Help with Vpap Auto 25

Divreon · Post by **Divreon** » Wed Feb 04, 2009 10:41 am

For reference, I have OSA, and CSA. My doctor believes that treating the OSA may cure the CSA.

I was prescribed a Nasal CPAP at 14cm h20, I was given an VPAP Auto 25 and a FlexFit432 full face mask.

I breathe through my mouth a lot and have a deviated septum, so it only makes sense that I'd get a full face mask, but my doctor didn't feel I needed one.

I obviously am not on what was prescribed for me, so I'm kind of lost as to where I should go from here.

Okay, Night 1.
I was determined to not mess with settings until I was sure the settings wouldn't help.
The machine was set to auto by my local medical supply store where I bought it.

The mask felt great and the pressure was fine. Fell asleep in about 10 minutes(about double normal time) good considering the full face mask I'm wearing.

Slept for 1 hour. Woke calmly and realized that I felt like I was suffocating a little. The high amount of pressure that I had gone to sleep with was gone. Despite calmly trying to breath in deeper and hence trigger more airflow, I was unable to get it to perform at the same pressure. I turned the machine on and off to try to reset it to the comfortable higher pressure, but it didn't.

Unable to think straight in the middle of the night, I whipped the mask off and went to bed.

I haven't looked at the actual settings yet, but I'm thinking I need to do one of two things. Increase the minimum pressure, or turn off auto and set my EPAP and IPAP pressures.

What information would be helpful in getting better advice?

dsm · Post by **dsm** » Wed Feb 04, 2009 2:48 pm

Hi Divreon & welcome to the forum.

Are you able to list the settings from the machine ? - that is can you step through the settings and note down what they all are & that will help quite a bit.
If you don't know how to get into clinical mode just ask & you will get a ton of replies on how to do that

One aspect of cpap therapy that is a common experience is that when starting out, we often wake & wonder if the machine is even on. I think everyone goes through this. Often the only way to be sure is to feel the air venting from the mask holes.

Also, with AUTO machines, if the starting pressure is set too far below the titration pressure, that too may cause the effect you are describing, if the machine has lowered its pressure too far.

Good luck with this

DSM

Divreon · Post by **Divreon** » Wed Feb 04, 2009 10:59 pm

Settling 20 minutes
Mask: Mir Full

Clinical Settings Menu
Mode: VAuto
MAx Ipap:16
Min Epap:4
Ti Max: 2 sec
Ti Min: 0.3 sec
Exhalation: Medium
Smart Start: Off

Clinical Advanced Settings Menu
Trigger: Med
Cycle: Med
Tube length: 2m
Max Settle: 45min

I'm thinking of changing min Epap to 8 or 10 to prevent the feeling of suffocation but I really don't know what will work. Advice?

Slinky · Post by **Slinky** » Thu Feb 05, 2009 1:32 am

Wow! That's a h*ll of a spread in pressure range! What is your Pressure Support set at? No way I'm gonna advise you on VPAP Auto 25 settings as I'm still struggling w/figuring out settings on my VPAP Auto. There's so doggone much to learn about these auto bi-levels. *sigh*

Do you have the Clinicians Manual? There's something in there about a Pressure Support - or a pressure range - of more than ... 10 .... I'm not where I can check my VPAP Auto's Clinicians Manual and it wouldn't necessarily for sure be the same ...

Divreon · Post by **Divreon** » Thu Feb 05, 2009 7:54 am

Pressure support was set to four, both on my first night, and last night.

As an update for night 2, Setting the min Epap pressure to 9 I had strange results.

First my ears popped. No big deal. Secondly, I woke up in the middle of the night to find the mask on my nightstand and the machine turned off. My wife wouldn't have touched it, she knows better, meaning I did it. I woke up, took off the mask, set it on the bed stand, and turned off the machine all without remembering a thing.

My current machine run time is 2 hours, over 2 days. Meaning an hour of sleep with the mask each night.

I think the min Epap was too high last night. If I adjust it to 7 I'm hoping I can keep the mask on for the duration of the night.

Any other advice as to what might help would be great.

-Steve

Slinky · Post by **Slinky** » Thu Feb 05, 2009 9:32 am

Even w/Settling turned Off, my understanding is that ONE hour is NOT enough time for any meaningful data.

dsm · Post by **dsm** » Thu Feb 05, 2009 2:19 pm

Set min epap to 10 - I think you will find 'problem solved'

Goodluck

DSM

#2 Further comments after reading your other posts...

As an added experiment try TI Max = 3 secs

DSM

Divreon · Post by **Divreon** » Sun Feb 08, 2009 7:22 am

DSM, thanks for the helpful advice, I changed it to min epap of 11 last night when I woke up without the mask AGAIN, and slept comfortably. I could even sleep on my stomach(I rarely do it, but whenever I "can't" it makes me want to more)

Slept from 3am - 8am no issues at all.

I also turned off the settling just to be safe. (Its the only timed feature and It seemed that according to my mask I was taking it off after about an hour each night, so something had to be causing this particular timing issue.

My typical pressures now stand at 11 exhale, 15 inhale, with the ability of the machine to go up to 16 if it feels I need it. I've basically taken the auto out of the auto machine, but as long as I'm sleeping I don't care.

Tonight I'm hoping that the new settings will again produce the same results, and I'll get my first complete night with the VPAP

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