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+--- Thread: Getting New Aircurve 10 Bilevel today (/Thread-Getting-New-Aircurve-10-Bilevel-today)
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Getting New Aircurve 10 Bilevel today - slam7241 - 09-09-2022
Looking for recommendation for settings on new Aircurve 10 VAUTO.
I have been on CPAP since age 61 & now at 76. Went from S9 & currently on Airsense 10 APAP for last 5+ years (15200 hrs). Been dealing with HBP more than 15 yrs & later weened off beta blocker through regular exercise. After retirement & reduced exercise due COV19, HBP not under control & on Calcium Channel blocker for over 1 yr now. Went to see Pulmonary doctor 7/13/22 suspecting HBP related to not getting proper CPAP therapy, follow by Home Sleep Study & prescription for Bilevel machine (Apria). Fedex to delv today.
My thought is to set Bilevel to mimic old machine for few days under CPAP mode before trying to go to VAUTO mode.
My current settings on Airsense 10 APAP 7.0 - 11.2 EPR 1 P10 HUM 3 temp 85F heater hose with insulation. I have UAR & allergy, but not use Flonase because not effective after continued use; use higher humidifier setting to compensate.
What is your recommendation? Apria will follow Dr's prescription at 4 -20 PS 4.
Attached Charts
Oscar 0 Data last 6 months Note resp rate went up to 50 after 6/14/22.
Oscar 1 Last night 9/8
Oscar 2 normal breathing flow rate @ 2300 hr
Oscar 3 abnormal breathing pattern @ 0330hr
Thank you for all your previous help when I brought my issues to this forum in July 22.
RE: Getting New Aircurve 10 Bilevel today - slam7241 - 09-09-2022
One more attachment..
RE: Getting New Aircurve 10 Bilevel today - slam7241 - 09-09-2022
Received Aircurve 10 VAUTO.
There are 3 modes (1) CPAP (2) S mode (spontaneous) (3) VAUTO
Decided to use VAUTO mode with following Setting:
MAX IPAP 15.0 MIN EPAP 6.0 PS 4.0
TI MAX 2.0S TI MIN 0.3S Trigger High Cycle Med
Mask Pillow RAMP time Off
Climate Contrl Manual Tube Temp 85F Hum Level 3
AB Filter No Essentials Plus Leak Alert Off Smart Start On
Question:
1. What is the "S" mode designed for?
2. Is the PS (Pressure Support) VAUTO 's improved method of providing support vs Airsense 10's EPR setting ?
3. Finding the right Pressure Support. Is it true that too high or too low PS causes excess "CA" reading?
Thank you.
RE: Getting New Aircurve 10 Bilevel today - Crimson Nape - 09-09-2022
slam7241's questions:
1. What is the "S" mode designed for?
This is a static pressure setting. You set the IPAP and the EPAP pressure, and the difference is considered the PS value. In the "S" mode, the AC10 will not report flow limitations. If you want a static pressure and still get flow limitations reported, set the AC10 to VAuto, set the desired min EPAP pressure, then set the max IPAP, then set the PS to match the difference between these two values.
2. Is the PS (Pressure Support) VAUTO 's improved method of providing support vs Airsense 10's EPR setting ?
I don't know which came first. The PS setting is added to the EPAP pressure to determine the IPAP pressure. The EPR value is subtracted from IPAP pressure on an AS10. According to Resmed, the PS setting is for therapy and the EPR is for comfort. . . Go figure.
3. Finding the right Pressure Support. Is it true that too high or too low PS causes excess "CA" reading?
Usually, too high a PS value can cause CO2 washout, causing CAs. Too low, and your flow limitations will increase.
- Red
RE: Getting New Aircurve 10 Bilevel today - slam7241 - 09-09-2022
Thank you for your help!
set the AC10 to VAuto, set the desired min EPAP pressure, then set the max IPAP, then set the PS to match the difference between these two values.
Do you mean my setting should be : EPAP 6 IPAP 11 PS 4
rather than: EPAP 6 IPAP 15 PS 4
RE: Getting New Aircurve 10 Bilevel today - Crimson Nape - 09-09-2022
No. EPAP of 6 with the PS of 4 = an IPAP of 10 to make it a sudo "S" mode. The setting you purposed would allow the EPAP to increase to 7 (7+4=11).
A setting of EPAP of 6, PS of 4 and an IPAP of 15 will give you a pressure range of 6/10 up to 11/15.
RE: Getting New Aircurve 10 Bilevel today - Sleeprider - 09-09-2022
Your zoomed inspiration wave is one we have seen from time to time, and bilevel pressure support may help to support inspiration. What we see is a recorded respiration rate of 30 to 50 breaths per minute, but in reality, it is about 17-18 BPM. This is a form of flow limitation or poor pulmonary tone. Each inspiration consists of at least two distinct peaks with an M shaped inhale. Inspiration starts, hesitates and drops momentarily to zero flow, then resumes before dropping into expiration.
I have some fairly complex settings I'd like to propose here if you're willing to really go pretty far-out of conventional treatment. It almost looks like you should be using a ST machine. Can you describe any pulmonary or health conditions you are aware of before we begin? A quick preview of what I will propose. You need enough pressure support to encourage a sustained inspiration and a minimum time of inspiration that will ensure you get at least 1.5 seconds of pressure support once inspiration begins. It will take some experimentation to get the proper sensitivity to trigger (inspiration) and cycle (expiration) to normalize your breathing.
RE: Getting New Aircurve 10 Bilevel today - slam7241 - 09-10-2022
Thanks to Sleeprider * Crimson Nape for their replies yesterday!
Attached is my sleep data on my first night use on the Aircurve 10 VAUTO (brand new machine zero hours use)
1. Felt slightly easier breathing, improved comfort; still tired, dry eyes, dry mouth..
2. No leak ... have never seen leak rate this low before.
3. Resp rate back to normal reading (3 breath cycles per 10 sec or 18 per minute) Sleeprider was right. Suspect my old machine not working properly.
4. AHI mostly "CA" (although lot of them were from period I was awake/semi awake.)
I like to change my setting :
from EPPA 6 IPPA 12 to EPPA 7 IPPA 14
Keep PS at 4
Keep Trigger at HIGH
Keep Duration at Normal
What do you guys think !
Sam
RE: Getting New Aircurve 10 Bilevel today - Sleeprider - 09-10-2022
Definitely increase the trigger rate. The increase in minimum EPAP pressure should be based on comfort and avoiding obstruction. Looks good to me to make the changes. Watch for that chin tuck in the morning.
RE: Getting New Aircurve 10 Bilevel today - clownbell - 09-10-2022
@Slam - two things to remember
1- Please update your user profile, which shows old machine.
2 - If you are certain (absolutely, positively certain) you were awake, then events recorded then can be disregarded since they are not part of SLEEP apnea.
Congratulations on persevering.