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AirCurve 10 VAuto not set to VAuto
#1
AirCurve 10 VAuto not set to VAuto
I did a sleep study a few weeks back, and was diagnosed with Obstructive Sleep Apnea.  Sleep study says I need Bi-Level (E0470) with pressure settings of 11/16 cm.  The clinic gave me an AirCurve 10 VAuto, and it is set to Mode "S", and 11/16 cm.  From what I have read, the VAuto setting is what makes this a more expensive machine, as it will adjust the airflow within a range to better treat my sleep Apnea.

Is there a reason why the doctor would choose not to use the VAuto setting?  I asked the tech that gave me the equipment, and was told the order by the specialist was for BiPAP, so that was the way she configured it.  She also added the Auto Bi-Level is often more comfortable for the patient, but is a therapeutic recommendation from the reading physician.

I don't plan to change anything, at least not for the first 45 days, as I guess they will download and check my progress after that point.  I guess its just the engineer in me that wants to understand the machine, and tinker. Smile
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#2
RE: AirCurve 10 VAuto not set to VAuto
See how it works out, but it's an easy change. You can change this to Vauto mode at any time, and the machine will continue to adjust for your obstructive sleep apnea, and will likely provide lower overall pressures. Your settings of 16/11 (IPAP/EPAP) means you have pressure support (PS) of 5.0 cm. So in Vauto mode, you could probably try an EPAP min of 9.0, PS 5.0 and IPAP max of 18.0. That would maintain your titrated pressure support and provide a range of 14/9 to 18/13 automatically adjusted by the Vauto mode. You will be able to tell pretty quickly if the fixed titrated values are ideal.

How did you end up with a full face mask? Did you ever try a nasal pillow interface?
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: AirCurve 10 VAuto not set to VAuto
A second thought, it is kind of unusual to be issued a bilevel. What were the results of your sleep study and titration study? Do you know why bilevel was recommended? If you had a large number of hypopnea with CPAP, that would explain the move to bilevel. Hopefully it is not a band-aid for central events.

Be sure you get copies of all sleep studies and prescriptions for your personal records. You will want these as the years pass and you change medical providers and have to meet future insurance documentation requirements. It can save you from a future study or delays in obtaining equipment, and gives you much more independence if you want to source anything from another suppliers.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: AirCurve 10 VAuto not set to VAuto
Thank you for such a quick response, and suggestions on VAuto settings.

I haven't tried the nasal pillows yet, they said they preferred the full face mask as it doesn't tend to get removed if you move around in your sleep.  Funny how many people are on these machines when you start to ask around. Come to find out, everyone on my mother side of the family has been on them for years. Several of my co-workers and my neighbor use the nasal pillow.  It does look more comfortable and they said I could switch to them, but I have found I end up sleeping in all positions, so not sure it would stay.  Other than my face being itchy at time because of very dry skin, it hasn't really bothered me.

My sleep study went well as far as not having to come back a second time.  Apparently I was doing pretty bad, so they put me on a machine after an hour.  I had an AHI of 107.5 per hour.  Still can't believe I was that bad, and had put this off so long.  I do have the complete study, and attached some screen shots.  I'm sure they will answer your questions better.

Much like everyone else, my insurance is going down hill every year.  I am glad I got this done, as somehow the study and equipment only cost me two co-pays.  Still not sure how they worked that, but just saw this morning the equipment claim went through, so pretty happy.  Was afraid it was going to come back that I needed to pay the deductible, then 15% co-insurance.

Thanks again for the help, gotta love internet forums. Smile

           
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#5
RE: AirCurve 10 VAuto not set to VAuto
It wouldn't let me upload the last two pages, and I guess I can't put in a link yet.  Guessing this is enough to answer your questions.  Last two are just a summary of the data.

Thanks.
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#6
RE: AirCurve 10 VAuto not set to VAuto
Really interesting study results. As I guessed, hypopnea was the major feature of your diagnostic test. During titration, you developed some central apnea but had persistently low oxygen saturations (SpO2) during all CPAP tests, mainly due to hypopnea. Bilevel resolved the hypopnea and in some trials replaced them with centrals, and SpO2 improved significantly. Your event rate at 16/11 was acceptable, but not the lowest, but SpO2 was at 94 which was the best of the night.

You have some indications of complex apnea and mild PLM here, and your successful titration was only based on a fairly short trial with no time in REM sleep. All of this is to say, keep an eye out on your AHI rate and particularly if centrals start to emerge. The problem with complex apnea is it's very hard to get consistent results, so the successful titration can be a matter of "luck of the draw" or it may be actually what works best. If you see more hypopnea and centrals in your Sleepyhead results, consider picking up an inexpensive oximeter from Supplier #19 to track your oxygen. You would not be the first one titrated on bilevel to end up on a device with a backup rate like a VPAP ST or ASV. Hopefully it all goes smoothly with a low event rate, but if not, you will know why, and will want to follow-up with your medical team. Given your sensitivity to alternative pressures, and possibility you may be graduating to a machine with backup, I strongly agree with your decision to keep your doctor's prescribed settings and getting a good sense of how well they work.

Good stuff! Welcome to Apneaboard and good luck with your therapy.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: AirCurve 10 VAuto not set to VAuto
Even for fixed bi-level, it is better to use the VAuto mode since in S mode flow limitation is not calculated.
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#8
RE: AirCurve 10 VAuto not set to VAuto
(11-26-2017, 01:35 PM)Sleeprider Wrote: Really interesting study results.  As I guessed, hypopnea was the major feature of your diagnostic test. During titration, you developed some central apnea but had persistently low oxygen saturations (SpO2) during all CPAP tests, mainly due to hypopnea.  Bilevel resolved the hypopnea and in some trials replaced them with centrals, and SpO2 improved significantly.  Your event rate at 16/11 was acceptable, but not the lowest, but SpO2 was at 94 which was the best of the night.

You have some indications of complex apnea and mild PLM here, and your successful titration was only based on a fairly short trial with no time in REM sleep.  All of this is to say, keep an eye out on your AHI rate and particularly if centrals start to emerge.   The problem with complex apnea is it's very hard to get consistent results, so the successful titration can be a matter of "luck of the draw" or it may be actually what works best.  If you see more hypopnea and centrals in your Sleepyhead results, consider picking up an inexpensive oximeter from Supplier #19 to track your oxygen.  You would not be the first one titrated on bilevel to end up on a device with a backup rate like a VPAP ST or ASV.  Hopefully it all goes smoothly with a low event rate, but if not, you will know why, and will want to follow-up with your medical team.  Given your sensitivity to alternative pressures, and possibility you may be graduating to a machine with backup, I strongly agree with your decision to keep your doctor's prescribed settings and getting a good sense of how well they work.

Good stuff!  Welcome to Apneaboard and good luck with your therapy.

Thanks for all the great info, it has really helped me to understand my therapy.  I'm not going to change anything for now, but will pick up an oximeter and play around with viewing my results with Sleepyhead.
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#9
RE: AirCurve 10 VAuto not set to VAuto
(11-26-2017, 11:31 AM)hcbrf3 Wrote: I did a sleep study a few weeks back, and was diagnosed with Obstructive Sleep Apnea.  Sleep study says I need Bi-Level (E0470) with pressure settings of 11/16 cm.  The clinic gave me an AirCurve 10 VAuto, and it is set to Mode "S", and 11/16 cm.  From what I have read, the VAuto setting is what makes this a more expensive machine, as it will adjust the airflow within a range to better treat my sleep Apnea.

Is there a reason why the doctor would choose not to use the VAuto setting?  I asked the tech that gave me the equipment, and was told the order by the specialist was for BiPAP, so that was the way she configured it.  She also added the Auto Bi-Level is often more comfortable for the patient, but is a therapeutic recommendation from the reading physician.

I don't plan to change anything, at least not for the first 45 days, as I guess they will download and check my progress after that point.  I guess its just the engineer in me that wants to understand the machine, and tinker. Smile

The AirCurve 10 VAUTO (which does both S mode and VAUTO mode) and the AirCurve 10 S (which only does S mode) both cost exactly the same amount of money.  Since the VAUTO does everything the S model does and also has VAUTO mode, there's no reason to buy the S model.  Even if someone is prescribed S, giving them the VAUTO allows the doctor the flexibility to change over later without the insurance company incurring the cost of another new machine.

As to why the doctor prescribed S therapy instead of VAUTO, you'd have to ask him/her.  I've heard that people who are new to CPAP sometimes adjust more easily to fixed pressures rather than adjusting pressures.  Maybe that's it?
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#10
RE: AirCurve 10 VAuto not set to VAuto
(11-30-2017, 12:09 AM)Reznik Wrote: The AirCurve 10 VAUTO (which does both S mode and VAUTO mode) and the AirCurve 10 S (which only does S mode) both cost exactly the same amount of money.  Since the VAUTO does everything the S model does and also has VAUTO mode, there's no reason to buy the S model.  Even if someone is prescribed S, giving them the VAUTO allows the doctor the flexibility to change over later without the insurance company incurring the cost of another new machine.

Interesting. ResMed does price the AirSense CPAP cheaper than the AirSense AutoSet but the AirCurves are the same.
At the same price, no reason to buy the S model.
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