APAP vs Air Curve VAuto

Just purchased an Air Curve 10 VAuto functions with cpcp, bilevel and vauto through our insurance provider. Was using an old resmed cpap only function machine. When in Vauto mode is this considered the same as an APAP machine since when using in VAuto mode this will adjust the settings as needed as long as the the epap and ipap are set accordingly and correctly ...is this correct. It has been awhile since my last sleep study. Settings were than 8 epap and 12 ipap. To maximize the full functionality of the vauto mode where as the machine will set and run as my needs dictate through the night, what should I be setting the machines epap, ipap as ps levels to. Much appreciate the advice.

WW4B wrote: ↑

Thu Feb 27, 2020 6:56 pm

Just purchased an Air Curve 10 VAuto functions with cpcp, bilevel and vauto through our insurance provider. Was using an old resmed cpap only function machine. When in Vauto mode is this considered the same as an APAP machine since when using in VAuto mode this will adjust the settings as needed as long as the the epap and ipap are set accordingly and correctly ...is this correct. It has been awhile since my last sleep study. Settings were than 8 epap and 12 ipap. To maximize the full functionality of the vauto mode where as the machine will set and run as my needs dictate through the night, what should I be setting the machines epap, ipap as ps levels to. Much appreciate the advice.

The VAuto is an APAP on steroids...

Try:

Mode - VAuto
Max IPAP - 20
Min EPAP - 8
Pressure Support 4.0

That will get you to the 8 epap/12 ipap window right away (assuming you have ramp off) but let the machine give you more pressure as it calculates that you need it.

Make sure to pick the right mask type.

New to the forum and thanks for the replies. Will set the machine as you have noted and will turn ramp off. Currently using the DreamWear nasal mask (not pillows) and the machine is set for this as I find face masks very uncomfortable and intrusive. Like the nasal pillows as well but my nostrils seem to get irritated when using the mask, may need to get use to this mask before using full time. Also like the idea of the mask hose on the top. So with the settings you recommend, the lowest pressure the machine will go on epap is 8 with a max epap pressure of 12 due to a ps setting at 4. In regards to the ipap setting..with a pressure setting of 20 the machine will reach a pressure setting of 12 (epap 8 + ps 4 = 12) with the capability of reaching a pressure of somewhere between 12 -20 on Vauto if the machine dictates that more pressure is needed while I sleep through the night. On the flip side, if less ipap pressure of 12 is needed the vauto mode will operate and set accordingly as my nights sleep needs are monitored by the vauto setting. Is understanding correct?
If using the S mode (bi level), what would you recommend 4 all the settings. Have been on cpap therapy for 10+ years, new machine and would like to fully understand its full potential and start to take charge of my own therapy.
Will also be downloading Oscar for data results next week.

WW4B wrote: ↑

Fri Feb 28, 2020 11:54 am

New to the forum and thanks for the replies. Will set the machine as you have noted and will turn ramp off. Currently using the DreamWear nasal mask (not pillows) and the machine is set for this as I find face masks very uncomfortable and intrusive. Like the nasal pillows as well but my nostrils seem to get irritated when using the mask, may need to get use to this mask before using full time. Also like the idea of the mask hose on the top. So with the settings you recommend, the lowest pressure the machine will go on epap is 8 with a max epap pressure of 12 due to a ps setting at 4. In regards to the ipap setting..with a pressure setting of 20 the machine will reach a pressure setting of 12 (epap 8 + ps 4 = 12) with the capability of reaching a pressure of somewhere between 12 -20 on Vauto if the machine dictates that more pressure is needed while I sleep through the night. On the flip side, if less ipap pressure of 12 is needed the vauto mode will operate and set accordingly as my nights sleep needs are monitored by the vauto setting. Is understanding correct?

I don't really know what your understanding is, because I couldn't follow it.

I'd recommend a maxipap of 25, the machine default, because unless there's a compelling reason, the machine shouldn't be limited in what it can do.

MinEPAP 8, PS 4, MaxIPAP 25, means the machine will vary between a 12/8 pressure (12 inhale, 8 exhale) up to 25/21, and anywhere in between. EPAP will vary with IPAP moving along however much PS is. Pressure will increase in response to breathing events, and then decrease when breathing events stop happening.

WW4B wrote: ↑

Fri Feb 28, 2020 11:54 am

So with the settings you recommend, the lowest pressure the machine will go on epap is 8 with a max epap pressure of 12 due to a ps setting at 4. In regards to the ipap setting..with a pressure setting of 20 the machine will reach a pressure setting of 12 (epap 8 + ps 4 = 12) with the capability of reaching a pressure of somewhere between 12 -20 on Vauto if the machine dictates that more pressure is needed while I sleep through the night. On the flip side, if less ipap pressure of 12 is needed the vauto mode will operate and set accordingly as my nights sleep needs are monitored by the vauto setting. Is understanding correct?

No. Maybe. It depends on what you mean. Using the settings I recommended above the machine will start out at epap 8 and ipap 12. If it calculates that you need more pressure it will increase the epap, and the ipap will always be 4 more than the epap. The pressure support dictates the spread between the epap and ipap. It will increase pressure as necessary to a max ipap of 20 with those settings. As palerider says, you could increase the max ipap to 25 to really let the machine do its thing.

I'm probably biased, but the VAUTO is the best xPAP that isn't an ASV or anything else more complex. The increased pressure support and higher pressure are stellar - if you need them.

Now I understand how this works..thank you. I have been sleeping terribly the past few months due to the stress of life changes etc. I just wanted to be sure I was not limited on possibly needing increased pressures an not getting them. Like I have mentioned, it has been several years since my latest sleep study (12 ipap & 8 epap prescribed) and really wanted to be sure due to the longevity in my sleep studies that my prescription, should it have changed to more pressure possibly needed that the machine would recognize and provide the correct pressures needed. Your suggested pressure settings explains that this would do so without limitations in vauto mode.
Question in regards to pressure setting, why your recommendation on a pressure setting of 4. Is there a limit one should not exceed or reduce too. Is there a sample reading on the forum in regards to the do's and dont's of PS.
Very much appreciate the knowledge gained.

WW4B wrote: ↑

Fri Feb 28, 2020 4:35 pm

Question in regards to pressure setting, why your recommendation on a pressure setting of 4. Is there a limit one should not exceed or reduce too. Is there a sample reading on the forum in regards to the do's and dont's of PS.

I seem to recall that pressure support can have implications for complex apnea and/or aerophagia and maybe some other things I can't remember, but don't get me lying. That is someone else's expertise. 4 is a pretty normal setting for pressure support. It makes exhaling easier. It's comfortable for me and I like it.

WW4B wrote: ↑

Fri Feb 28, 2020 4:35 pm

Question in regards to pressure setting, why your recommendation on a pressure setting of 4. Is there a limit one should not exceed or reduce too.

I would not advise going above 6 cm PS without careful consideration and watching the data closely.
The majority of people who have an in lab bilevel titration for just plain OSA (central apnea we have a different discussion) will come out of it with a 4 or 5 cm PS suggestion and sometimes 6 cm.
That is of course assuming no lung or respiratory issues that might cause a person to need extra ventilation and those people need to be directly under a doctor's care anyway.
Too much PS can trigger central apneas in some people.

WW4B wrote: ↑

Fri Feb 28, 2020 4:35 pm

Question in regards to pressure setting, why your recommendation on a pressureSUPPORT setting of 4. Is there a limit one should not exceed or reduce too. Is there a sample reading on the forum in regards to the do's and dont's of PS.

I suggested a pressure support of 4 because that's what you had before so it's what you were used to.

Thanks to all who have replied..Not totally sure of my prescribed epap and ipap settings as I was originally using cpap with a setting of either 10 or 12. Insurance allowed a new machine an was given the Resmed Aircurve Vauto. Settings were at 12 ipap, 8 epap and ps of 4. Still feeling very tired and napping during the day when not working. Wife says I snore every now and than and make gurgling sounds through the night and she leaves for the other bedroom. Maybe mouth breathing possibly ? Mask and hose settings were corrected to what I am currently using. Work/life schedule at the moment a little hectic (just found out a granddaughter is on the way) so haven't had the chance to download oscar as yet to post results and get a more clearer picture of what is going on. In the interim I have been trying to learn and tweak by reading forum posts using the search feature.
Settings have been set as recommended in earlier posts. Ipap 25, Epap 8, ps 4, ramp off and humidity set at 4-5. Thinking of dropping ps to 3, any comments would be appreciated.
Not enough min pressure ? Too much minimum pressure ? I'm very tired of being tired all of the time. Also what does the "essentials" features do. It is currently set as "on" What does the "plus" setting do.

WW4B wrote: ↑

Tue Mar 03, 2020 10:02 pm

Also what does the "essentials" features do. It is currently set as "on" What does the "plus" setting do.

Has to do with the level of detail you get on the sleep report.
With Essentials set to "On"....you get hours of use.
If you change it to "Plus"...you get hours of use plus AHI and category breakdown as well as leak and pressure numbers....
In other words...more details about the effectiveness of your therapy.

Thank you. Will be changing essentials to "plus". Any other suggestions to improve my sleep quality.

I can't really make any suggestions on things to change without knowing what the results are with the existing settings.

As far as improving sleep quality itself....it all depends on what is disrupting the sleep quality in the first place.

At this point, all you can do is mask up and be aware of and identify anything that disturbs your sleep.
If you tend to wake too groggy to remember, a pen and paper might help.
Sleep well, but observant.