).

[PeaceLoveAndPizza]

You will need an ST or ST-A machine. The Vauto has no backup rate feature.

[Sleeprider]

The Aircurve 11 Vauto offers both S and Vauto mode. My recommendation is to try the machine with your normal pressures and use the Trigger Sensitivity at Very-High. This can cause the device to trigger IPAP with minimal spontaneous effort and flow. It's not a timed rate, but it does work with some mild forms of central apnea and hypopnea. Timmy, can you describe what condition you are treating that requires the timed backup rate? If it is complex or central apnea, I would suggest you look at the Aircurve 10 ASV instead of ST. If you actually experience hypoventilation from COPD, neuromuscular conditions or other pulmonary conditions appropriate for ST therapy, you should look at the ST-A.

[SarcasticDave94]

I suppose there's a few things S/T is good for. Basic Apnea therapy isn't one. As Sleeprider mentions, complex or Central Apnea, the ASV is the best answer. Breathing conditions maybe the ST-A is right. If it's just Apnea, VAuto.

What is it you're dealing with?

[timmytoo]

...can you describe what condition you are treating that requires the timed backup rate?

I was diagnosed with limb-girdle muscular dystrophy in 1978 after a muscle biopsy. It is neuromuscular weakness in my arms, shoulders, facial, and torso muscles. Four years ago I had genetic testing and I have something called DOK7 congenital myasthenic syndrome. Same symptoms, more complex name.

I've been using a BiPAP machine since 1997 and it has worked well. My diaphragm weakness requires the steady in/out breathing. As my disease progresses my PFT has gone down to 18% with my most recent test last month. I have been using 2 liters of oxygen when using the BiPAP at night.

I wear my BiPAP during the day while working and my O2 levels are mid-90s. My O2 levels at night have been dropping the past few months and I now am under 90% most of the night.

I purchased the AirCurve 11 to provide sleep data for my pulmonologist. That was my mistake purchasing the wrong machine.  I believe my next step is a Trilogy non-invasive ventilator.


   

[SarcasticDave94]

OK, then if ventilators is on the table, plain ST is out. ResMed AirCurve 10 ST-A is within the CPAP class, but will do the ventilator mode iVAPS, ResMed version of AVAPS. There's a ResMed true ventilator called Astral in 100 and 150, one item the Astral 150 has is built-in oxygen sensor. That's likely your best bet.

My RT told me some time ago, regardless of machine level, if you are used to a brands breath pattern and feel, it's best to stay with the brand, even into ventilator class.

And if you're needing a machine day and night, the Astral has battery power, similar with Trilogy from Philips Respironics.

You can configure the limb circuit to have a heated hose and external humidifier if needed too. Single limb leak circuit is basically identical to CPAP class. Masks can be used for CPAP and vents if you have a favorite that has minimal leaks.

[StuartC]

I am going to point you in the direction of an organisation called Breathe with MD (https://breathewithmd.org), which has some useful information and a Facebook group with people in similar situations.  You might get some good answers and support there as well.

[Sleeprider]

The ST-A has more modes than a ST, It can provide S, ST, iVAPS, PAC and others. There are several Aircurve 10 ST-A devices on DotMed for under $2000. Machines are full-data and compatible with Oscar. The capabilities and titration protocols for the ST-A are discussed in some detail in this publication https://www.resmed.com/us/dam/documents/...er_eng.pdf The Trilogy is currently discontinued by Philips under its consent decree, but there is one on DotMet at about $6K. It is a much more complex device, and you would need professional software to read data.

[jcp519]

It seems like either an ST-A or a true ventilator is probably best for you. This is especially true if you are using it during the day to help you breath. I'd suggest looking for either the Astral vents that Dave recommended, or a Trilogy Evo. I'm more familiar with the Evo and I know they work pretty well. With a vent you can use it all day and run it on battery power if you want to travel with it too. Ventilators typically have an internal and removable battery so that you never have a gap in power.

Typically with neuromuscular diseases that affect respiratory muscles you need a ventilator to compensate for the muscle weakness. This is especially important at night, because you don't want your blood O2 dropping that much for very long.