[Equipment] ResMed AirCurve10 VAuto blockage

[bfrakes256]

I'm a retired IT Network Engineer and have done development work on software.  I had an application for fire sprinkler inspection at one time until one of the manufacturers reverse engineered it and put me out of business.

As to the before an after, you mean before last night then after last night or wait until tomorrow to show the results of this last change?

I like the looks of the software...

Let me know...

[Sleeprider]

In your post #6 you compared data from 5/8 to 5/14. If you could take a screenshot (F12) of one day of typical before data (5/8 to 5/13), and the daily detail of 5/14, I would like to see it.

[bfrakes256]

Here are two screen shots from 05/14 and today (05/15)

There were no graphs for any of the other days.

I fiddled with the settings slightly last night to make it more comfortable.  As you can see I got 1 minute short of 5 hours on it.  Still had some blockages.  

The splash screen warns that there is excessive leakage.  Not sure about how to fix that.

[Sleeprider]

brakes256, we need you to get some use out of the machine. On the 15th at PS 8.0 over 15 to 23, you stopped therapy every time the pressure rose and ended up with less than 2-hours of use. On the 14th at PS 8 over 4 to 25 this looks like a nap with 13 minutes of use.

Let's review your previous AVAPS settings:
AVAPS Rate: 10 cmH2o
Tidal Volume: 400 ml
Max Pressure: 40 cmH2O
Pressure Support Max: 30 cmH2O
Pressure Min: 4.0 cmH2O
EPAP Max: 14 cmH2O
EPAP Min: 4.0 cmH2O
Breath Rate: Auto
Trigger Type: Auto
Rise Time: 1
Ramp: Off

With the Airsense 10 Vauto, we can give you variable EPAP pressure, but the machine does not have variable pressure support to target a tidal volume; however it does help us to know that your targeted Vt was 400 mL. In both of the charts you posted, your Vt was over 1000 mL and that tells us the pressure support is far too high. It would help a lot if you could look at your old machine and tell us your median and/or 90% EPAP pressure, because that is the range I would use for your next trial on Vauto. With that said, you have far too much pressure and pressure support. Let's try this:

Mode Vauto
EPAP min 6.0
IPAP max 16.0
PS 4.0
No changes to trigger or cycle.

This setting will start at pressures of 10/6 and will rise if any obstruction occurs to a maximum of 16/12. This should be more tolerable. What we don't know is if it will provide adequate Vt. We will adjust the minimum EPAP if you have obstructive events, and we will increase PS until you have at least 400 Vt. If you can pull a graphic of your old Philips therapy (it should import into your Sleepyhead profile if you have a SD card), or provide some therapy data with median and 90% EPAP and PS from the screen of your AVAPS, it would give us a big head start.

[bfrakes256]

I've imported from the Phillips Trilogy 1000.  How do I get the data from the SH software to you?

I'll wait for your analysis to reset the ResMed...

[Sleeprider]

I don't think Sleepyhead will read the Trilogy results. Can you take a look at your median EPAP pressure and PS for the last 30 days from the on-screen data? If you can see actually the Trilogy data in Sleepyhead let me know and I'll give you place to put the information.

[bfrakes256]

Will do and send it to you later today...

I've set the device to your suggested settings...

[bfrakes256]

All I can see are the following:

Mode: AVAPS-AE
Tidal Volume: 400 ml
Max Pressure; 40 
PS Max: 30
PS Min: 4
EPAP Max: 14
EPAP Min: 4
Breath Rate: Auto
Trigger Type: Auto-Trak
Rise Time: 1
Ramp: Off

From the screen I cannot see and of the history.

[bfrakes256]

Ok, last night I started using the device at 10:55 CDT.  At about 3:00am this morning I shut it of for a bathroom trip and restarted it about 10 minutes later and ended at about 4:05am.

This was the most restful time I have had on either of the devices.  The I could never get more than about 2 hours on the Trillogy.  Even though my doctor reset it to a lower setting (those I posted yesterday),  after about 2 hours it was blowing so much air, my nose would hurt and I would wake up.  

Last night there was one blockage but after it settled down I did not wake up until the potty break.  After I put the mask on again there were three blockages.  

I've attached the screen shot for 05/17 for your analysis.  I did see the AHI above zero, so I think some adjustment of the PS might be in order.

I will be out of pocket until about 10:00 am CDT and unable to reply. 

I think we are pretty close now...

[Sleeprider]

Okay, we hit the tidal volume, but you may need a new mask. Let's try this:
EPAP min 7.0
PS 4.0
IPAP max 14.0