RE: Are these settings OK?
What do you want to get out of a titration study that we don't already know?
RE: Are these settings OK?
The difference betweenthe 2 cm from flex and the 4 cm from work is arguable from a comfort point of view. Personally I believe the comfort I'd higher on the ResMed with EPR because the ResMed follows your natural breathing. It senses when you start an inhale or exhale then relieved or applies the pressure as appropriate. Flex tries to predict it and sometimes gets it wrong. Buy comfort is subjective an this is always arguable.
Therapy wise the difference is huge. We do not see the flex helping with flow limits, Hypopnea, RERAs or
UARS at all.
ResMed andbEapR to an excellent job of treating those. That is the biggest reason we like ResMef so much.
RE: Are these settings OK?
Thanks Gideon, that explains it clearly.
Sleeprider I don’t understand your question on titration study. Are you asking me for information on my titration study that determined I need treatment for sleep apnea?
RE: Are these settings OK?
I think I read someone else was considering a titration study and my post ended up here. Confusion happens at my age.
03-15-2021, 08:47 PM
RE: Are these settings OK?
I always say that I have first claim to the phrase: at my age. In my younger days, the saying was: Why are the bobbies (that’s what we called coppers in London) getting younger every year?
RE: Are these settings OK?
My children are giving me a new machine for my birthday. So I want to make sure I get it right this time. The Aircurve VAuto is typically described as the better machine with more functions. But on the Resmed site, it says Airsense Autoset has RERA and CSR detection that Aircurve VAuto doesn’t have. Would I be wrong then in assuming the Airsense is the more useful machine?
RE: Are these settings OK?
Also I read somewhere that the VAuto is essentially overkill. That it’s only for people with obstructive apnea who have such a high inhale pressure that they aren't comfortable breathing against that inhale pressure, so when the person exhales the machine drops the pressure a lot to make exhalation easier. What do you all think?
RE: Are these settings OK?
Both machines detect and respond to flow limitations. RERA detection is a farce. The Airsense 10 flags periods of increasing flow limitation ending in an arousal as indicated by increased tidal volume. You can do that more accurately with Airsense 10 and the Vauto using Oscar charts. CSR is also a fallacy. In most cases the machine is flagging fluctuating breathing volume that may be characteristic of periodic breathing. No machine can diagnose CSR, and again, this breathing pattern is readily picked out by a regular fluctuation of tidal volume where flow is less than 50% of normal, and fluctuates to greater than normal in a smooth sine wave. You posted some flagged periodic breathing which was clearly obstructive. If that had been flagged as CSR, would that have been helpful? The answer is no, and it would have resulted in unnecessary and unwarranted alarm.
You have indicated your issues is UARS related flow limitation and the best treatment for that remains the pressure support you can only get with the Vauto. With the Aircurve 10, pressure support can be adjusted in up to 2-cm increments with no effective limits. You can also adjust minimum and maximum time of inspiration and the sensitivity of trigger to IPAP and cycle to EPAP. The Airsense 10 has EPR that we use when nothing better is available, but there is no comparison. That's why I own 2 Vauto machines, and use PS 4. My issues are unrelated to the overkill you speak of. Your charts show significant obstructive apnea and flow limitation that could be resolved by pressure support. If you are looking for the most effective and comfortable option, the Vauto is ideal, however even the Airsense 10 will do much better than your current Dreamstation which has no pressure support capability.
RE: Are these settings OK?
On UARS, read this which is written by a very well-respected doctor who specializes in UARS among other things.
http://www.apneaboard.com/wiki/index.php..._and_BiPAP
Note that he has UARS patients on as little as 2-3 PS with the average being a PS of 4-6 and a high of 12. with the exception of the few at 2-3 PS he has found that a BiLevel is needed to treat most patients with UARS.
Assuming your issues are UARS, get the VAuto, if it isn't the VAuto will do an excellent job of managing your obstructive apnea.
RE: Are these settings OK?
Thanks guys. I really really appreciate this. One more question. Are second hand machines from a reputable shop OK if they provide documentation, hours used etc?