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[Pressure] Change Pressure on AirCurve 10 VAuto
01-01-2016, 07:55 PM
I just upgraded to a ResMed AirCurve 10 VAuto from a Respironics System One Pro BiPAP. The pressure on my Respironics was set to * inhalation and 4 exhalation. The AirCurve set itself to 10.9 and 7.0. It was reasonably comfortable, however, small amounts of air are pumping into my stomach leaving me feeling a bit gaseous in the morning. Should I manually set the numbers at a lower point? If so, where would you suggest I start and where would I find explicit directions?
01-01-2016, 08:55 PM
WELCOME! to the forum.!
Hang in there for answers to your question and much success to you with your CPAP therapy.
01-01-2016, 09:26 PM
G'day Info, welcome to Apnea Board.
When you say "The AirCurve set itself to 10.9 and 7.0" do you mean that literally? I don't think the machine can set itself, though it will vary the pressure as required within pre-set ranges. Alternatively, has your doctor or DME adjusted the pressure remotely? If it was me I'd be unhappy about somebody changing my pressure without consulting me.
On the face of it, if the 8 / 4 was comfortable and giving good treatment on your previous machine, that would be a good place to start. However, it may be that you actually need the slightly higher pressure to control your apnea. You need to know what results you're getting in order to make an educated change, if a change is in fact required. You will get some basic data from Resmed's MyAir service. For a more detailed view, download and use either SleepyHead or ResScan. I'm not sure if Sleepyhead provides full bullet-proof functionality for the AirCurve series. ResScan does, but is (IMHO) an inferior product for end users.
You can also obtain the clinician's manual for your machine from this site. That will give you a better understanding of the detailed operation of the machine.
To obtain SleepyHead, go here: http://www.sleepfiles.com/SH2/
To obtain ResScan go here: http://www.apneaboard.com/forums/Thread-...hines-only
To obtain the manual, go here: http://www.apneaboard.com/adjust-cpap-pr...tup-manual
In relation to the manual, be sure to follow the instructions - there are hundreds of manuals available, and we need to make life easier for the elves.
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(01-01-2016, 07:55 PM)info Wrote: It was reasonably comfortable, however, small amounts of air are pumping into my stomach leaving me feeling a bit gaseous in the morning.
That is normal.
If it becomes painful, you may need to restrict the upper pressure limit to 10 or whatever. This would be expected to allow more obstructive events, allowing daytime sleepiness and fatigue, but some people find they need to do that in order to not be awakened by an uncomfortable amount of swallowed air (aerophagia).
If you reduce the upper pressure limit, I would suggest reducing Pressure Support an equal amount, in order to try to allow EPAP to still be able to reach 7, which you may need to avoid obstructive apneas and hypopneas.
In general, though, it is usually best to leave everything unchanged for a week or longer before considering an adjustment.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
01-01-2016, 11:24 PM
try increasing your ramp times .. my AirCurve 10 vauto has been very easy to get used to .. very gentle transitions
I am confused. Is the machine running in S mode or Auto mode? If it is running in S mode then the 10.9/7 would be IPAP/EPAP and there would be no PS setting. If, on the other hand, it is being operated in Auto mode, then the 10.9/7 might be max IPAP/min EPAP and the PS would be in question. It sounds to me like the DME set the Aircurve to S mode with the IPAP=10.9 and the EPAP=7.0 but I am not really sure.
(01-02-2016, 12:20 PM)PaytonA Wrote: I am confused. Is the machine running in S mode or Auto mode? If it is running in S mode then the 10.9/7 would be IPAP/EPAP and there would be no PS setting. If, on the other hand, it is being operated in Auto mode, then the 10.9/7 might be max IPAP/min EPAP and the PS would be in question. It sounds to me like the DME set the Aircurve to S mode with the IPAP=10.9 and the EPAP=7.0 but I am not really sure.
the first thing you need to do is go into clinical mode by pressing both home/round button down for a few seconds
second line down is mode: options will be .. Cpap .. S .. Vauto
scroll all the way down to options: switch essentials to plus. this will display a slew of info without going into clinical mode.
press home, then exit clinical mode. then scroll to sleep reports: all sorts of critical info is now displayed.
Aircurve 10 Vauto will auto titrate pressure settings in Vauto mode. but note it only auto titrates max ipap only. min ipap is determined by PS setting. for example Vauto determines 11.8 ipap or what ever is needed, with default PS setting of 4 .. you would get 11.8 ipap with 7.8 epap
PS controls pressure difference between ipap/epap.
another recommended tweak is to change Ti max settings. default is 2.0 seconds .. take a split second stop watch and time your max breathing cycles. this will reveal your baseline. then with default 2.0 seconds setting .. breath normally during rampup and observe if your breathing cycle length matches airflow coming out. you want to set Ti max to match your breathing cycle length.
I'm currently in the process of experimenting with changing PS settings to lower epap pressures to see if that stops air from getting pumped into stomach. Max ipap is current set at about 15% over max ipap set by Vauto. really don't want to set max pressure limits below vauto max ipap values.
02-01-2016, 05:27 PM
Now I am confused!!! I thought that in Vauto mode the machine adjusts the EPAP and the PS sets the IPAP to go with the machine set EPAP and this is all done to keep the EPAP and IPAP within the settings for Min EPAP and Max IPAP. As far as I know, the machine does not set the max IPAP. That setting must be made manually.
If you must set the Ti max, it is best to set it to allow the maximum time that your body will spend inhaling. It is meant to be a limit not an exact setting.
(02-01-2016, 05:27 PM)PaytonA Wrote: Now I am confused!!! I thought that in Vauto mode the machine adjusts the EPAP and the PS sets the IPAP to go with the machine set EPAP and this is all done to keep the EPAP and IPAP within the settings for Min EPAP and Max IPAP. As far as I know, the machine does not set the max IPAP. That setting must be made manually.
yup aircurve 10 vauto sure has a lot of settings ..
unlike Respironics BiPAP Auto which adjusts ipap and epap independently. Aircurve 10 vauto only adjusts ipap with epap determined by PS setting.
max ipap and min epap are set in clinical mode. which set limits Aircurve 10 operates within. example say max ipap is set to 19 with PS set to 4 .. but aircurve 10 determine only 11.8 is needed. then aircurve 10 vauto will operate at: ipap 11.8 / epap 7.8 .. PS sets the spread between ipap and epap. if PS is 4.0, then spread will be 4.0. if say you need epap to be higher or 8.8 in above example .. then PS needs to be changed to 3.
aircurve 10 vauto will track your Ti max and Ti min which is number of seconds your breathing cycle takes. during rampup if you will experiment with Ti max settings. you will notice air delivered during ipap will take longer or shorter. then Aircurve 10 Vauto is adjusting ipap duration to match natural breathing with Ti max setting limits. so aircurve 10 vauto allows pressure adjustment for ipap/epap and duration of ipap by changing Ti max settings.
behavior of Ti max settings were arrived at by increasing/decreasing Ti during rampup and tracking what Ti max actually changed.
02-02-2016, 07:43 PM
(02-02-2016, 03:59 AM)_cy_ Wrote: yup aircurve 10 vauto sure has a lot of settings ..
The Aircurve 10 Vauto sets the EPAP to splint the airway and the IPAP is then determined by IPAP=EPAP+PS.
(02-02-2016, 03:59 AM)_cy_ Wrote: aircurve 10 vauto will track your Ti max and Ti min which is number of seconds your breathing cycle takes. during rampup if you will experiment with Ti max settings. you will notice air delivered during ipap will take longer or shorter. then Aircurve 10 Vauto is adjusting ipap duration to match natural breathing with Ti max setting limits. so aircurve 10 vauto allows pressure adjustment for ipap/epap and duration of ipap by changing Ti max settings.
The Aircurve 10 Vauto does not change the Ti max or the Ti min. These are static settings which limit the amount of time for the user to cycle from IPAP to EPAP.
If the Ti min is set to 0.3 and the user starts to exhale 0.2 seconds after the the start of inhalation, the machine will remain in IPAP until the 0.3 second mark has been reached.
Conversely, if the Ti max is set at 2.0 and the user has not started to exhale 2.0 seconds after the beginning of the inhale, the machine will drop to the EPAP that the machine is currently using.
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