zonker therapy thread redux: in the arms of morpheus

[zonker]

thanks to forum friend fithavenue, i have a used resmed aircurve vauto heading my way!

when it shows up in a few days, i would like help in getting it setup. currently, my "for her" is set with a min pressure of 18.4 and max pressure of 20. i also have it set with an epr of 2. and i don't know if this amounts to a hill of beans, but i have selected soft response.

what should my settings be on the vauto?

i am curious to see how i feel under the vauto therapy. my ahi is currently very good at always under 1 with an occasional 0 thrown in. often i get .11 or .22. so i'm really not looking for straight zeroes though i won't be unhappy to have that!

mostly i'm concerned about comfort at this stage of my life. and i'm still trying to keep myself from those multiple awakenings that have been with me since, well, forever.

so i'll see how it goes. if it doesn't really improve anything, i will set it up to mimic my apap and have one hell of a backup machine.

tia!

[Pugsy]

So what you do is translate the Autoset settings into bilevel settings.

With the minimum set to 18.4 and using EPR set to 2 that means during inhale (IPAP) you are getting 18.4 cm and on exhale (EPAP) you are dropping to 16.4 cm because of the 2 cm drop that EPR brings.

You won't have an EPR setting on the VAuto but you will have PS (pressure support) which will give you the difference between inhale and exhale that EPR does but in a backwards way of thinking.
EPR comes off inhale.
PS gets added to exhale.

So you start with the exhale that you get on the AutoSet which is 16.4 and you add PS to it to get to what your inhale was which was 18.4.

So.... Minimum EPAP setting on the VAuto needs to be 16.4
PS needs to be 2 cm
and that will give you the 18.4 inhale and 16.4 exhale you got on the AutoSet.
Should feel pretty much like what you feel on the AutoSet.

The maximum IPAP setting....might as well go 25 and see what happens. If/when the machine wants to increase the pressure it will always be with the 2 cm difference.

So in Auto bilevel mode these are the main settings
Minimum EPAP
PS
Maximum IPAP

There are other settings available but I always suggest starting those out with the factory defaults because for most people those settings will work just fine. They are mainly comfort settings anyway.
Don't forget to go to the apneaboard and get the clinical/provider manual for your new machine.
I usually suggest people just go ahead and do the restore to factory defaults and erase any prior user data from the machine first (along with erasing the SD card if you are getting one)...and then start fresh with the settings.
Don't forget to change the clock while you are in there if there is a time difference.

Should you have a problem with the timing of inhale/exhale with the factory defaults then we go ahead changing those settings with little tweaks to match your own respiration pattern. I was happy with the factory defaults...Palerider ended up doing a little tweaking on his VAuto to match his respirations. He is better suited to offer ideas on what to change or how much than I am.
Start with the factory defaults though....there's a strong probability they will work just fine.

Sometimes it's hard to wrap your head around all this stuff but once you get it then it is a piece of cake.
You just think about what is happening on the AutoSet and match it to what you will get with the VAuto settings.

[palerider]

What Pugsy said.

[ChicagoGranny]

in a backwards way of thinking.
EPR comes off inhale.
PS gets added to exhale.

I've always been curious how they came to market their machines that way??

Did the EPR development group and the bilevel group not talk to each other?

Or is it more likely they wanted to promote --> "Having trouble exhaling? We got EPR!" and "Need more pressure? We got PS!"?

[zonker]

So what you do is translate the Autoset settings into bilevel settings.

all righty, then, let's do that.

So you start with the exhale that you get on the AutoSet which is 16.4 and you add PS to it to get to what your inhale was which was 18.4.

oh lord, more math. no, i'm following it, just being a wise guy.

Don't forget to go to the apneaboard and get the clinical/provider manual for your new machine.

you mean i shouldn't come to the forum and start a new post every time i have a new question?

I usually suggest people just go ahead and do the restore to factory defaults and erase any prior user data from the machine first (along with erasing the SD card if you are getting one)...and then start fresh with the settings.
Don't forget to change the clock while you are in there if there is a time difference.

thanks for the sensible tips!

[zonker]

You won't have an EPR setting on the VAuto but you will have PS (pressure support) which will give you the difference between inhale and exhale that EPR does but in a backwards way of thinking.
EPR comes off inhale.
PS gets added to exhale.

granny's post reminded me that i missed commenting on this first time around.

i remember when i first started epr. i had the devil's own time getting used to it! it didn't seem to do for me what it was doing for other people. to the contrary, it seemed to make it harder. finally got used to it by relaxing myself to the rhythm. pretty sure that's going to be the case here, too.

mostly i feel that i'll just be getting used to bilevel for sometime, perhaps a couple of weeks.

again, thanks for the info.

[zonker]

What Pugsy said.

oh, you rebel, you!

[Pugsy]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

[zonker]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

[palerider]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

You know she'd do it, too.

[zonker]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

You know she'd do it, too.

[Jlfinkels]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

You know she'd do it, too.

I would expect her to use the force from home. No travel required.

[Dog Slobber]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

And if she has trouble figuring out where you live, I'll give her your address.

[SleepyCPAP]

I found adjusting to VAuto pretty comfortable. On the other forum someone said adjust the trigger, if things seem out of sync. I set my to “High”
She thought EPR on an AutoSet was by default baked in at “Very High”

[zonker]

you mean i shouldn't come to the forum and start a new post every time i have a new question?

Sure...go ahead...remember I can figure out where you live and come whip your ass.

that was, literally, laugh out loud!

And if she has trouble figuring out where you live, I'll give her your address.

snitch! snitch! snitch!