New User's First Post, Sleepy in GV's therapy thread

[Sleepy in GV]

Sleeping decently and feeling decent with these new changes?
If so...I would give things some time to see if this hold consistently enough to be a well established trend.

How we sleep and feel is just as important (if not more so) as nice low numbers and pretty graphs.
Nice low numbers and pretty graphs don't mean much if we sleep and feel like crap.

YES, sleeping decently and feeling great! So glad I raised the pressure. I’m going to hold steady for a week I think. Thank you for advising me to raise it to 7. !!

[Sleepy in GV]

Quick update on my therapy. I went up to 7.5, ahi went up, flow limits didn’t change much, leaks woke me up (partly because of mask cushion needing replacement). I held there for maybe 4 days and dropped it back to 7. Slept better.

I spoke to a respiratory therapist at my DME while at my functional pharmacist visit (he wanted me to mention my flow limits to the RT). The RT quickly had lots of questions about how in the world I knew, I went into sleepyhead software, he mostly discounted it not knowing anything about it. Long story short, he looked at my charts on his computer (not sleepyhead, but what he can download from my machine) and said I should be very pleased with my result, and though he didn’t recommend me changing my pressure on my own, he probably would have done the same thing after consulting with my doctor. He wanted to see sleepyhead charts and all I could do was enlarge my charts that I’d posted here on my phone. Next time I go down there, I’ll go better prepared. I think I should have explained to him that it calculates breath by breath algorithms to detect flow limits? How do I tell him the flow limits are real?

One other little update. Bought nasal pillow, tape, headgear, and once my current cold ends, I’m going to attempt nose breathing all night. I’m going to shoot for next weekend. I also bought an oximeter I’m going to try out soon.

Now for my current question. I came across a brand new ResMed AirCurve 10 VAuto with HumidAir for $500. Would I benefit from a bilevel? Should I buy it? Might my therapy be improved with a bilevel?

Thank you experts .

[palerider]

I think I should have explained to him that it calculates breath by breath algorithms to detect flow limits? How do I tell him the flow limits are real?

SH doesn't "it calculates breath by breath algorithms to detect flow limits?" it just reports what the *machine* determines based on the airflow changes as you breathe. The same data shows up in Resscan.

I came across a brand new ResMed AirCurve 10 VAuto with HumidAir for $500. Would I benefit from a bilevel? Should I buy it? Might my therapy be improved with a bilevel?

Would it be improved? maybe. would it be any worse? no. At worst, you'd have an awesome backup, or primary machine.

A bit more pressure support might lower the flow limitations you're having.

[Sleepy in GV]

[/quote]
Would it be improved? maybe. would it be any worse? no. At worst, you'd have an awesome backup, or primary machine.

A bit more pressure support might lower the flow limitations you're having.
[/
Thank you PR. You make a good point, having a good backup would be nice. I wouldn’t have to pack it all up for travel.

Well, I think I might try and buy it. I’ll need help setting up pressures. I know I’ll have good support here. The experts here can help with the bilevel pressure set up too?

Sorry about still not being able to cut/snip/quote properly. Don’t know what I’m doing wrong
Oh well, not going to worry about it.

[Pugsy]

When you want to just quote a portion of what someone says...
Open your reply box where you compose stuff
Scroll down to where the box of comments is that you want to quote and just highlight the text you want to include...then click on the little quote button on the forum editor.

Then you should see just something like this

Don’t know what I’m doing wrong

Use the preview button to see if it shows up like you want it to.

And yes...we can help you set up the bilevel machine to work like what you are using now if you wish. It's easy to do.

[Sleepy in GV]

[quote=Pugsy post_id=1289896

Use the preview button to see if it shows up like you want it to.

Trying that now... I think my problem was, I was just straight away hitting the quote button in the top right corner, then trying to delete what I did not want.

And yes...we can help you set up the bilevel machine to work like what you are using now if you wish. It's easy to do.

[/quote]

I think I did it! Ok, thank you for helping me set up the new machine. I’m going to try to meet the person to buy it tomorrow. Snowing today, so I don’t want to drive an hour to get it. Its been snowing mostly continuously for a week now. Getting very old!

[Sleepy in GV]

I got the machine. It is a ResMed AirCurve 10 Vauto w/ the letters S and ST also. There is an SD card in it, I don't really want to download that onto sleepyhead, is there a way to wipe it clean?

Anyway, I'm ready when you to get it set up. I am looking forward to feeling support on both the inhale and the exhale. My breath forms look so bizarre when I have those flow limits, almost like I'm hardly breathing at all. I think having this extra support of my airway as the breath goes in AND out will help. Do you need any additional information from me in order to get it setup? I'll be busy shoveling snow, but I"ll keep checking back often for directions on what to do next.

Thank you !!

P.S. I don't know if this matters, but my individual breaths often look like the "chair" or like hardly anything at all, like this example.

[Pugsy]

It is a ResMed AirCurve 10 Vauto w/ the letters S and ST also.

Can you confirm what it says on the front of the machine please?
It sounds like you are talking about what the manual covers.

[Sleepy in GV]

Can you confirm what it says on the front of the machine please?

Yes, Aircurve 10 Vauto (I had originally written what the manual said).

I was just able to look in the clinical portion of the unit, has 14 hours on it in the past year. Total of 5 days use. So the SD card probably has a little data on it.

[Pugsy]

You can manually erase the SD card if you wish. That's what I do when I get a used machine to make sure other people's stuff doesn't get mixed in with mine.

Also you can erase all past data on the machine in the setup menu...so the machine won't have anyone else's data in it.
Doing this might also erase the card...I never tested it though. I just got used to using my computer to manually remove any files and folders on any SD card.

Won't change run hours though...

Next to new machine...good deal on it.

Tell me what your current settings are and I will tell you how to match them on the VAuto.
Sometimes how EPR works and how PS works confuses people in terms of which setting to base it off of.

At some time if you want to play with PS some more...by all means play with it. Some people love it and some don't...another one of those YMMV things.

[Sleepy in GV]

My settings are 7-20 with an epr of 2. Do you need to know anything else? In the meantime, I’ll see if I can’t figure out how to erase the past data on the machine first. I just requested the setup manual from ApneaBoard, but of course it isn’t here yet.

What is PS?
Pugsy said:

At some time if you want to play with PS some more...by all means play with it. Some people love it and some don't...another one of those YMMV things.

[Sleepy in GV]

I managed to erase the data on the machine and I restored factory defaults.

[Pugsy]

PS is pressure support or just the difference between inhale and exhale.

When you use EPR set to 2 you are creating a bilevel situation ...2 cm difference between inhale and exhale..
EPR is essentially pressure support but called exhale pressure relief.
EPR comes off/is subtracted the inhale pressure setting to get the exhale pressure.

PS is added to minimum EPAP to get the inhale pressure.

With APAP machine...7 minimum and EPR of 2 you are using 7 cm on inhale and 5 cm on exhale.
If the machine goes up...it's always going to have that 2 cm difference. If it get up to 12 on inhale...exhale will be 10.

To get the same function out of the Bilevel auto machine...Auto mode
Minimum EPAP 5
PS 2
and you can set the max IPAP at 20 or 25...doesn't matter really. The machine will only go where it feels it needs to go for a good reason. We can limit it if needed due to centrals popping up or aerophagia issues.

With minimum EPAP at 5 and PS of 2...on inhale (IPAP) you will have the 7 that you had on the APAP inhale and 5 EPAP/Exhale that you had with EPR of 2.
Going to feel pretty much the same except that the timing might seem a bit different and if that is the case you can tweak the timing (those ti min and max and response settings).

[Sleepy in GV]

Ok, set all that. It is defaulting to
Ti Max 2.0s
TiMin 0.3s
Does that seem reasonable? Or should I change it? I have no idea...
Also, what about Trigger? Set to Medium but has five options from very low to very high.
Cycle? Also set to medium with same options as trigger.
Tube? I have the heated tube. Options say slimline, standard, and 3m.

Thank you! I can’t wait to go to bed !

[Pugsy]

When you actually attach the heated hose/tube the machine will recognize it and default to the heated hose appropriate setting.
If the heated hose isn't attached you won't see that option until you actually attach the hose.

All those other settings you mentioned are related to the timing between inhale and exhale. If you feel the machine is rushing you to breathe at a different rate or not keeping up with your own rate of breathing those settings let you tweak the timing to best match your own respiration rate. Right now they are set on the factory defaults which is what is comfortable for "most" people.

Palerider can actually explain those settings better than I can because he actually changed some things to better suit his respiration rate and pattern.
Me...I never messed with them because I like the defaults just fine. So I didn't mess with them much.
Start with the factory defaults and then go from there is what I usually suggest to people. There's a real good chance they will work out just fine.

Did you get the user manual or the provider/clinical manual.
If you don't have the clinical manual go here and get it. It's got more good stuff in it than the user manual.
https://www.apneaboard.com/adjust-cpap- ... tup-manual