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+--- Thread: PacificNW - therapy thread (/Thread-PacificNW-therapy-thread)
PacificNW - therapy thread - PacificNW - 01-20-2023
Hello All,
new guy here. I realize this is an old thread. Google has found it for me when researching for BIPAP use for central apnea. At home I use AirCurv3 10 ASV and with success so far (whole 3 months) fighting severe complex apnea. Efore treatment started it was giving me AHI of 50
However for travel I cannot afford a second ASV and was researching other options. After reading this discussion I decided to give an Aircurve 10 Vauto a try. Bought it used with low milage from Supplier #2 (great transaction, helpfull people).
After experimenting using the info from this thread:
1. So far I am not able to find settings which would work for me (reduce central apnea enough) in BIPAP. Niether “S” mode nor “VAuto”.
2. Best results achieved so far are in CPAP mode with pressure 10 and EPR 3 cmH2O. I was able to reduce AHI to 9 - 10, which I think is OK for the purpose of travel, definitely better than 50.
I hope the below helps somebody.
Please note that the trigger/cycle settings in BIPAP mode on the AirCurve 10 are not direct sensitivity settings. Page 15 of the manual states:
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Trigger: Set the level of inspiratory flow above whichthe device changes from EPAP to IPAP.
Cycle : Set the level of inspiratory flow below whichthe device changes from IPAP to EPAP.
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And the low flow means the higher sensitivity. So if you want highest sensitivity than set those parameters to “very low” and not to “very high”. If you set it to “very high”, then you will have to create a lot of flow on your own before the machine starts helping you. Counterintuitive.
Cheers.
RE: ResMed AirCurve 10 VAuto vs ASV to Treat Central Apnea - Gideon - 01-20-2023
Pacific NW,. Please provide an OSCAR daily charts as that provides the info on helping us to help you optimize your therapy with the VAuto.
Also what is your Trigger setting?
RE: PacificNW - therapy thread - PacificNW - 01-20-2023
Here is the last night. I used AirCurve 10 VAuto for about 5 hours and then switched to ASV - have to work in the morning and need clear head, so needed to get a few hours of normal sleep. Not sure what is going to happen if I try to import data for the same day from 2 different machines and decided not to experiment.
[attachment=47192]
P.S. My trigger is set to "very low" and the cycle is to "high". I feel that the main issue is with inhale not exhale for me.
RE: PacificNW - therapy thread - Gideon - 01-20-2023
We find that very, very few individuals need to touch the Cycle setting,
And by setting the Trigger setting to very low low you are telling the machine you do not want it to respond to a low level of change from exhale to inhale meaning you are willing to accept the resulting central apneas.
Please set both Trigger and Cycle to Medium, the default values the repost tomorrow. I suspect we will suggest setting Trigger to High, possibly Very High but please only one step at a time. Many of the forums users finds that this resolved low to .moderate central apneas.
RE: PacificNW - therapy thread - PacificNW - 01-20-2023
Thank you! I will give it a go tonight.
However do I read it wrong? Please see the attached screenshot from the device manual.
The event is flow change. We are setting the level of event to fire the trigger. "Very low" means that it is more sensitive. I have tested it and it does feel (subjectively) easier to go from IPAP to EPAP on a "very low" setting of a trigger. Is it just me?
[attachment=47193]
RE: PacificNW - therapy thread - Gideon - 01-21-2023
You have got it backwards. Higher sensitivity means it fires with less signal, thus more sensitivity..
I assume you have nothing like COPD which is one condition which may, only may, need an adjustment on Cycle.
Either way a baseline at medium will help us and determine what you need.
RE: PacificNW - therapy thread - Sleeprider - 01-21-2023
You're in good hands with Gideon, but I want to emphasize that your trigger settings need to be set to Very-High to help trigger a breath with CA events, and the cycle needs to be set to Medium. The Vauto relies on spontaneous breathing to trigger IPAP, and for someone using an ASV, it is rarely a good choice. The machines travel exactly the same, why do you think you need a dedicated travel machine? You should just use the ASV which is the correct device for your problem.
RE: PacificNW - therapy thread - PacificNW - 01-21-2023
I am in Canada. The price I paid for the ASV and accessories (hose, mask) was ~$7300. The machine helps so much I cannot risk taking it places. Probably just paranoid, but to me it is a ticket to normal life that I cannot risk.
The price of a travel CPAP they quoted locally was ~$2500. Which is ridiculous. I bought a very low milage VAuto much cheaper!
And since I have now a VAuto which also has “S” mode, and there is a thread here on how to use it to defeat CA, wanted to give it a try. Unfortunately there are no attachments on that discussion anymore, so There is a room for an experiment. This is the reasoning.
I can bring it down to 10 AHI in CPAP mode. Can it be brought down to below 5 with BiPAP?
Regards.
PNW.
RE: PacificNW - therapy thread - PacificNW - 01-21-2023
Changed the trigger and cycle. So the current settings are:
Max IPAP 13
Min EPAP 7
PS 4
Trigger: Very High
Cycle : Med
Any specific graphs which need to be in a screenshot beside the volume?
Will post the charts tomorrow.
Thank you again!
PNW.
RE: PacificNW - therapy thread - pholynyk - 01-21-2023
It's easiest to see what's going on if you post a screenshot of the entire Daily screen. Use OSCAR's built in screenshot, from the menu View->Take Screenshot or F12. This will remove the calendar and pie chart during hte shot, and restore them if necessary after.