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New machine Aircurve vauto questions
#1
New machine Aircurve vauto questions
Hi All,

I finally got my Aircurve vauto, went through the user manual, the clinic manual some topics in the forum and still have questions Smile.

So first, how I can reclaim my VAT in UK? I ended paying it because I couldn't explain to the customs why they shouldn't charge me. I quoted them the commodity code that shows 0% VAT but they said that this doesn't matter and sent me to some articles saying that the medical equipment must be donated  Huhsign .

Now question 2, I bought Aircurve vauto but I have the S mode is this normal I thought that I should have vauto only? Also which mode is more advanced/better and how should I configure it? my current CPAP pressure is 15 and this gives me snoring for 1-3 minutes 1-2 nights per week (probably caused by micro leaks). I would like to set the smallest exhale pressure if possible.

Question 3 - in the clinic manual it says that if I use the antibacterial filter it may mess the statistic and then it list some standards or something like that. Now if I use the original resmed antibacterial filter will this still mess the statistics?

Question 4 - I have SleepyHead software already, is this the best for my machine?
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#2
RE: New machine Aircurve vauto questions
SleepyHead is the best for home use. You want to use the VAUTO mode. Set your minimum EPAP to 13cm and your PS to 4. Also set your maximum IPAP to 25cm. This will give you a good range to find your needed pressures. Once you get a few days data post a sleepyhead chart and folks here can give you any feedback you might need.
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#3
RE: New machine Aircurve vauto questions
OK, I also just ordered a SD card reader, will get it just in time to share some charts.
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#4
RE: New machine Aircurve vauto questions
You could try contacting

HM Revenue and Customs
Dorchester House
52-58 Great Victoria Street
Belfast
Northern Ireland
BT2 7WF

Telephone: 03000 513 310
email: niru@hmrc.gsi.gov.uk

Not tried but they may be able to assist or advise further

https://www.gov.uk/government/publicatio...aim-relief


This is the legislation I think
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#5
RE: New machine Aircurve vauto questions
Hmm I found a form that I should fill for the VAT refund but it asks me about some details of my representative (Parcel Force) that I don't have. I sent an email to niru@hmrc.gsi.gov.uk , lets see what will happen.
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#6
RE: New machine Aircurve vauto questions
Get the clinical manual, you can change the mode out of S, to auto or such.
https://www.apneaboard.com/resmed-airsen...setup-info
If you want to set it up similar to your cpap pressure and how the bpap can be titrated. You could use min epap 11 and ps 4 which equals ipap 15, you cpap pressure. I'd have the max epap at 20. You can review in sleepyhead if min epap 11 is enough pressure
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#7
RE: New machine Aircurve vauto questions
I think ajack meant 20cm Maximum IPAP.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#8
RE: New machine Aircurve vauto questions
OK I went through my first night with the new machine and I'm very happy, surprised and also freaked out. I can't download the data to SleepyHead yet but I got some pictures of the settings + some of the machine report.

But first let me explain what happened. So first I tried those - "Set your minimum EPAP to 13cm and your PS to 4. Also set your maximum IPAP to 25cm." and I couldn't breath at all. There were some strange pulses just when you finish inhaling and start exhaling like the machine was trying to pop my lungs. Then I started playing with the settings with the mask on and ended using this -      and      .

Now what I realised is that the most problematic setting is Ti Max which I reduced from the default 3 to 2 but this was only comfortable when I reduced the Max IPAP and EPAP together with the PS (which I still can't understand). In general when I tried higher Max IPAP and EPAP the Ti Max needed 1,5 or 1,4 but this was still causing pulses and also actual shortage of IPAP. While playing with the settings I also tried the S mode and realised that I can't use it without the EasyBreath mode but with it is something that I would like to explore as it seems to be more intelligent? then the VAUTO mode. However the S mode requires too much fine tuning and it was already too late.

Anyway what I was trying is to somehow make the machine to detect when I'm inhaling and when I'm exhaling and this seems to be the S mode however those Ti settings and my be the cycle and trigger settings need some adjustment because I was getting either too short inhale pressure or too long one. Is there a way to automate this on this machine because I suspect that while asleep those change all the time not to mention that it will change between my awake and asleep states.

Now about the reports and why I'm freaking out. First of all I got 0 leaking and that is solely because of the bipap. Just before my old CPAP was giving constant 15 probably not because I needed 15 but because of the micro mask leaks that I was experiencing. Now due to the lower exhale pressure this doesn't happen anymore. I was originally diagnosed for pressure of 10 and I suspect that 10 is the correct one for me. That is the good part that makes me happy. Now about this -      Central AI 0,9 does this mean that I got Central Sleep Apnea? And is AHI = 2,8 any good - [attachment=4602] . Also what about the other statistics in the rest of the report attachments?


Attached Files Thumbnail(s)
   
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#9
RE: New machine Aircurve vauto questions
The default Timax is 1.8, and many people like 2.0 to 2.2 if they have larger tidal volume and need the longer inspiration time. A setting of 3 would be very long and only used by someone with restrictive lung problems that needed unusually long inspiration time at IPAP. Your move back to 2.0 is normal.

I would not have encouraged you to use a starting EPAPmin of 11.0. Early in titration we need to see how you respond to bilevel pressure and a starting EPAP of 8.0 to 9.0 usually works for most people. You may find in time that you actually average a higher pressure. When setting someone up for bilevel therapy, my preference is to get EPAP min within 2- cm of the median pressure, and avoid swings greater than 3-4 cm through the night.

What you came up with looks pretty good, except I would suggest you drop the PS to 4.0. You may want more pressure support later, but 6.0 is a lot for a new user of bilevel, and that is probably mostly to blame for you feeling blown out. I would setup your machine with the following:
Mode Vauto
EPAP min 8.6
IPAP max 20.0
PS 4.0
Timax 2.0
Timin 0.3
Cycle med
Trigger med

The images of your machine setting are interesting, but it's just as easy to relate in a list as above.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#10
RE: New machine Aircurve vauto questions
I just wanted to add, that a big reason we start with lower EPAP pressure than your previous CPAP, is with CPAP we only have one pressure to do everything. With Bilevel, EPAP only has to control obstructive apnea events, and we rely on pressure support to deal with hypopnea, flow limits and snores. It is a common error to transpose CPAP pressure to bilevel, only to find out it is too high.

The settings I have suggested have many defaults including PS, TiMax, TiMin, Cycle and Trigger. We are only going to depart from defaults to address specific issues, rather than anticipate them. I'm a bit surprised you managed to sleep with your initial settings.
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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