switched from Dreamstation to aircurve 10 VAUTO...settings aren't working

[dpolitzer]

Hi folks,
I purchased the Aircurve back in Sept...used it for a few weeks and then went back to the dreamstation as I just couldn't find the good sleep I had on the DS. I have some OSCAR data but am unsure what files I need to upload...please let me know and I hope the gurus here can help.
Thanks,
David

[staceyburke]

The charts needed are in my signature on organizing charts. It also tells you about OSCAR.

[dpolitzer]

Hi folks,

I'm trying to switch from the Dreamstation Bipap to the Aircurve 10 Vauto due to the foam issue...I tried in Sept but could not get it right...During the ramp phase (I do this since I get into bed with an ipad for about 30 min) it was not as comfortable as the DS...I felt that normal breathing was harder on the Aircurve and I had to make the mask extremely tight vs the DS. Also I never really felt great the next day...always felt as if I was in another dimension and rarely in a positive mood.

The settings that work perfectly on my Dreamstation are:

AutoB
Ipap 25
Epap 4
PS 2-8
Flex 2
Ramp 30

Please see the screenshots of OSCAR for a few nights back in Sept and lend me your thoughts...
Thanks in advance,
David

[SarcasticDave94]

I would think you're going to need pressures other than default wide open like 4-25 on the ResMed, even much more on Philips since they are slow responders. The therapy on VAuto seems ok but could always have more consistent leaks control.

Ramp shouldn't be necessary with low starting pressures. Trying to lock a Ramp of 4 for 20 minutes costs you that same 20 minutes of minimal therapy every time you start therapy on ResMed. There's no dedicated Ramp button here.

[Sleeprider]

What were your settings on the Dreamstation CPAP? My impression of your therapy on the Vauto is that your you need settings of EPAP min 8.0, IPAP max 14.0 and PS 3. This will stabilize pressure, prevent more events and allow less disrupted sleep.

[dpolitzer]

The dream station was a Bipap version and the settings were:

AutoB
Ipap 25
Epap 4
PS 2-8
Flex 2
Ramp 30

The epap min of 8 would be too high to be comfortable with as I try to fall asleep.

Based on the Oscar data are you seeing any red flags/issues? As mentioned in my original post I gave up on the Aircurve because I wasn't feeling good the next day..

[Sleeprider]

Do you have a chart of the Dreamstation you would consider typical? You were using variable pressure support, and a wide range of pressure. I'd like to try to compare events and pressure to see what is there.

[dpolitzer]

Thanks, attached are 3 recent nights with the Dreamstation

[Sleeprider]

Your AHI and event rate is noticeably lower on the Resmed Vauto, but pressures are considerably higher. It is hard to imagine that AHI ranging from 6.8 to 11.2 is more restful than 06 to 3.3! Your 95% pressure on the Philips examples posted never exceed 9.2 cm-H2O, while with the Resmed, the 95% IPAP pressure is 11.5 to 15.2. Pressure support rarely gets above 3 on the Philips and is frequently near 2-cm. I can only speculate on why you find therapy on the Resmed more disruptive to sleep in spite of fewer events, but it seems logical that lower pressure is going to help. Based on what I'm seeing on these charts and inferring what you find more comfortable, I think setting lower pressure and accepting a higher event rate might work on the Resmed. If you want to give this a try, let's set EPAP min at 4.0, IPAP max pressure at 9.0 and PS 2.4. All we can do is try this and get your input. Try to relate what you find disruptive and we can work on small changes to hopefully improve it.

[dpolitzer]

Sounds good...I'll try that. Do I need to do anything with the other settings on the aircurve e.g. trigger sensitivity