SleepRes V-Com - Opinions?

Who has heard about this device? I was reading an article about it from the guy who helped invent it. I got mine in the mail a few days ago and tried it out last night.

The idea is to limit the inspiratory flow (kind of how EPR limits the flow out). Instead of that quick rush in when you take a breath, it’s much more controlled. The idea is to help with compliance and make higher pressures more tolerable.

I have been tested to have an AHI of about 11-14 apneas per hour. My cpap helped me get that down to consistently under 4 since November 2021. I’ve had quite the struggle to get started but with the help of a few members here I think I got back on track. No night is perfect and I realize that.

However I searched to find information about the V-Com and it seems no forum or Reddit has discussed it so let me begin.

I know one nights data doesn’t mean much so I’ll post back when I get more. But the biggest thing that stood out to me was how even my inhale:exhale flow chart was. It’s the straightest I’ve ever seen it and the biggest thing was I had 0 obstructive apneas. I’ve never had that my entire tenure with cpap. The events at the end when I was waking up were the only ones triggered. I did have a leak later on but that was because my humidity wasn’t correct I think.

Anyways I know I need more data but I am hopeful for this product I can tell a huge difference in that i can breathe at a normal pace rather than having a flood of air come in.

Apparently a flow restrictor.
Caution--check with your pneumonologist before use.
It sounds like a very bad idea.

Bad for you---bad for your cpap.
Likely to void the warranties on both.
Are you aware that the pressure of your cpap is ADJUSTABLE?

Any other opinions? Already used one night and for a nap and I've had 0 obstructions. It is amazing. My tidal volume is 500 so it seems fine..

https://sleepreviewmag.com/sleep-treatm ... adherence/

Please read this article about it.

The flow restictor is more than likely to skew the data seen by the cpap.
I would not believe anything, especially the "article", a obvious plug for the gadget.
Like I just said, the cpap pressure is adjustable, which would accomplish
the same effect with reliable data--and no damage to your machine--or you.
Show it to your DOCTOR--unless he owns stock in the company.

jlsmithseven wrote: ↑

Thu Jan 05, 2023 4:22 pm

Any other opinions? Already used one night and for a nap and I've had 0 obstructions. It is amazing.

Mark your calendars - I am agreeing with CF.

chunkyfrog wrote: ↑

Thu Jan 05, 2023 7:31 pm

The flow restictor is more than likely to skew the data seen by the cpap.

Anything in the hose can block the cpap from sensing obstructions or changes in flow. Even adding a longer (10ft) hose w/no obstructions or increasing the volume of the water chamber can affect sensitivity.

I think the way you feel after a few days with this will tell you the truth.

So come back in a few with your results.

SleepGeek wrote: ↑

Thu Jan 05, 2023 9:24 pm

jlsmithseven wrote: ↑

Thu Jan 05, 2023 4:22 pm

Any other opinions? Already used one night and for a nap and I've had 0 obstructions. It is amazing.

Mark your calendars - I am agreeing with CF.

chunkyfrog wrote: ↑

Thu Jan 05, 2023 7:31 pm

The flow restictor is more than likely to skew the data seen by the cpap.

Anything in the hose can block the cpap from sensing obstructions or changes in flow. Even adding a longer (10ft) hose w/no obstructions or increasing the volume of the water chamber can affect sensitivity.

I think the way you feel after a few days with this will tell you the truth.

So come back in a few with your results.

That is why I posted here to see what people thought. The funny thing is as good as those results were I did not feel that rested. The article states that it is FDA approved and it’s totally safe and doesn’t mess with Resmeds algorithm, it did detect some clear airways and stuff when I woke up the one time. I’ve discontinued use it just doesn’t seem safe to me I guess. My problem is the abrupt pressure changes wake me up at night , so I’ll continue working with that I guess.

jlsmithseven wrote: ↑

Fri Jan 06, 2023 8:39 am

My problem is the abrupt pressure changes wake me up at night

So if you think pressure changes are "abrupt" and cause wake ups.....set the machine to fixed pressures and eliminate the chance of any pressure changes from even happening.

BTW....what is your definition of "abrupt"? What exactly are you seeing that makes you think that the pressure changes are causing the wake ups?

I don’t know anymore. I already have a thread started for my therapy , it seems like 8-8.6 range was good enough and I thought I was set but then if I move to my back it’s not enough pressure and it’s back to square one.

This thread was just about the VCom so I’ll stop it here.

I’ve tried CPAP mode several times it’s either never enough or too much aerophagia. I’ve tried balancing it too between 8 and 9 and such but it just doesn’t ever agree with me.

When the FDA approves something it means that it can't hurt you...it doesn't mean it will help you.

LSAT wrote: ↑

Fri Jan 06, 2023 11:20 am

When the FDA approves something it means that it can't hurt you...it doesn't mean it will help you.

Having read the advertising copy at the link, I can say that I've got mixed feelings about what's being claimed.

After talking at length about how V-Com "reduces inspiratory pressure" and how this is supposed to relieve anxiety of newbies and make learning how to breathe with an xPAP easier, the ad goes on to say:

During typical breathing, you’re actively inhaling, and then you relax and passively exhale. But let’s say I put you on 15 centimeters of CPAP and I pharmacologically sedated and paralyzed you, the CPAP machine would inflate your lungs and hold them there—it would hold the lungs distended. That illustrates the fact that when you go on CPAP, you’re actively having to resist the pressure forcing the air in.

This phenomenon is exactly why expiratory relief was invented: EPR and Flex are designed to make it easier to exhale against the positive air pressure.

And, to use their own example of putting someone who is pharmacologically sedated and paralyzed on CPAP, having the pressure reduce from 15 to 12 when the patient has stopped inhaling would encourage the lungs to deflate very slightly allowing a bit of "passive" exhalation to take place.

Now having said all that, it's also true that for some newbies (and I was one of them), the fact that CPAP can feel like it's pumping more air than you want to inhale does in fact create some real anxiety and some real problems. In my case I felt like a goose being force-fed for the creation of foie gras. And all that "too much air" on inhalation triggered swallowing of air which led to some really bad aerophagia, which in turn allowed an insomnia monster to move into my bedroom.

When I was switched to a PR BiPAP, I found that by turning Bi-Flex off and turning Rise Time to 3 (its maximum setting), the change to inspiratory pressure that now occurred over 3/100 of a second no longer felt like I was being forced to inhale more air than I could possibly inhale. And that (plus a lower IPAP than my original fixed CPAP pressure) was enough to take the edge off things. Even so, it took me months of hard CBT-Insomnia to fight and defeat the insomnia monster in my bedroom. (And even 12 years later, I still have to be vigilant about keeping that insomnia monster at bay.)

Resmed VPAPs and VAutos also have settings that allow you to control how fast the pressure goes back up to IPAP. If you are using VAuto mode the "Trigger" setting essentially controls how quickly the machine transitions from EPAP to IPAP. If you are using S mode, then "Trigger" and/or "Rise Time" can both be used to fine tune the way the machine increases the pressure from EPAP to IPAP.

Now as near as I can tell, the ad for V-com seems to be saying that it can make the change from expiratory pressure to inspiratory pressure "more comfortable" for new xPAP users. I can't help but suspect that the "feel" of V-Com could be achieved on a bi-level machine by playing around with the Trigger and/or RiseTime settings along with a modest changes in the PS and/or IPAP settings.

I'm also skeptical about the ad's claim that a reduction of the set pressure when using EPR or Flex is not going to provide the same kind of "relief" as V-Com: The ad claims:

The other question I get frequently is, “Can’t you just turn the pressure down for the same effect as V-Com?” But if you turn the pressure down, then you’re decreasing both inspiratory and expiratory pressure while increasing the likelihood of respiratory events. The V-Com decreases the inspiratory, the offending pressure, but it preserves the therapy of the expiratory.

If your set pressure is 9 cm and you are using EPR = 3, then your expiratory pressure is 6 cm. If you want to reduce the inspiratory pressure to 8cm and keep the expiratory pressure the same, all you need to do is reduce EPR = 2. Similarly with flex, although Flex is not a straightforward reduction in pressure. But even so, if you start with a pressure setting of 9cm and Flex = 3, then your expiratory pressure is typically between 6 and 7, and usually closer to 7. So decreasing the pressure to 8cm and setting Flex = 2 is still going to keep that expiratory pressure between 6 and 7, although it may be closer to 6 on more breaths.

The ad goes on to say:

What about bilevel devices–do they have a setting to decrease inspiratory pressure only?

No, they don’t. No positive airway pressure device has a feature to drop inspiratory pressure only.

This is pure malarkey.

On a Resmed VPAP or VAuto, the PS setting controls the relationship between IPAP and EPAP. If IPAP = 10 and PS = 4, your expiratory pressure is 6cm. If you reduce IPAP to 9 and use PS = 3, then IPAP is now 9 and EPAP is still at 6.

On a PR BiPAP, IPAP and EPAP are separate settings. So if you start at IPAP = 10 and EPAP = 6 and change the settings to IPAP = 9 and EPAP = 6, you've decreased just the inspiratory pressure only.

On a PR BiPAP Auto, the situation is just a bit murkier, but you can still effectively reduce IPAP while keeping EPAP at its original level. It would involve appropriately setting both the PS min and PS max settings. If you start with min EPAP = 5, max IPAP = 12, min PS = 3, and max PS = 5, then you start off with IPAP/EPAP = 8/5. You might eventually reach 12/9 if the machine detects the right combination of events. But when IPAP = 12, it's also possible that EPAP could be as low as 7 = 12 - 5.

If you want to reduce IPAP by 1cm while leaving EPAP the same, then you'd need to change the settings to min EPAP = 5, max IPAP = 11, min PS = 2, and max PS = 4. Those settings cause you to start off with IPAP/EPAP = 7/5. You might eventually reach 11/9 if the machine detects the right combination of events. But when IPAP = 11, it's also possible that EPAP could be as low as 7 = 11 - 4.

So in any case, changing the settings effectively reduces IPAP without reducing EPAP.

I'll have to read the "clinical notes" more carefully to see what they're actually saying about how V-com "works" to figure out why they seem to think this is different than setting RiseTime on a PR BiPAP or some combination of RiseTime and Trigger on a Resmed VPAP or VAuto.

LankyLefty has a video of it, he likes it. But the cpap sales site that supports him sells it.

Denase wrote: ↑

Sat Apr 15, 2023 5:26 pm

LankyLefty has a video of it, he likes it. But the cpap sales site that supports him sells it.

what a coincidence!

zonker wrote: ↑

Sat Apr 15, 2023 7:59 pm

Denase wrote: ↑

Sat Apr 15, 2023 5:26 pm

LankyLefty has a video of it, he likes it. But the cpap sales site that supports him sells it.

what a coincidence!

No wonder he sounds so excited about it!
I like the guy--but . . .

Come on folks...Jason does a lot of really good educational material and he puts it out there free for everyone.
He doesn't put it behind a pay wall.
Doing all that sort of stuff takes money.
Do you all really begrudge Jason getting some funds elsewhere to help pay his internet presence bills?

Do you think that all positive comments he makes about anything were paid for by the product and not his true thoughts?

Why is everything a big conspiracy and why so negative?

This thread was someone wondering if anyone had heard of or tried it.
How did it get derailed? How come now we are questioning Jason's motive for saying he tried something and liked it?