Translating from M Series Auto Bipap to AirCurve 10 VAuto

[dtremit]

Hi all -- long time lurker and (almost) first time poster.

After a lengthy fight with bureaucracy, I have just gotten a ResMed AirCurve 10 VAuto to replace my aged (9 years, 23000+ hours) Respironics M Series Auto Bipap. It seems like the AirCurve is a good machine, and I'm really looking forward to using SleepyHead with the data.

Unfortunately, the tech who delivered it doesn't seem to have configured it properly. My prescription was for 25/10, which matches the settings on my old machine. However, the tech left the thing in S mode rather than setting it to VAuto. What followed last night was about two hours of half-asleep discomfort at an IPAP of 25 -- I thought maybe the machine needed to learn? -- followed by a lot of research while the aerophagia wore off.

I was able to switch the ResMed into VAuto, but am not certain I am getting the other settings right. And while I'll be reaching out to my doctor, I haven't had a sleep study or a titration since I got my previous machine -- so I suspect more definitive answers will be a little slow in coming. In the meantime I'd like to get as close as I can to my previous machine's behavior.

I checked the settings on my M Series and they are as follows:

• Max IPAP: 25.0
• Min EPAP: 10.0
• Max Press Sup: 8.0
• BiFlex Setting: 1

The old machine also reports the following 30 day statistics:

• 90% pressure: 13.9/10.1
• Apn-Hyp Index: 1.1

I think I understand correctly that the pressure support on the ResMed machines works rather differently from the Respironics; the ResMed adjusts EPAP and sets the IPAP a fixed interval above it, whereas the Respironics sets a maximum differential and floats both IPAP and EPAP independently. Based on the statistics, it doesn't look like the Respironics got anywhere near that maximum pressure support of 8 in practice.

Given all that -- I am inclined to set the ResMed to max IPAP of 25, min EPAP of 10, and SP of 4 for the time being. Does that seem reasonable?

Thanks in advance for the assistance!

[Pugsy]

I am inclined to set the ResMed to max IPAP of 25, min EPAP of 10, and PS of 4 for the time being. Does that seem reasonable?

Very reasonable starting point. ResMed machines don't have a variable PS like the Respironics machines had.
With your M Series bipap in auto mode you started out with the default PS of 2 that you couldn't change as it was a hidden default and it could have gone up to 8 cm PS max but most likely it never did. Models after the M series would let a person set a minimum and max PS but that only came about on the 60 series and newer.

The setting of 4 PS is a commonly used setting...should be quite comfortable for you.
Whatever you do don't go above 6 PS without careful watching on your software reports. For some people (relatively very small number of people) when they use higher PS numbers it can trigger centrals.
PS of 4 or 5....the most commonly used settings.

Welcome to the forum.

[Pugsy]

I predict you will really like the AirCurve 10 VAuto.
I assume you know how to get into the clinical setup menu area where you can change the pressure settings.

Go here and request the clinical/provider manual if you don't have it. Not only does it explain how to get to the setup menu are but it has some really useful information in it that the user manual doesn't have.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

I have actually used both brands of bilevel machines including one Respironics that had the hidden default minimum of 2 cm PS.
I much preferred the ResMed even with the fixed PS. It's a smoother transition and you can customize the timing of the inhale/exhale change if you wish and it's quieter.

Your idea of
Auto mode
10 Minimum EPAP
PS of 4
Max IPAP of 25
is where I would start if it were me making the change you are making from Respironics to ResMed bilevel auto.

[dtremit]

Thanks so much for the quick response, and for the gut check! I really appreciate it.

I was able to get into the clinical setup menu, yes -- will check out the clinical manual as well.

I ended up calling in this morning to get a few hours' nap -- with the resmed set to auto 25/10/4 it worked pretty well.

The only exception was that I found the auto setting kept spiking to 22/25 for no apparent reason. Eventually realized that I had knocked the ResMed sideways and our cell phone organizer was mostly blocking the intake. It seems to register that as an event! I see some small plastic bumpers in the device's future.

Will start digging into SleepyHead today -- so nice to have a standard SD card and community written software. Ten years ago the only option was a scavenger hunt for a surplus card reader and pirated software.

[palerider]

Pugsy's handled the important bit's, I'll just make one comment:

It seems like the AirCurve is a good machine,

That's incorrect, the AC10 vauto isn't a good machine... it's a GREAT machine.