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I was diagnosed with severe sleep apnea a few months ago at 73 because I had a problem when coming out of the anaesthetic after an operation. A sleep study showed I was having around 70 apneas an hour.
I've been using a loan BMC BiPAP machine for about two months. It was originally set at 10cm IPAP and 6cm EPAP and my AHIs are now consistently around 2. I saw the doctor last week who suggested I could go down to 9cm IPAP and 5cm EPAP.
I have to return the loan machine and am buying an AirSense 10 AutoSet in a couple of weeks. (In my country the AirSense 11 is not available because of regulatory requirements and, in any event, I think I prefer the 10 for a number of reasons.)
Over the last few weeks I've watched so many YouTube videos and read lots of forum posts but I've still got a lot to learn.
TL:DR What my question is where should I start setting the maximum and minimum pressure settings on the 10. I am a bit concerned at moving from a BiPAP to an APAP because I have got used to the different IPAP and EPAP settings but at these levels I hope it won't be a problem. Should I try at something much higher than 9 or 10 maximum to start with? What minimum should I try?
There will be one hopefully minor issue. The AutoSet can only be set for a maximum of 3cm between IPAP and EPAP. You have been at 4 cm. Probably not significant, but there is no way to get more pressure support than 3 cm with the APAP.
My suggestion with the AirSense 10 would be to set it as follows:
Mode: AutoSet
Min Pressure: 9 cm
Max Pressure 12 cm
Ramp Time: Auto
Start Pressure: 7 cm
EPR: On
EPR Type: Full Time
EPR Level: 3 cm
Climate Control: Auto (if you have a heated hose)
That should get you close to where you were with the BiPAP. IPAP will be 9 cm to start and EPAP will be 6 cm. IPAP will increase as needed to a max of 12 cm. EPAP will always be 3 cm lower.
Thank you, Sierra. That is most helpful. I may also just try with EPR off just to see if that gives me a problem. I should know in a couple of weeks when I get the machine.
If your objective is to replicate the BiPAP settings it would not make sense to turn the EPR off. EPR on the APAP is like Pressure Support on a BiPAP. Based on what you said the machine was set at, your BiPAP had a pressure support of 4 cm (10 cm IPAP minus 6 cm EPAP). Setting the APAP to 3 cm is giving you almost as much. In general pressure support or EPR makes breathing more comfortable. I also find for me that it reduces the incidence of hypopnea. But each person is different and what works for one, may not work for another.
I would also suggest downloading OSCAR so you can track your results in detail to ensure the APAP is working well for you. Some CPAP suppliers play a dirty trick and remove the SD card that is needed to capture the detailed data. If your machine comes without one I would suggest putting one in right from the start so you capture all the data. Standard is 4 GB, but up to 32 GB will work.
Yes, I've already downloaded OSCAR in readiness for the new machine as it doesn't support my existing machine. I've also bought a 16Gb SD card from Amazon. I used to have so many SD cards. I don't know where they all went!
Interestingly ResMed claim they put a SD card in every machine they ship, but many report their machine has no card. I have a ResMed branded card which came with my A10 machine which I purchased from an online supplier.
There is a development! The company I am dealing with (I am not in the US) has offered me the AirCurve 10 VAuto at a good price. Should I get it instead of the 10 AutoSet? It is quite a bit more expensive than the AutoSet but I am tempted. Even though my current IPAP figure is not high, things could change when I have an APAP and, being a bit paranoid, I am worried at the possibility that EPR may not be enough for me if the AutoSet says I need a higher IPAP. Once I buy an AutoSet, I won't be able to change it and, as it's my money, I certainly won't be able to afford to dispose of it (we don't have ebay here) and buy a new machine. If I buy the AirCurve, it might be overkill but, as far as I can see, I don't lose anything over the AutoSet, apart from the extra money. Are there any disadvantages of the AirCurve over the AutoSet?
Thanks, Sierra. I don't think I'm bothered about Auto Ramp. I tend to get to sleep quite quickly so I would either set Ramp to 5 or 10 minutes or just turn it off.
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