Higher CA events on Aircurve at same settings as Airsense.

Apneak · Post by **Apneak** » Sat Sep 26, 2020 1:00 pm

Hi there, I've been experimenting with this for a while. And It's quite clear that Aircurve Vauto, for some reason I can't figure out, induces more Centrals than I get with just the Airsense 10.

Both machines on a pressure support of 3, min ipap 9.6cm. Aircurve settings close to default, with a Med/Med trigger and cycle sensitivity, and a nice broad range for the min/max inspiration time.

I believe I'm switching back to the Airsense, which is crazy, because the Aircurve is clearly a better machine, with smoother flow curve output than the Airsense. But the data is the data. As anyone else ever seen anything like this? Airsense centrals are consistently below 1.3/hr, and the Aircurve is a bit higher, at around 2.3.

I've also gone through and made sure that they weren't fake centrals, like from movement....Would appreciate any feedback, thanks.

palerider · Post by **palerider** » Sat Sep 26, 2020 3:33 pm

Apneak wrote: ↑
Sat Sep 26, 2020 1:00 pm
with smoother flow curve output than the Airsense.

Oh yah? which is the autoset, which is the Vauto?

Apneak · Post by **Apneak** » Sat Sep 26, 2020 3:42 pm

It's besides the point, but on my breath flow curve, aircurve produces more consistent, smoother waveforms. I'd like to focus on the CA if that's ok.

palerider · Post by **palerider** » Sat Sep 26, 2020 3:48 pm

Apneak wrote: ↑
Sat Sep 26, 2020 3:42 pm
It's besides the point, but on my breath flow curve, aircurve produces more consistent, smoother waveforms. I'd like to focus on the CA if that's ok.

Ok, it's either your imagination, or one of your machines has a problem.

How's that?

Dog Slobber · Post by **Dog Slobber** » Sat Sep 26, 2020 4:14 pm

If you truly want opinions then you should:

Set the BiLevel specific settings back to default
Post the actual settings of the two machines, to ensure you haven't made any mistakes
Post some charts, actual CA values, how long your test was

Right now, all we know is you have two machines configured similarly (but not identically), one has higher centrals. We don't know the sample size, haven't seen the pressure traces, and where the centrals appear.

Set your Airsense up, ensure response is set to standard, run it for a week, post your graphs, trends and averages.
Set you AirCurve up, configure it identically, set BiLevel settings to default, run it for a week, post your graphs, trends and averages.

Apneak wrote: ↑
Sat Sep 26, 2020 1:00 pm
But the data is the data. As anyone else ever seen anything like this?

You're the only one who's seen the data, all we've seen is your interpretation of the data from an inconsistent experiment.

Apneak · Post by **Apneak** » Sat Sep 26, 2020 4:38 pm

Dog Slobber wrote: ↑
Sat Sep 26, 2020 4:14 pm
If you truly want opinions then you should:
Set the BiLevel specific settings back to default

Post the actual settings of the two machines, to ensure you haven't made any mistakes

Post some charts, actual CA values, how long your test was

Right now, all we know is you have two machines configured similarly (but not identically)

The machines are configured as identically as they can be, and Bilevel is basically at default except my inpiration min/max is .8s/4s, which I believe is different from default. Seems that you're all of the mindset that this shouldn't happen....I'm not sure what good images proving that I have the machines at the same setting, and that one has a higher CA over a period of 7 days each, will change....plus you'd really have to dig into each central apnea tag, it wouldn't be sufficient to just see a few images. I understand the need to be accurate, but Then what? Then you'd ask, did I wear the same clothes, was it the same temperature, with the same sheets? And did I eat the same thing every day?

In anycase, your incredulity supports my decision to switch back to Airsense.

Dog Slobber · Post by **Dog Slobber** » Sat Sep 26, 2020 5:12 pm

You've pointed out that you have changed the BiLevel defaults, but insist that the two machines are configured as identically as they can be. How can you not see the problem with your thought process?

I pointed that out and you won't accept it.

I also pointed out other factors that are potentially problematic in your comparison and you ignored them.

but Then what? Then you'd ask, did I wear the same clothes, was it the same temperature, with the same sheets? And did I eat the same thing every day?

I suggested nothing of the sort, and wouldn't. My suggestions and questions were reasonable and intended to reduce as much variables as possible. Your response is dishonest and a strawman?

Why don't you actually support your claims, and quit creating strawmen?

Why did you come here, ask for opinion?

Apneak wrote: ↑
Sat Sep 26, 2020 4:38 pm
In anycase, your incredulity supports my decision to switch back to Airsense.

I don't care what you do, but that fact that you will not even consider that there might be problems in your methods, data and interpretation of the data, supports my conclusion that you are ill-equipped to do a proper comparison and make another poor decision.

Apneak · Post by **Apneak** » Sun Sep 27, 2020 11:41 am

Dog Slobber wrote: ↑
Sat Sep 26, 2020 5:12 pm
You've pointed out that you have changed the BiLevel defaults, but insist that the two machines are configured as identically as they can be. How can you not see the problem with your thought process?

I pointed that out and you won't accept it.

I also pointed out other factors that are potentially problematic in your comparison and you ignored them.

but Then what? Then you'd ask, did I wear the same clothes, was it the same temperature, with the same sheets? And did I eat the same thing every day?
I suggested nothing of the sort, and wouldn't. My suggestions and questions were reasonable and intended to reduce as much variables as possible. Your response is dishonest and a strawman?

Why don't you actually support your claims, and quit creating strawmen?

Why did you come here, ask for opinion?

Apneak wrote: ↑
Sat Sep 26, 2020 4:38 pm
In anycase, your incredulity supports my decision to switch back to Airsense.
I don't care what you do, but that fact that you will not even consider that there might be problems in your methods, data and interpretation of the data, supports my conclusion that you are ill-equipped to do a proper comparison and make another poor decision.

The only thing that is not default is the time in min and time in max, which is at .8s / 4s instead of .3s / 2s....However, this should have no impact on central apneas. Otherwise, what are you seeing that can affect this? That's the only "variable" however it is not a significant variable, just like what I ate for dinner. And I'm assuming you don't mean to also set the pressure range and support to default, as that would create more differences between the 2 machines. I'm not creating strawmen. I'm telling you I've studied this for several days on each machine back to back, since I too was completely dumfounded....I really wanted the Aircurve to work, since it does produce more consistent flow curves, But I'm just giving up on it. Going back to airsense.

raisedfist · Post by **raisedfist** » Sun Sep 27, 2020 12:47 pm

There is no reason to touch Ti min at all unless you have a respiratory disease and have problems sustaining the inspiratory phase. The machine is not at fault. You tinkering makes the comparison to the autoset useless. Increasing Ti min means that if at some point during the night you wanted to do an inhalation quicker than .8 seconds, the machine won't let you. Ti min is NOT simply a comfort feature because it can alter respiration. You can't alter settings that the autoset doesn't have and then call it a comparison.

Apneak · Post by **Apneak** » Sun Sep 27, 2020 1:56 pm

So basically you're suggesting that even though my typical inspiration time is 1.2s, that the .8s minimum is the cause of having all the centrals?

raisedfist · Post by **raisedfist** » Sun Sep 27, 2020 5:42 pm

No, that is not what I said. Try adjusting the trigger sensitivity and see if a higher setting reduces the CA index. It's worked for many.

palerider · Post by **palerider** » Sun Sep 27, 2020 8:43 pm

Apneak wrote: ↑
Sun Sep 27, 2020 11:41 am
The only thing that is not default is the time in min and time in max, which is at .8s / 4s instead of .3s / 2s....However, this should have no impact on central apneas.

Changing TiMin without knowing what you're doing is *stupid*.

The ONLY time that should ever legitimately be changed is if you have *lung disease*, (nothing to do with sleep apnea).

Apneak · Post by **Apneak** » Mon Sep 28, 2020 3:48 pm

again, your points, whether they're true or not, are not relevant, as the TI min is already substantially low, at .8s. And for the record, I didn't change it from the default, for some reason when I got my machine the TiMin was set to 2s! And nobody at DME/Doctor can tell me why...so I just moved it down well below a length where I was getting spontaneous cycles of my breath.

My normal breathing doesn't approach .8s. Guarantee you that were it .3s, I'd have the same results.

I've tried adjusting the cycle and trigger sensitivities down and up, respectively, but both just feel unnatural. Haven't tried adjusting cycle sensitity to high, but can't imagine that'd help? In any case, I've switched back to an APAP. Aircurve has better waveforming, but I gotta call it quits at some point.

palerider · Post by **palerider** » Mon Sep 28, 2020 6:47 pm

Apneak wrote: ↑
Mon Sep 28, 2020 3:48 pm
again, your points, whether they're true or not, are not relevant,

"I've made up my mind, don't confuse me with facts"

Apneak · Post by **Apneak** » Mon Sep 28, 2020 7:03 pm

What is the fact palerider? WHy don't you actually respond to what I'm saying, that a move from .8s of timin to .3s cannot conceivably change the stats, since it is already far outside the range of my breath cycle? How's that for a fact?

Higher CA events on Aircurve at same settings as Airsense.

Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

Re: Higher CA events on Aircurve at same settings as Airsense.

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