Post Reply 
Newbie needing help. CPAP or VPAP?
Author Message
filo4u Offline

Members

Posts: 10
Joined: May 2016

Machine: ResMed AirCurve™ 10 VAuto
Mask Type: Full face mask
Mask Make & Model: Fisher and Paykel Simplus
Humidifier: Built-in
CPAP Pressure: PS 3.0 over 8.0-16.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #1
Newbie needing help. CPAP or VPAP?
Hello,

First I would like to thank you for this forum and the amazing SleepyHead Software! Thankslike

I have been on the CPAP for almost 2 years now and initially I owned the ResMed Autoset S9. I had issues having a ton of gas in the mornings and so about a year ago my doctor switched me to a VPAP ResMed AirCurve 10, I'm not sure if this is just because my body wasn't use to the machine yet. I have been messing around with the settings to find out the best setting for me and even tried a couple CPAP only settings and was surprised that the best record was from a set CPAP setting. I wish I could link my statistics but since I am new I can't.

I was wondering if someone could tell me what I should be looking for in finding out if VPAP or CPAP is best for me. Thanks in advance!
05-13-2016 02:59 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
trish6hundred Offline

Advisory Members

Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Newbie needing help. CPAP or VPAP?
Hi filo4u,
WELCOME! to the forum.!
Hang in there for answers to your questions and much success to you as you continue your CPAP therapy.

trish6hundred
05-13-2016 03:34 PM
Find all posts by this user Post Reply Quote this message in a reply
PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #3
RE: Newbie needing help. CPAP or VPAP?
The basics are AHI below 5 and sleeping well
05-13-2016 03:53 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
filo4u Offline

Members

Posts: 10
Joined: May 2016

Machine: ResMed AirCurve™ 10 VAuto
Mask Type: Full face mask
Mask Make & Model: Fisher and Paykel Simplus
Humidifier: Built-in
CPAP Pressure: PS 3.0 over 8.0-16.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #4
RE: Newbie needing help. CPAP or VPAP?
(05-13-2016 03:34 PM)trish6hundred Wrote:  Hi filo4u,
WELCOME! to the forum.!
Hang in there for answers to your questions and much success to you as you continue your CPAP therapy.

Thank you! Glad to be a member of this forum!
05-13-2016 04:43 PM
Find all posts by this user Post Reply Quote this message in a reply
filo4u Offline

Members

Posts: 10
Joined: May 2016

Machine: ResMed AirCurve™ 10 VAuto
Mask Type: Full face mask
Mask Make & Model: Fisher and Paykel Simplus
Humidifier: Built-in
CPAP Pressure: PS 3.0 over 8.0-16.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #5
RE: Newbie needing help. CPAP or VPAP?
Thank you for you reply. Luckily for both CPAP and VPAP setting I am under 5 AHI . I guess I was hoping for something to look at on the VPAP statistics to know for sure that VPAP is the right for me, I am also trying to help my dad with his CPAP machine and wanted to know for sure that he doesn't need a VPAP.

When I open the SleepyHead program I always get this message

Your machine was under 10-14 cmH2O for 95% of the time.

Can someone please tell me what this is suggesting for me to do? Is it suggesting I lower the settings? I also have major leaks so probably lowering my setting will help. Thanks again!
05-13-2016 04:54 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
filo4u Offline

Members

Posts: 10
Joined: May 2016

Machine: ResMed AirCurve™ 10 VAuto
Mask Type: Full face mask
Mask Make & Model: Fisher and Paykel Simplus
Humidifier: Built-in
CPAP Pressure: PS 3.0 over 8.0-16.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #6
RE: Newbie needing help. CPAP or VPAP?
(05-13-2016 04:54 PM)filo4u Wrote:  Thank you for you reply. Luckily for both CPAP and VPAP setting I am under 5 AHI . I guess I was hoping for something to look at on the VPAP statistics to know for sure that VPAP is the right for me, I am also trying to help my dad with his CPAP machine and wanted to know for sure that he doesn't need a VPAP.

When I open the SleepyHead program I always get this message

Your machine was under 10-14 cmH2O for 95% of the time.

Can someone please tell me what this is suggesting for me to do? Is it suggesting I lower the settings? I also have major leaks so probably lowering my setting will help. Thanks again!

Sorry, to add some information on this.

My setting now is PS 4.0 over 7.0-14.0 (cmH2O)
SleepyHead shows that I always hit the upper limit on the IPAP so I have always tried increasing IPAP. My original RX was PS 4.0 over 7.0-11.0 but was hitting 11.0 almost instantly and stayed there for almost the whole night. I don't know if i should change anything on the PS or EPAP because I've been getting mostly Hypopnea's lately.
05-13-2016 05:47 PM
Find all posts by this user Post Reply Quote this message in a reply
DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #7
RE: Newbie needing help. CPAP or VPAP?
Welcome to the forum. Resmed make several different types of bilevel machines ("VPAP"), being:

AirCurve™ 10 S The AirCurve 10 S is ideal for sleep apnea patients who find it difficult to adjust to sleep apnea therapy on a continuous fixed pressure device, as well as patients who need extra pressure support. This bilevel machine has two different, adjustable set pressures which can make therapy feel more comfortable.

AirCurve™ 10 VAuto The ResMed AirCurve 10 VAuto is an APAP machine that uses our advanced technologies to treat sleep apnea patients who require enhanced pressure support.

AirCurve™ 10 ST The AirCurve 10 ST is a bilevel positive airway pressure device with backup rate that provides exceptional patient–ventilator synchrony.

AirCurve™ 10 ST-A The AirCurve 10 ST-A is a highly effective ventilator that also allows you to proactively monitor and follow up with respiratory insufficiency patients.

AirCurveTM 10 ASV The ResMed AirCurve 10 ASV features the most clinically-studied and only adaptive servo-ventilator that targets the user’s own recent minute ventilation. This machine is also called the "CS Pacewave" in some markets.

It's important to know which machine you have in order to provide useful advice. The model name will be printed on the lower right corner on the machine. It would also help to see some Sleepyhead output, specifically the pie chart and summary, events, flow, mask pressure and leak graphs. http://www.apneaboard.com/forums/Thread-How-to-HOW-DO-I As a new member you may attach an image up to 200 kb in size. Once you have 8 or more posts you will be able to post a link to an image file (eg on Imgur).

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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.
05-13-2016 11:11 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
filo4u Offline

Members

Posts: 10
Joined: May 2016

Machine: ResMed AirCurve™ 10 VAuto
Mask Type: Full face mask
Mask Make & Model: Fisher and Paykel Simplus
Humidifier: Built-in
CPAP Pressure: PS 3.0 over 8.0-16.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #8
RE: Newbie needing help. CPAP or VPAP?
Thank you for your reply. Sorry, my machine is the AirCurve™ 10 VAuto.

Last night I tried the setting PS 4.0 over 8.0-19.0 (cmH2O) just to see how high the machine will need to go to correct my AHI's and it looks like it hit max a couple times. Good news is when I increased my EPAP from 7 to 8 it stopped my Hypopneas. I tried using the "Take Screen Shot" option in SleepyHead but images just come as black blank shots so I used Snipping Tool. Any help would be great! Thanks so much in advance.
(This post was last modified: 05-14-2016 01:48 PM by filo4u.)
05-14-2016 01:36 PM
Find all posts by this user Post Reply Quote this message in a reply
DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #9
RE: Newbie needing help. CPAP or VPAP?
G'day filo4u, thanks for posting the chart.

Obviously your apneas and hypopneas are well under control, with an AHI of 1.0. At this stage I wouldn't make any changes except to maximise your comfort and manage leaks. The machine isn't spending much time at the minimum pressure and is ramping up and down quite rapidly - this can disturb your sleep. You might like to try increasing EPAPmin just a bit more to see if that stabilises things. It will be a trade-off between minimising pressure swings and not getting too much gas in the stomach. For interest's sake, have a look at the snore and flow limitation graphs to see if there is activity there which is setting off the pressure rises.

The other issue is the large leaks which seem to be following high pressures. I have the Simplus and find it very good. However, it does blow air up the side of my nose and into my eyes. It also "face farts" occasionally. I fixed the first by laying a small strip of fabric (such as you would use for pyjamas) over the part of the mask which covers my nose. That pretty much eliminates the eye leaks. For the face farts, I always run the razor over my face at night and make sure my face is completely clean. Also have the straps adjusted firm but not too tight.

In an earlier post you were asking if the VAuto was the appropriate machine for yourself and your father. It looks like it's working well for you. That's no guarantee it will work for your father - everybody is different and everybody responds in different ways to CPAP therapy. we really need to see his charts to provide any advice as to what is appropriate.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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.
05-14-2016 11:16 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
robysue Online
Wiki Editor
Advisory Members

Posts: 1,235
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #10
RE: Newbie needing help. CPAP or VPAP?
(05-13-2016 02:59 PM)filo4u Wrote:  I have been on the CPAP for almost 2 years now and initially I owned the ResMed Autoset S9. I had issues having a ton of gas in the mornings and so about a year ago my doctor switched me to a VPAP ResMed AirCurve 10,
The gas problem is called aerophagia around here.

When I was first diagnosed back in 2010, I had a Resmed S9 AutoSet and within 2 weeks I was experiencing severe aerophagia, which in turn led to severe insomnia problems and a precipitous decrease in my daytime functioning. I was switched to bilevel after 3 months of misery. But I also wound up with a PR System One BiPAP rather than the S9 VPAP Auto. The switch to BiPAP took the edge off the aerophagia right away, but it took another couple of months of using the BiPAP along with a couple of changes in pressure settings before I could really say that the aerophagia was completely under control. I still have some problems with aerophagia now and then even after 5 years of using the BiPAP: But it's not chronic any more and most of the time I can go a week or two (or more) between times when I wake up with serious pain.

I tell you this bit of background so that you know you're not the only one who has been in this position. And to let you know that bilevel can help with the gas problem.

Quote:I'm not sure if this is just because my body wasn't use to the machine yet. I have been messing around with the settings to find out the best setting for me and even tried a couple CPAP only settings and was surprised that the best record was from a set CPAP setting. I wish I could link my statistics but since I am new I can't.
Here's the thing about aerophagia: The AHI stats in particular are useless for figuring out how to handle the aerophagia. In other words, a near perfect AHI (such as your data shows) that is accompanied by severe aerophagia usually means that the aerophagia is keeping you from getting really good, solid sleep. And, of course, there's the misery of the aerophagia itself to deal with. In my case the aerophagia would last most of the day and it wasn't just an issue of "fart/burp it out" for an hour or so after waking up.

I learned that in my case, I have to tolerate a slightly higher treated AHI (mine is usually in the 1.5-3.0 range) and more flow limitations and a bit more snoring in exchange for significantly less air in the stomach. And less air in the stomach usually means better overall sleep for me.

As a result of this, I've learned that I have to keep my max IPAP setting at the highest level my stomach can handle. I've experimented with increasing the max IPAP by 1-2cm for a week or two at a time. That usually reduces the AHI to the 0.5-1.5 range, but it also increases the aerophagia and decreases the overall quality of my sleep.


Quote:I was wondering if someone could tell me what I should be looking for in finding out if VPAP or CPAP is best for me. Thanks in advance!
Here's my advice on what you need to do at this point:

1) Track how bad is the aerophagia? and how do you feel? rather than worrying about the AHI stats. Focus on whether a give set of test settings makes the aerophagia more bearable and whether less aerophagia leads to you feeling better overall. If you can find settings that reduce the aerophagia down to what you can easily tolerate, but the AHI goes from the 0.5-1.5 range up to the 2.5-3.5 range, you're better off with the higher AHI and better sleep due to less aerophagia.

2) Do check up on your leak rate: If you are doing a lot of things in an effort to prevent mouth leaks, that may be leading to your swallowing a lot of air. You may be better off either switching to a full face mask OR tolerating a slightly higher than desired leak rate while using a nasal mask or a nasal pillows mask. It's important to remember that if your largest leaks are only in the 10-15 L/min range with the Resmed AirCurve, that's fine. It's also important to remember that if you only have one 15 minute long official large leak that you sleep through, that's also something that you can tolerate in terms of your therapy----provided of course you sleep through the leaks and wake up feeling decent in the morning.

3) Based on the one night's data that you posted, it's not clear why the AirCurve is increasing the pressure so high at times. My guess is that the AirCurve is responding to activity in the Flow Limitation graph or the Snore graph. In either case, it's worth seeing if reducing the Max IPAP from 19cm to (say) 17cm might reduce the aerophagia without increasing the AHI too much. (That would reduce your max EPAP to 13cm)

4) Finally I'll throw this idea out, even though it is most likely not practical. You might want to see if you can switch from a Resmed AirCurve 10 VPAP Auto to a PR DreamStation BiPAP Auto. Yes, it's an expensive gamble. But the reason I suggest this is because the PR BiPAP Auto algorithm does NOT increase the EPAP everytime it increases the IPAP. And keeping the EPAP as low as possible can also help with aerophagia problems. If the AirCurve is increasing both the IPAP and EPAP in response to a lot of activity in the Flow Limitation graph, the PR DreamStation would only increase the IPAP in response to that same activity. It could also be the case that the very rapid and aggressive pressure increases made by the Auto algorithms used by the AirCurve and the S9 AutoSet are aggravating your aerophagia. And if that's a factor, the more gentle and slower pressure increases by the PR DreamStation BiPAP's Auto algorithm may also trigger less aerophagia.

Good luck in figuring out a workable solution.

Questions about SleepyHead?
See my Guide to SleepyHead
05-15-2016 11:10 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
Question [Equipment] S9 VPAP AUTO QT2U 0 153 11-05-2016 12:27 AM
Last Post: QT2U
  Needing basic help to get started Linda Bee 8 343 10-28-2016 06:42 PM
Last Post: Rcgop
  resmed s9 vpap s faliure marcus112 6 377 10-21-2016 08:57 AM
Last Post: Sleeprider
  [CPAP] Newbie - CPAP Settings Racman 4 372 10-12-2016 01:17 PM
Last Post: Racman
  newbie yossarian 14 734 09-01-2016 02:01 PM
Last Post: Maskup Sleepwell
  From a Newbie to a newbie PappinLikeABoss 11 1,053 08-22-2016 05:38 PM
Last Post: chill
  [CPAP] Needing help (Keeping mask on at night) naata 18 744 08-05-2016 11:48 AM
Last Post: icyura10

Forum Jump:

Who's Online (Complete List)