Sierra

You got a good buy on the ResMed AirCurve 10 VAuto. You can do pretty much everything with it that you could do with an AirSense 10 AutoSet. About the only thing I can think of that is missing is the AutoRamp feature, which is nice but not essential. And the ability to use EPR in ramp only is there, but only for the CPAP mode.

That was kind of what I suspected. Probably the best way out of the situation you are in is to post one or two of your ResMed AirCurve Daily Detail screenshots from SleepyHead. It should give a good idea where you are now, and how it could be best set up. To use SleepyHead if you do not have it, you need a PC or Mac and a SD card reader. The general process is to take the SD card from your machine and let SleepyHead copy the data on it. SleepyHead can then display the detailed data so you can see how well it is working for you. The software is free. Some links:

SleepyHead download

SleepyHead basic manual

It would now be better to not scrunch down the Flow Rate as much. It is OK if AHI slips off the bottom I have not found the AHI graph to be really useful. Also not so much zoom in on that RERA event. It is hard to see the shape of the inhale and exhale flow. If you zoom out and put the RERA event off to the right it should be easier to see if there is any flattening, and if there are any other events leading up to it. Something more like this:

What was the model of your DreamStation machine? Was it a BiLevel or an Auto CPAP? From what I see in your sleep study report the recommendations was to get a basic CPAP set at a fixed 9 cm of pressure. An Auto CPAP can also be set to fixed CPAP mode for the same treatment.

I guess I am wondering why you bought a BiLevel machine? I have seen studies which have found that in about 60% of the cases when a patient was switched from a CPAP or APAP to a BiLevel the outcome actually became worse, not better. What I am getting to is the thought that if you were getting good results with the DreamStation in fixed CPAP or APAP, that it may be better to stick with that setup rather than jump into the pressure support mode of a BiLevel. I have seen a number of posters here that have used a BiLevel when all they needed was an APAP, and to get the best results they have to switch it back to APAP or CPAP mode. You can essentially put the AirCurve 10 VAuto machine in APAP mode by setting the pressure support at zero. Or you can also put it into fixed CPAP mode. See page 14 of the technical manual at the link below.

Technical Manual

If you really need a BiLevel I will leave it to bonjour to give you advice on how to set it up, as he uses one. The caution is that it may not be what you really need.

I don't think there should be any conflict in SleepyHead if you transfer the data from your old machine SD card first, and then start transferring in the data from the new machine after that. Assuming there is a lot of data on the old machine it may take some time for that data to transfer to your computer...

If you google CBC youtube sleep it should bring up a number of the CBC National reports on sleep. Not sure if they will work in other countries though...

I get some RERA events flagged in my sleep. I have seen no indication they are linked to sleep onset apneas or hypopneas. When ResMed flags a RERA event it seems to be associated with flow restriction and flattening off of the top of the inhale breath flow rate, and an irregular breathing event signalling an arousal. If you end up getting an AirSense 10 AutoSet For Her, it is especially set up to respond to RERA flow limitations, and snoring.

I would still set up the AutoRamp as I described in the post 14 days ago first. If it does not stop sleep onset apneas, then there are the options I also described. In other words set it up for maximum comfort first, and if that does not work, then try the other options.

BUG, I think they can be a good idea if you have the standard SlimLine non-heated hose and get condensation (rainout) in the hose. If you have the heated ClimateLine hose they should not be necessary. I use the heated ClimateLine hose but still put it under the covers just to help keep it out of the way.

I think I would spend the AU$79 for a ClimateLine hose before I would spend the AU$42 for a hose cozy though.

2" wide pink tape of course!

It would be best to start with posting a screenshot from SleepyHead. You need a PC or Mac with a SD card reader. The software is a free download. There is a basic manual at this link. Basically what I do is look to see what is happening and what events are occurring at higher pressures. If there are more CA events there, then there may be a benefit in lowering pressure. However it is not really that cut and dried. If you see breathing instability with waxing and waning cycles in flow, as well as ups and down in Minute Ventilation, that can be an indication of central related instability. That instability can in turn cause hypopnea and obstructive apnea. About all you can do is zoom in on events that occur at higher pressure and try to figure out what the initiating factor is.

On the low pressure side it is usually simpler. Look for areas when you are getting OA events. If it is when the pressure is at minimum or near it, then there tends to be benefit in increasing minimum pressure. A higher minimum can avoid those events, instead of letting them occur to trigger an auto response to increase pressure. This is a bit of an iterative process and I find it takes a minimum of a week at one setting to determine if it is an improvement or not.

But it would be best to post a SH chart for comments. With the Daily Detail at full screen just press the F12 on a PC and a screen shot image will be saved to a directory which will display briefly in the bottom right. To post it here, open a new message with the Write a Reply button to get a full width window, then drag the saved .png file from Windows Explorer to the open body of the message.