ResMed AirCurve 10 VAuto - Can it function like an Airsense Autoset APAP?

[Fetou]

I just recently sold a VAuto unit to a board member here and I made an error when interpreting the clinicians manual. I saw the 4-20cm in the chart w/ EPR capabilities and improperly interpreted that it was a range setting instead of a fixed pressure setting. My answer to his inquiry was therefore incorrect despite actually owning and using the VAuto myself.

Is there any difference whatsoever between a VAuto running in VAuto mode with a pressure support setting of 3cm and a max pressure of 20cm vs a ResMed AirSense 10 Autoset running in APAP mode with an EPR of 3? My understanding is that EPR and pressure support are the exact same thing in ResMed terminology, with EPR up to 3 being a limited range bi-level pressure support feature available on regular APAPs. The VAuto then simply extends the EPR range beyond 3 to higher levels of pressure support.

The user purchased with the intent of being able to compare standard APAP functionality with bi-level functionality, to have maximum flexibility in adjusting settings. I still think that this is the case within the VAuto mode, despite the CPAP mode being basically a pointless fixed pressure option. Obviously if this is not the case, I will have to make the buyer whole for my error here. Thanks.

[Pugsy]

Using 3 EPR is the same as using 3 PS.

The difference where you start with the pressures to make the VAuto function like the Autoset.

Example...EPR on the AutoSet comes off the minimum pressure setting.
Using the VAuto you add PS to the minimum EPAP setting.

I am currently using the AutoSet at 7 minimum with 3 EPR... so on inhale I get 7 IPAP and on exhale I get 4 EPAP.
If I wanted to use the VAuto and have it function and feel like the AutoSet I would set minimum EPAP of 4 and PS of 3 and then I would have the IPAP of 7 I am getting with the AutoSet.

Maximum doesn't matter.

So there's no issue making the VAuto function like the AutoSet once you understand that with the VAuto you start working with EPAP and then add PS...
with the AutoSet you start working with IPAP and use EPR reduction to get EPAP.

Shouldn't be a problem at all.

[palerider]

I just recently sold a VAuto unit to a board member here and I made an error when interpreting the clinicians manual. I saw the 4-20cm in the chart w/ EPR capabilities and improperly interpreted that it was a range setting instead of a fixed pressure setting. My answer to his inquiry was therefore incorrect despite actually owning and using the VAuto myself.

I don't understand what you're saying.

Is there any difference whatsoever between a VAuto running in VAuto mode with a pressure support setting of 3cm and a max pressure of 20cm vs a ResMed AirSense 10 Autoset running in APAP mode with an EPR of 3? My understanding is that EPR and pressure support are the exact same thing in ResMed terminology, with EPR up to 3 being a limited range bi-level pressure support feature available on regular APAPs. The VAuto then simply extends the EPR range beyond 3 to higher levels of pressure support.

The only difference is that EPR is a pressure DROP, and PS is a pressure INCREASE. However, they function the same. There is no effective difference between an autoset with a min15, epr 3, and a vauto with minepap 12, ps 3. The waveforms, and pressure changes are the same:

[cpapbro]

So I am the buyer in this scenario. I just got diagnosed and posted my noob thread a few days ago.

my prescription was for apap with range 7-10 wtih EPR 3

Since I don't really want to deal with the the PIA sleep center, my plan was to get a airsense autoset and just start with the prescription and dial it in.

I was reading around different models and hearing people rave about using the vauto even if not diagnosed with bipap, that adjusting the exhale pressure allows for more comfort, so I was interested in this, but haven't slept with any pap at all. So I was talking with fetou about an autoset 10 he had for sale and he mentioned the vauto, so not really understanding how regular cpap prescribed people are using bipap to dial in better results I asked about using the vauto as an apap so I could just use my prescried settings and maybe have the option of messingwith bipap configs as I got my bearings, and as he stated he said it was an option in the menu but i just got it today and was dismayed to see the only oopitnos were cpap, S, and vauto and I don't know where to set it to make it behave like an apap 7min 10 max with epr 3.

but reading palerider's post I should be able to set vauto mode with epap set to 12 and ipap set to 15? is that correct?

Also does vauto have the same algorithm for adjusting if you have events?

[Fetou]

I just recently sold a VAuto unit to a board member here and I made an error when interpreting the clinicians manual. I saw the 4-20cm in the chart w/ EPR capabilities and improperly interpreted that it was a range setting instead of a fixed pressure setting. My answer to his inquiry was therefore incorrect despite actually owning and using the VAuto myself.

I don't understand what you're saying.

Sorry. Buyer was considering the AirSense 10 Autoset vs. AirCurve 10 Vauto I had available and I explained that the bi-level has added pressure support/relief capability. I stated that he could try an Autoset with the EPR of 3 and then if more P/S was desired, he could sell and buy a bi-level. Or conversely, he could buy the VAuto and then if it turned out that the extra P/S wasn't desired, he could sell that and downgrade to an Autoset. In other words, the VAuto can do everything exactly like the Autoset can, but it can do extra things as well.

He then asked me to clarify if I meant that the VAuto set to APAP mode would be the same as the Autoset. I knew the VAuto had a mode where the max pressure support was via EPR of 3, and the range was lowered from 4-25cm to 4-20cm max, like an Autoset. I mistakenly confirmed to him that yes, you can set it to the other mode and it will be just like an Autoset. Not true, the CPAP mode is fixed pressure only, like the S mode but without the extra P/S capability or additional timing options.

So I think the situation here is that although I gave a wrong answer regarding the mode options, but the actual premise is still exactly the same, the VAuto can do everything exactly like an Autoset, and it can also do more.

The only difference is that EPR is a pressure DROP, and PS is a pressure INCREASE. However, they function the same. There is no effective difference between an autoset with a min15, epr 3, and a vauto with minepap 12, ps 3. The waveforms, and pressure changes are the same:

Thank you for confirming. I understood this to be true in essence, but I misled the buyer in the form of how it is achieved. I'll direct him to this thread.

EDIT: Nevermind, I see he has found the thread!

[Pugsy]

my prescription was for apap with range 7-10 wtih EPR 3

In the AutoSet.....the setting for this RX would be 7 minimum...10 maximum....EPR set to 3.
When you first start the night you will experience 7 inhale (IPAP) and 4 exhale (EPAP) and the highest it could go is 10 IPAP which would give you 7 EPAP if it went to 10.

If you wanted the exact same settings on the bilevel you would set
EPAP minimum at 4
PS of 3
IPAP max of 10.
When you first start the night you would have inhale at 7 and exhale at 4...which is what the above RX would give you if you were using the AutoSet.

but reading palerider's post I should be able to set vauto mode with epap set to 12 and ipap set to 15? is that correct?

You could but it is no where near what the RX would be. Way more than the RX calls for.
The 12 EPAP is a LOT higher that what you would experience on the AutoSet.

What I would suggest is this if you want to come close to what the RX settings were for the AutoSet but give the machine a little bit of room to roam if it needs to
EPAP minimum 4
PS 3
IPAP max of 20....when first starting the night you will have 7 inhale and 4 exhale and should be quite comfortable.
If the machine needs to go higher it will but it won't go anywhere without a good reason.
Use it one night and then evaluate the software reports and see if some minor adjustments need to be made.

Since you are brand new to cpap therapy I don't advise 12 EPAP with PS of 3 giving you IPAP of 15...it's not going to be all that comfortable and you may not need anything near that pressure.

[Fetou]

So I am the buyer in this scenario. I just got diagnosed and posted my noob thread a few days ago.

my prescription was for apap with range 7-10 wtih EPR 3

Since I don't really want to deal with the the PIA sleep center, my plan was to get a airsense autoset and just start with the prescription and dial it in.

I was reading around different models and hearing people rave about using the vauto even if not diagnosed with bipap, that adjusting the exhale pressure allows for more comfort, so I was interested in this, but haven't slept with any pap at all. So I was talking with fetou about an autoset 10 he had for sale and he mentioned the vauto, so not really understanding how regular cpap prescribed people are using bipap to dial in better results I asked about using the vauto as an apap so I could just use my prescried settings and maybe have the option of messingwith bipap configs as I got my bearings, and as he stated he said it was an option in the menu but i just got it today and was dismayed to see the only oopitnos were cpap, S, and vauto and I don't know where to set it to make it behave like an apap 7min 10 max with epr 3.

but reading palerider's post I should be able to set vauto mode with epap set to 12 and ipap set to 15? is that correct?

Also does vauto have the same algorithm for adjusting if you have events?

Based on my experiences with my own settings and your prescription numbers, I would start with minimum EPAP of 4, pressure support of 3, and a max IPAP of 25. See what kind of results you get and adjust the minimum from there. Based on your experience with the pressure support of 3, consider trying a pressure support of 4 to see if you prefer the lower exhalation pressure (decrease minimum EPAP by one if you want to keep the same IPAP for comparison purposes)

EDIT: Pugsy seems to agree with my initial settings other than the max IPAP. Go with her suggestion of 20. There's a very good chance it won't make a difference.


I do sincerely apologize for the bad info on the CPAP mode. I too hastily checked the chart on the manual, saw the 4-20cm range that I had expected, and mistakenly confirmed my incorrect notion that it was an auto mode from 4-20. It does state nearby that it is fixed pressure in that mode: https://www.oxystore.it/Brochures/37826 ... ow_eng.pdf (pdf page 17) Fortunately, the same goal is achievable within the VAuto mode itself.

[Pugsy]

Given a choice between the ResMed AirSense 10 AutoSet and the AirCurve 10 VAuto I would take the AirCurve any day of the week as my first choice.
You can indeed make it function just like the AutoSet once you understand how EPR is removed from IPAP and PS is added to EPAP to obtain same results. It's the beauty of the VAuto plus you get EasyBreathe technology which makes the transition from inhale to exhale smoother than the transition when using EPR. It just feels better for most people. There are some outliers that don't like EasyBreathe but they are in a very tiny minority.

If you don't like it...I got an AirSense 10 AutoSet I would happily swap with you.

[palerider]

So I am the buyer in this scenario. I just got diagnosed and posted my noob thread a few days ago.

my prescription was for apap with range 7-10 wtih EPR 3

Since I don't really want to deal with the the PIA sleep center, my plan was to get a airsense autoset and just start with the prescription and dial it in.

I was reading around different models and hearing people rave about using the vauto even if not diagnosed with bipap, that adjusting the exhale pressure allows for more comfort, so I was interested in this, but haven't slept with any pap at all. So I was talking with fetou about an autoset 10 he had for sale and he mentioned the vauto, so not really understanding how regular cpap prescribed people are using bipap to dial in better results I asked about using the vauto as an apap so I could just use my prescried settings and maybe have the option of messingwith bipap configs as I got my bearings, and as he stated he said it was an option in the menu but i just got it today and was dismayed to see the only oopitnos were cpap, S, and vauto and I don't know where to set it to make it behave like an apap 7min 10 max with epr 3.

but reading palerider's post I should be able to set vauto mode with epap set to 12 and ipap set to 15? is that correct?

Also does vauto have the same algorithm for adjusting if you have events?

You're in the exact same position I was... I wanted an autoset, and I came across a vauto for a great price... not a single regret.

The vauto is like an autoset on steroids, all the same great features AND MORE!

If you were told to get an apap with 7-10 EPR 3 (which is kinda dumb, in my estimation), then you'd set your vauto to
mode: vauto, MinEPAP 4, PS3, maxipap 10.

However, I think that's a *dumb* setting. the max is too low, the min is too low, it's just too low all around.

I suggest minepap 6, ps 3, maxipap 25. (just leave it at defaults).

[palerider]

Buyer was considering the AirSense 10 Autoset vs. AirCurve 10 Vauto I had available and I explained that the bi-level has added pressure support/relief capability. I stated that he could try an Autoset with the EPR of 3 and then if more P/S was desired, he could sell and buy a bi-level. Or conversely, he could buy the VAuto and then if it turned out that the extra P/S wasn't desired, he could sell that and downgrade to an Autoset. In other words, the VAuto can do everything exactly like the Autoset can, but it can do extra things as well.

This is correct.

He then asked me to clarify if I meant that the VAuto set to APAP mode would be the same as the Autoset. I knew the VAuto had a mode where the max pressure support was via EPR of 3, and the range was lowered from 4-25cm to 4-20cm max, like an Autoset. I mistakenly confirmed to him that yes, you can set it to the other mode and it will be just like an Autoset. Not true, the CPAP mode is fixed pressure only, like the S mode but without the extra P/S capability or additional timing options.

It has to be set to vauto mode, then it's settings can be adjusted so as to mimic the autoset.

The CPAP mode is just that, cpap. not apap. The VAUTO does CPAP, S and VAUTO mode, and can *act like* an autoset when in vauto mode.

So I think the situation here is that although I gave a wrong answer regarding the mode options, but the actual premise is still exactly the same, the VAuto can do everything exactly like an Autoset, and it can also do more.

Yes.

[Pugsy]

However, I think that's a *dumb* setting. the max is too low, the min is too low, it's just too low all around.

So you think my AutoSet setting of 7 with EPR at 3 is "dumb" and if I wanted to use similar on the VAuto with EPAP 4 , PS of 3 and max IPAP whatever is a "dumb" idea too. It's what I used for years when I used the S9 VPAP Auto.

You know it can work just great sometimes...those dumb low settings.

Now if we were talking about the slow as molasses Respironics bilevel response time...probably not a good starting point but the quicker response of ResMed lets us get by the lower pressures quite often.

Now if you were talking about the RX of 7 min max of 10 EPR of 3....I tend to agree with you but you know he might never have even hit that 10 cm mark anyway.

[cpapbro]

Thanks everyone. This gives me a starting point then with vauto. I'll get a little data and post here. and I guess I'll only ask for a 50% refund from fetou

[Pugsy]

Oh shoot...I was hoping you would swap with me.

Think of the AirCurve 10 VAuto as a Lexus with all the extra goodies to make it extra nice...and the AutoSet as the more base model Lexus.

[cpapbro]

why would you guys suggest the higher ipap of like say 20.

is it just to let the algorithm keep jacking me up if I have events?

I set it for ipap 20, epap min 4, and ps4. I just laid in bed and sat with it on for like 30 minutes just to experience it. after the 20 minute ramp, it was going up to 13 with the exhale dropping down to 9, why does it keep increasing? while i was laying there it felt like a lot of pressure. is it just going to increase up to 20? when does it stop?

[palerider]

However, I think that's a *dumb* setting. the max is too low, the min is too low, it's just too low all around.

So you think my AutoSet setting of 7 with EPR at 3 is "dumb" and if I wanted to use similar on the VAuto with EPAP 4 , PS of 3 and max IPAP whatever is a "dumb" idea too. It's what I used for years when I used the S9 VPAP Auto.

You know it can work just great sometimes...those dumb low settings.

Now if we were talking about the slow as molasses Respironics bilevel response time...probably not a good starting point but the quicker response of ResMed lets us get by the lower pressures quite often.

Now if you were talking about the RX of 7 min max of 10 EPR of 3....I tend to agree with you but you know he might never have even hit that 10 cm mark anyway.

Well, in ALL FAIRNESS... *cough* I posted that before I read what you said... at least you didn't suggest leaving the max at 10.

But, really, an epap of 4 is too low for most people, and many don't feel comfortable.