A new study

[ischua]

I had to get a new sleep study done because of changes to my health for the best I had dropped the settings from 18 and 24 to 13 and 18. I have been able to keep my AHI to basically under two sense June. My new study says that I should be using a setting of 15 as a CPAP now. My question is what is the difference? I mean I understand. CPAP is constant pressure and Bipap has a high and low. Is that all there is to it? And how hard is it to change the VPAPauto to a cpap   Tonight will be my first night with the new settings.

[CPAPfriend]

In short, there can be a pretty drastic difference between bilevel and fixed CPAP. Switching is as simple as going into your clinical menu and changing the mode. Not saying one thing over another, but as someone who helps patients with PAP every day, a lot of titration studies are half-baked efforts / come to incorrect conclusions. Could perfectly well not be the case for you, however. Just food for thought.

[SarcasticDave94]

You'll be OK with the VAuto you have in my opinion. Remember if insurance will help pay, you enter a 13 month rental again with copay.

As for CPAP vs bilevel, yes it's possible CPAP will be 1 pressure, but ResMed AutoSet also has a range plus EPR to reduce for exhale. This sounds like bilevel too. VAuto might be more comfortable with its added abilities.

Besides, 13-18 is near the top of CPAP settings already. And if you need higher, it's not there. Nope I wouldn't switch machines.

[ischua]

Right now my AHI stays under 3 with the settings I have now. I'm afraid to mess things up. I know how to change the settings but I'm not sure what the settings should be other that what the doctor said (cpap and set to 15) I cant get a copy of the report till next week to see whats on it. should I wait till I get it or just drop the pressure to 15 and leave the EPR at 3?

[Phaleronic]

You should sleep better on the new mode @ 15cm, but you can use the AC10/AC11 bipap in s mode where the epap pressure is locked and can't slide up as it does in vauto mode.

If you're going to try cpap mode I'd suggest going to 15cm @ 1 EPR or off completely, but it will likely be too much pressure.

[ischua]

I switched to CPAP mode last night. I struggled at first feeling like I couldn't exhale but let it proceed. I think I had a better nights sleep but I am going to need more than one night. Charts are for the last 2 nights one is VPAP the other is CPAP  If you cane give me any insights I would be grateful.

[Deborah K.]

Since your machine is a Vauto, you can increase your pressure support. I can't see what you are currently using, but I suggest you turn it up at least 1 from wherever you have it set. That should help with exhaling.

[Dormeo]

I'm curious why you changed your pressure support from 4.8 to 3. This may be why you experienced a different "feel" with the new settings. You also wound up with more flow limitations, though perhaps that didn't make a difference to the soundness of your sleep.

I'd suggest you return to VAuto mode and set your EPAP min = 11, IPAP max = 15, with PS of 4. With these settings, you'll always have an EPAP pressure of 11 and an IPAP pressure of 15. See if that feels a bit better to you.

It's fine to ignore this suggestion, of course, or to prefer using your current settings another few night before deciding whether to make a change.

[ischua]

The only settings I changed were the VPAP to CPAP  and setting the pressure to 15. I have no idea why the pressure support changed from 4.8 to 3.
 I will go back to the Vauto settings tonight with the epap at 11 and the ipap at 15 with a ps of 4.

[Phaleronic]

You can turn EPR on with cpap mode enabled, your chart looks good on cpap mode, I'd give it another night with EPR on @ 1 this will help with exhalation..