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AirCurve Vauto 10 ramp question - Printable Version

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AirCurve Vauto 10 ramp question - Cpap626 - 03-22-2021

On my Phillips machine I could set the ramp pressure to 6.5cm for 30 mins before it would slowly go up to the min of 9cm so i could fall asleep with less pressure. I am having trouble with the AirCurve Vauto, in Vauto mode I have PS 4 and EPAP 6. If i understand this correctly my min IPAP should be 10cm. When I go to adjust the ramp pressure all I can go to is EPAP of 4 or 5, when the ramp in enabled the pressure still goes up to 10 and back down to 5. Can I adjust the ramp to lets say 6 until the 30 min ramp time is done like the phillips? 

Thanks


RE: AirCurve Vauto 10 ramp question - Sleeprider - 03-22-2021

The pressure support on the Vauto is constant at whatever setting you apply, so if your PS is 4.0, the lowest possible pressure is 8.0/4.0. That should still be perceived as a lower pressure that the constant 8.0 pressure. If you need more time to adapt to using pressure support, you can simply reduce pressure support to 3 and it will be applied at ramp and therapy allowing a pressure of 7.0/4.0. Your machine also has a CPAP mode that uses EPR which can be set to 1, 2 or 3. The ramp can be set lower with CPAP mode, but the final pressure is fixed, not autoset.

You have never posted a graph that I'm aware of, so we really don't know what your therapy looks like or what your need for PS 4.0 is.


RE: AirCurve Vauto 10 ramp question - Cpap626 - 03-22-2021

I have an dreamstation apap but i am trying the resmed AirCurve vauto that i have not been using. Usually, right now i have epap of 5 and ps of 4 making it 10 as the min pressure on inhale. I am a little confused how the ramp setting only has an epap selection of 4 and 5. I wish it was a little lighter starting out so i can be asleep before it ramps up to regular pressure. Here is last nights graph, i was thinking of raising the epap to 6 to see if it would take out some of the OSA's. What do you think? 

[attachment=30978]


RE: AirCurve Vauto 10 ramp question - Sleeprider - 03-22-2021

The minimum pressure any of the mainstream CPAPs and VPAPs produce is 4.0 cm, including your Dreamstation, so with ramp on, the lowest possible pressure is 4.0 + PS 4.0. If you still find that uncomfortable then lower the PS setting. You don't appear to have flow limitations and a lower PS is certainly okay. I think aside from ramp you need a higher EPAP min to resolve the OA events, however you may be momentarily tucking your chin causing these events. Your pressure never gets above 12, so you don't need that 20 maximum pressure.

On your graphs, we don't need the AHI graph. Something like flow limit is more useful.


RE: AirCurve Vauto 10 ramp question - Cpap626 - 03-22-2021

Hi Sleeprider, 

I am trying to make it like an auto cpap, if i reduce the ps won't it be tougher to exhale? I am hoping i can dial it down to 6cm total for the 30 mins of ramp time then it can go to 10cm min and 4 PS, I am still a total newbie at this. I have a dreamstation that i like but I got the AirCurve for a deal and hoping i can use it like the dreamstation apap at 3 epr. The resmed seems to respond faster to events. I was thinking of increasing the epap to 6, what do you think by looking at this chart? 

[attachment=30986]


Here is my chart from the previous night 

[attachment=30987]


RE: AirCurve Vauto 10 ramp question - SarcasticDave94 - 03-22-2021

I think your goal of making a VAuto act like an APAP, given that you're used to a DreamStation APAP, is the wrong goal and will disappoint. Personally, I'd make the VAuto act like a VAuto.

Set your EPAP at 6, edit PS to 3 for now. Set Max IPAP to 14 or so as you don't touch higher than 12 as is.

I do think your Min pressure is showing not to be high enough with Obstructive events getting past the VAuto.

And you must work on leak control. ResMed leak rate redlines at 24 L/min and yours Maxes higher, sometimes over 27. It may be disrupting you, and it's definitely hindering Apnea treatment.


RE: AirCurve Vauto 10 ramp question - Cpap626 - 03-22-2021

Thanks! I will give that a try tonight! I really appricate it!


RE: AirCurve Vauto 10 ramp question - Cpap626 - 03-23-2021

Here is my data from last night. I upped the Epap to 6 and ps to 3. When you talk about leak control how do i do that? I am using the p-10 pillow system. 

[attachment=31009]


RE: AirCurve Vauto 10 ramp question - SarcasticDave94 - 03-23-2021

OK, if I've got the chart reading right on leaks, the sharp pointed looking areas on your leak graph are mask leaks which could be the mask being moved or not sealing correctly. I'd suggest reviewing proper adjusting.

Then the other, rounded and long leak sections are mouth leaks. That most likely means your mouth is opening or air is leaking past your tongue and lips. In this case, you may need to review the tongue suck method which is a refresher on getting your tongue to stay in the natural sealed position it automatically is in while awake. Or you may need the support of a chin strap to keep the mouth closed. Or consider mouth taping.


RE: AirCurve Vauto 10 ramp question - Sleeprider - 03-23-2021

I'm seeing distinct signs of chin-tucking as the OA events cluster in several place and arise out of no flow limitation or breathing resistance. Make sure your pillow does not cause your head to tilt forward or sharply to the side when sleeping on your side. Obstruction from flexing the airway is very common. I actually think leaks are acceptable here.