AirCurve 10 VAuto Bipap settings help needed

I got my new AirCurve 10 VAuto Bipap. I was using an Airsense auto 10 before this.

After a new sleep study, my doctor's office gave my equipment provider a simple setting - MaxIPAP = 9, Min EPAP = 5.

When I did the sleep study I couldn't handle air blowing at me higher than a 5 or so when I was trying to fall asleep. Also I take a very long time to fall asleep. Sometimes it's hours.

So I got this unit because the manufacturer said I could set it to start as low as 5/4 and set it to not rise until it detected I fell asleep. How do I get it to do this?

My provider knows nothing about this, and my doctor doesn't know how to set this either.

Also isn't the maxipap of 9 kind of low? I was testing well at an 8, but I would think they'd add a little more leeway. On my autopap I had a max of 20. I didn't usually get that high, but sometimes I did get higher than 9.

Also for the Epap, in the sleep study they told me that I tested well at 4, but the doctor set it at 5, so I'm not sure why.

You are getting bad information..you didn't need a bi level machine.

Go here and request the clinical manual for your machine.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
In it you will find how to get to the clinical menu setup area.

Which mode are those settings you are seeing?
There are 3 modes available.
For it to auto adjust you are missing a Pressure Support setting in what you are reporting.
Pressure support is the difference between inhale and exhale.

Auto ramp is the feature where the machine will suspend ramp (if you use ramp) and go directly to work with higher pressures if the machine thinks you are asleep. I think that you only have regular ramp available on the VAuto. I don't see it listed in the manual that I have.
Wouldn't matter much anyway...your starting pressures are almost where the machine's lower limits are anyway.

Angielynn wrote: ↑

Fri Mar 01, 2019 4:07 pm

I got my new AirCurve 10 VAuto Bipap. I was using an Airsense auto 10 before this.

After a new sleep study, my doctor's office gave my equipment provider a simple setting - MaxIPAP = 9, Min EPAP = 5.

When I did the sleep study I couldn't handle air blowing at me higher than a 5 or so when I was trying to fall asleep. Also I take a very long time to fall asleep. Sometimes it's hours.

So I got this unit because the manufacturer said I could set it to start as low as 5/4 and set it to not rise until it detected I fell asleep. How do I get it to do this?

My provider knows nothing about this, and my doctor doesn't know how to set this either.

Also isn't the maxipap of 9 kind of low? I was testing well at an 8, but I would think they'd add a little more leeway. On my autopap I had a max of 20. I didn't usually get that high, but sometimes I did get higher than 9.

Also for the Epap, in the sleep study they told me that I tested well at 4, but the doctor set it at 5, so I'm not sure why.

It's absurdly low, yes. I keep mine set at 25, because it doesn't matter and there's no reason to lower it.

As to the autoramp setting,I believe that the Aircurve 10 VAuto doesn't have auto ramp.

Your previous machine did have auto ramp.

You will get use to the pressure, it shouldn't take more than a week to a month for it to be a non issue. My start is 12/17 on ivaps
if you still have your old bpap you could slowly increase the start pressure, if your new one doesn't have ramp.
If you put up a sleepyhead chart, you could get some feedback on it.

I had called Resmed and they said it does have the "Autoramp" option, and on various sites it says:

"Ramp time - Ease into therapy with a period of lower pressure. Or select AutoRamp™ and the machine senses and adjusts when sleep begins."

Yet I do not see this option on the clinical menu. I only see "ramp time" and when I go to that option it just gives me times I can choose but doesn't have an Autoramp option that I can see.

I'm hoping I did not get misled about this unit. Am I missing something?

Also the other settings that it came with are:

Mode: VAuto
PS 4.0
Ti Max 2.0s
TI Min ).3s
Trigger Med
Start Epap 4

I currently have ramp time set to 30 minutes.

I don't see a start IPAP. Shouldn't there be one if it's going to ramp?

oops.

I have the aircurve 10 vauto.

I have both epap and ipap. I am not sure about the ramp as I don't use it. There is probably a setting somewhere. I just figured out I could shut the humidity off.

That's the settings menu, ramp is in the comfort menu, along with climate control, tube temp, humidity, etc.

Ok. I am there

It gives me off and goes up to 45 min. There is no other choices unless there is a trick I don't know about. I don't see the auto ramp mode the OP is looking for.

Cynmatthes wrote: ↑

Sat Mar 02, 2019 12:27 am

Ok. I am there

AE05D2FF-2C8B-4A73-B1CC-210F2E732289.jpeg


It gives me off and goes up to 45 min. There is no other choices unless there is a trick I don't know about. I don't see the auto ramp mode the OP is looking for.

Well, it's not in the manual either...

Angielynn wrote: ↑

Fri Mar 01, 2019 11:02 pm

I don't see a start IPAP. Shouldn't there be one if it's going to ramp?

No...not really.
IPAP is actually nothing but PS added to EPAP ....so it's really just going to be there by default no matter if ramp is used or not.
With ResMed bilevel machines the Pressure support setting (the difference between inhale and exhale) is fixed and won't vary no matter if you use ramp or not or auto adjusting pressures or not.

The only reason you see a max IPAP is because you are in auto mode...if the machine wants to go to max IPAP it will drag EPAP up with it.
With EPAP min of 4.0 and PS of 4...you get starting pressures of
4 on exhale
8 on inhale
and if the machine feels the need to increase the pressure it can only go up to 9 IPAP (I think that is what you said max IPAP was).
If it goes up to 9.0 IPAP....your EPAP will be 5.0.
It's an extremely tight range for the pressure to move around in...essentially only 1 cm roaming ability. Most people who need bilevel will need more pressure but it is entirely possible that this is all you need.
Forum member RobySue used a very similar tight range...4 EPAP and max IPAP of 10. She needed it for aerophagia control. Any more IPAP and her belly caused major problems.

As for there being Auto Ramp available on the AirCurve models....I can't find it as being available on any of the AirCurve models.
Now it is available on the AirSense models. Maybe whomever you talked to at ResMed was thinking AirSense machines and not AirCurve machines. To be honest at your current settings...auto ramp wouldn't do much for you anyway even if you did have it. If you had it...and chose to use it...here is what could/would happen....it would start the minimum EPAP at 3 and with 4 PS you would have 7 IPAP and it would either take 30 minutes to increase that 3 EPAP to 4 EPAP or sooner than 30 minutes if it sensed you fell asleep before the end of 30 minutes. It's only going to travel 1 cm during ramp time...whichever ramp you used. That 1 cm travel to your minimum EPAP setting is really not much of a difference.
Now if your minimum EPAP was 10 cm and your IPAP was then 14...ramp might be useful to someone but it's not really all that useful when someone's settings are already pretty much at the minimum settings. There's just no where for the machine to need to ramp to except that 1 cm to EPAP min of 4.

Your AirSense 10 you had and didn't do well with...it could only offer you max of 3 cm PS (they call it EPR on the AirSense models) and perhaps you need 4 cm PS so that you can get comfortable with the machine and fall asleep.

Thank you Pugsy so much for explaining so clearly. You always make things easy enough for me to understand. And thank you to everyone else who is helping as well.

It seems the guy at Resmed was mistaken. That's so frustrating. I had to fight to get this unit because he told me it could start at an IPAP as low as 5 with an EPAP of 4, and that the IPAP could ramp up without the EPAP having to change.

So it seems that it is what it is and I'm guessing that there is no other machine that does what the Resmed guy told me. So how do I adjust to this?

The good part is that when I put it on, the EPAP of 4 feels really good. I think you're right that I needed more than the airsense could give me.

The problem is that the IPAP is really bothering me. I feel like I'm hyperventilating and I get that feeling like I can't get enough air. I keep trying to take deep breaths but it doesn't give me relief. Also my ears immediately became blocked/full and began ringing.

It may help to know that when I had the resmed airsense 10, after some experimentation I found that I could start comfortably at around 5 for the IPAP. I still woke up with the ear ringing/fullness but at least I didn't feel that immediately or that sense of hyperventilation, so I could fall asleep. Also I have problems with vertigo from the inner ears, and failed cpap many years ago because it was inducing the vertigo. I only decided to try cpap again because I was told that the ability to start with a lower ipap and ramp up could help me to avoid that. In fact it did. I had to play around but when I ramped the starting and ramping pressure, I didn't get vertigo. I'm concerned about the possibility that starting at an IPAP of 8 will induce vertigo.

Also I don't think the max of 9 will be good enough. When I had the airsense, sometimes it went higher than that. It was set to a max of 20, and it was usually around 8-9 but sometimes went up as high as 12. If I understand correctly, if I change the max IPAP to 12, the EPAP will rise with it? When it rises, does that mean I'll have stronger air pressure when I exhale? If so, I'm guessing my body won't love that.

So is there a setting that will deal with some of these issues?

It can start at 4, but low pressure is only for the ramp. The treating epap is generally set high enough to clear most apnea, it is the same basically for any machine.
I haven't used an auto bpap, From memory and it would be in the manual, I think the PS stays the same and the epap rises to give a higher ipap on the resmed. I think the phillips may do both epap and PS?
It's basically going to work the same as your old resmed