Please help me fine-tune my dad's Vauto settings

[nimboo]

Hey guys,

So my dad has started using his new Resmed Aircurve 10 Vauto, with great success. He is waking up greatly refreshed in the mornings.

Here is an album with my dad's Sleepyhead graphs for the first 5 days of use: http://imgur.com/a/lDCc1

I don't know much about Sleepyhead, though I've read quite a bit about it.

We started him out at an epap min of 6, but as I watched him fall asleep the first couple nights, I noticed that as soon as he fell asleep he stopped breathing. I figured this was because the air stint collapsed, so for the third day I raised his epapmin to 7, and it seemed to help (I also noticed the machine had to raise his epapmin anyway several times). I noticed that the graph looked much more even for the last two days, as opposed to the constant ups and downs of the first couple days.

Please tell me about anything else you see - he has several Clear Airway events, but I read that when these happen in clusters it is either when he is falling asleep (and that's what I was seeing), or has to do with leaks (and some of them correlate to leaks).

I included a photo of the mask he is using now because I'd like advice on a new one. He believes this is a Large Nasal mask, but as he has a large Italian nose, he feels it presses on the sides of his nose sometimes, and this isn't good because he has a deviated septum. What do you think we should do about that? Full face mask? Better Nasal mask? His current one is 12 years old and is in disrepair

Thanks guys,
AJ

[palerider]

arranging the charts like this will convey more helpful information:
https://sleep.tnet.com/resources/sleepyhead/shorganize

[robysue]

nimboo,

What's the PS setting for your dad's VPAP Auto?

You write:

We started him out at an epap min of 6, but as I watched him fall asleep the first couple nights, I noticed that as soon as he fell asleep he stopped breathing. I figured this was because the air stint collapsed, so for the third day I raised his epapmin to 7, and it seemed to help (I also noticed the machine had to raise his epapmin anyway several times). I noticed that the graph looked much more even for the last two days, as opposed to the constant ups and downs of the first couple days.

It looks like he started actually sleeping with the mask once you raised the min EPAP to 7.

The data looks quite good. I think you probably ought to leave the settings where they are for the next week or so. That will let him really get used to sleeping with the machine. And see if his AHI continues to look as good as it has on these last two nights. If the data still looks this good after a week or so, I'd say that you've pretty much found the sweet spot.

Please tell me about anything else you see - he has several Clear Airway events, but I read that when these happen in clusters it is either when he is falling asleep (and that's what I was seeing), or has to do with leaks (and some of them correlate to leaks).

As long as the clusters of CAs happen when he's falling asleep, they're probably nothing to worry about. I'd keep an eye on them and if they start to get worse (as in a lot worse), then I'd consider whether something needs to be done.

If the clusters continue or if your dad starts waking up feeling unrested, then it may be worth playing around with the PS setting. But whether to increase or decrease it is hard to say. And at this point, I'd leave the PS setting alone, because the data looks pretty close to optimal on the last two nights.

I included a photo of the mask he is using now because I'd like advice on a new one. He believes this is a Large Nasal mask, but as he has a large Italian nose, he feels it presses on the sides of his nose sometimes, and this isn't good because he has a deviated septum. What do you think we should do about that? Full face mask? Better Nasal mask? His current one is 12 years old and is in disrepair

He needs a new mask.

If I were you, I'd take him to a DME and have him try on a variety of masks. Masks are funny things and what really fits Person A's nose can be an awful mask for Person B. And vice versa.

Be aware, however, that in order to buy a new mask, your dad will need a script. His PCP can write the script. It should say something like "CPAP mask of patient's choice".

[nimboo]

Sure thing, Palerider: http://imgur.com/a/HP2fK

I was hoping there was a guide for that around, I wasn't sure which charts were the most helpful.

Thank you for that

Thanks for the advice, Robysue. The PS is 3.

Glad to hear the 7 was a good move. Going to a DME is a good idea, he'd like to try them on ahead of time. We purchased a Nuance from amazon that we ended up needing to return (they didn't form a good seal, and the direct airflow didn't agree with him).

Thanks guys