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Switch to AirSense VAuto for UARS/low AHI
#1
Switch to AirSense VAuto for UARS/low AHI
Hello all-
I have most recently been changed to a VAuto machine as I was not able to sleep with the APAP.  I have also recently undergone a seproplasty and turbibate reduction with the goal of improving my nasal breathing.

The sleep doctor sent in the following settings- I set it up and my ears feel like they’re about to pop - it’s way too high for me- I didn’t even try to sleep.

I reached out to the doctor but usually replies take forever so was wondering if there were some settings I should try.

I had completed a titration study 3 years ago where they said level of 6 is the optimal, however I never adjusted to the CPAP machine. I had RDI of 17 and AHI of 5.7.

Below are the settings set in my script:

Max iPap - 20
Min epap - 6
Ps - 4

I have the Airfit f30i mask.

Thank you all!
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#2
RE: Switch to AirSense VAuto for UARS/low AHI
We need to see some OSCAR charts to offer advise. Initially, the graphs we need to see are:  Events, Pressure, Flow Rate, Flow Limitation and the Leak Rate Graph.  Always include the entire left side bar, minus the calendar and pie graph.  

Set your display to the Standard view.  
(View > Reset Graphs > Standard)
Take a screenshot of your Daily screen.
   * For Windows or Linux: Use the F12 key
   * For a Mac: Use Fn+F12 or cmd-space-3

Your current settings are not high at all. It sounds like you are getting stressed by it when you need to do the exact opposite and relax to breathe with the machine. We all have been frustrated by the little beasties at some time, so it is completely understandable.

You can change the settings yourself, but without data it is impossible to offer more than generic advise. You can drop the pressure a bit, maybe something like

EPAP min 5
IPAP max 12
PS 3
No ramp
Trigger medium

But without seeing a recent OSCAR chart that is a SWAG…

Here are some general things to consider. We can help with tweaking things.

1. Pressure too low - even though you may have a great AHI, if the pressure is not enough for both IPAP and EPAP, you may feel like there is not enough air. A bit more pressure should help.

2. Pressure too high - too much IPAP and/or EPAP pressure may be uncomfortable. It takes time to adjust for some, whilst others cannot get used to it. Dropping pressure slowly to find the sweet spot where events are handled and it is comfortable will help.

3. Fighting the machine - when we first turn up the pressure it feels uncomfortable to breathe for some. Breathing with the machine, not against it, will be much more comfortable. Relax. Breathe normally. It should not feel like a struggle, but if it does it is likely you fighting the machine and not the machine fighting you.

4. Mask and headgear sizing - mask and headgear need to be the correct size for you. Even if they are masks just do not fit people the same way. Subtle variances in physiology make a big difference in comfort. You have to find the right mask for you, but there is no secret to it. Many of us try half a dozen or more masks before finding the right one at the correct size. Give it a chance, but do not struggle with a mask or headgear. 

5. Hose management - Find what works for you positioning the hose. Some like it in the air hanging down, others above their head, and still more that like it under the covers across their bodies. Find what works for you.
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