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I had used a ResMed AirSense 10 for 2 years, but 3 months ago was switched to using a ResMed AirCurve 10. Currently the pressure settings are in VAuto mode with min EPAP at 13, PS at 3, and max IPAP at 25. Every day I review the nights data using SleepyHead software. My concern is this, when I start having Obstructive Apnea events, the machine increases EPAP to attempt to clear the apnea. The pressure continues increasing to about an IPAP of 21.5 and does not increase any further. As a result, if I am still having OA events, they continue until I wake up. I have taken the SleepyHead and ResScan graphs and met with both the Durable Medical Equipment folks, and my Pulmonologist, both of which don't see any problem. I was switched from the AirSense to the AirCurve because of the available higher pressure levels, but I don't seem to be getting much of that.
I am an Engineer, and do a lot of instrumentation and calibration work. I tested the machine, (in leak test mode), and determined that the AirCurve 10 is capable of delivering 25cm H2O. I have also noted a relationship between the Pressure Support (PS), and max IPAP. Unfortunately, to get max IPAP near 25, I have to set the PS to about 8, which makes it difficult to exhale. I have also played with the TiMin and TiMax, which don't seem to have any impact on this problem.
I am getting a little desperate since I any sleeping worse with the AirCurve 10 than I was with the AirSense 10.
You need to post your sleepyhead charts, you either need four more posts to be able to post directly or use imgur (cloud based picture sharing look up on internet), and post a link on your post.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
We have seen this behavior with the Vauto before. About the only way to force 25/22 pressure is to put it in S mode. My suggestion is that you try a soft cervical collar and see if you can resolve the OA through positional therapy. Many members have had success reducing AHI and max pressure needs using this strategy.
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Hi Tony
After 9 years of BiPAP 18/13 for OSA I was switched to a CPAP at 13 because of central Apneas. Don't know if this can relate to you situation. Good luck, Tom
08-04-2018, 10:19 AM (This post was last modified: 08-04-2018, 03:36 PM by Walla Walla.)
RE: AirCurve VAuto mode not reaching max IPAP
(08-04-2018, 08:52 AM)Sleeprider Wrote: We have seen this behavior with the Vauto before. About the only way to force 25/22 pressure is to put it in S mode. My suggestion is that you try a soft cervical collar and see if you can resolve the OA through positional therapy. Many members have had success reducing AHI and max pressure needs using this strategy.
I had the same thing happening when I was using VAUTO at high pressures. I've since had my pressure requirement drop below the 20cm mark. I went back and looked at my one of my charts and found that though pressure didn't increase at high pressures (over 20cm) after an event it did increase following a spike in flow limitations.
At lower pressures the pressure did react to events. I'm guessing it has to do with the way they wrote the algorithm. Why I have no idea.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Everyone, thanks for the quick responses. The 2 attached images show 1) that max IPAP is 25, 2) machine is running in VAuto mode, and 3) PS is 3. the image dated 7/21 shows that OA starts justs before 11PM., the EPAP is increased to clear the apnea, up to the max of 21.5. It then stays at that level even when additional apneas are noted. Basically, the OAs continue until it wakes me up. I have tried starting with a lower EPAP (12), and I have tried increasing PS. I have noted that when PS=3 max IPAP is 21.5. when PS=5, max IPAP is 22.5, when PS=7 max IPAP=23.5. So that would suggest that the only way to get max IPAP=25 would be with PS=10.
If that is the way the AirCurve is supposed to work, I would be better off continuing with the AriSense or ask to try a different brand of CPAP.
In response to zeeser, I was originally using a BiPAP mode of 12/18. It worked fine until I had an OA. Since the machine did nothing to clear it, I continued having OAs until it wakes me up.
Sleeprider, I will take a look at the cervical collar. I am getting desperate
Look at sleeprider's response. You have all the signs of tucking your chin and cutting off your windpipe. No amount of pressure will help that. Like Sleeprider I recommend getting a soft cervical collar. It'll prevent your chin from dropping to your chest while your sleeping. By the way your maximum EPAP was 18.5 so a PS of 6.5 would have maxed it out. I still don't think it would have resolved the problem though.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
walla walla,
whats are the "signs" that would indicate that I am tucking my chin. I know that with high pressure, I have to keep the straps very tight o prevent leakage. tight straps tend to pull the chin down. I do wear a CPAP cap, with chin strap to keep my mouth closed at night.
Normally when you see large clusters of OA events together it usually indicates the airway is being cut off. It only cost 10 or 15 dollars for a collar to find out if that's the fix. If it is you'll end up using less pressure as a result.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
