Resmed Airsense 10 Autoset vs Aircurve 10 VAUTO

[Sleepless_in_Seattle]

I'm hoping one of the experts here can help me understand the difference between the Resmed Air Sense 10 Autoset and the Air Curve 10 VAUTO if the settings of each machine are set in the following way:

Air Sense 10 Autoset
Set to auto
Min 5
Max 15
EPR 3

Air Curve 10 VAUTO
Set to auto
Min EPAP 5
Max IPAP 15
PS 3

In this context, will the user experience essentially be the same? Or will the algorithm of each machine feel significantly different or achieve different therapeutic results? I look forward to learning from this community. Thank you in advance.

[Pugsy]

EPR is removed from IPAP to give you EPAP

PS is added to EPAP to give you IPAP

Air Sense 10 Autoset
Set to auto
Min 5
Max 15
EPR 3

These settings will give you 5 cm inhale and 4 cm exhale while first starting the machine at the beginning of the night.
The EPR of 3 can't drop 3 because the machine can't go any lower than 4.
Now if a bit later your machine decided it needed to do 7 inhale...then the 3 cm EPR exhale relief would drop down to 4 cm on exhale.
Another example...if it went to 12 cm on inhale then exhale would be 9 cm.
The highest IPAP it will go would be the 15 max.

Air Curve 10 VAUTO
Set to auto
Min EPAP 5
Max IPAP 15
PS 3

With these settings you start the night with EPAP (exhale) of 5 and with PS added to EPAP you would have 8 inhale....so 8 inhale and 5 exhale.
If you went to the max IPAP of 15 then with PS of 3 that means that EPAP would be 12.

[palerider]

I'm hoping one of the experts here can help me understand the difference between the Resmed Air Sense 10 Autoset and the Air Curve 10 VAUTO if the settings of each machine are set in the following way:

Air Sense 10 Autoset Set to auto Min 5 Max 15 EPR 3

Air Curve 10 VAUTO Set to auto Min EPAP 5 Max IPAP 15 PS 3

In this context, will the user experience essentially be the same? Or will the algorithm of each machine feel significantly different or achieve different therapeutic results? I look forward to learning from this community. Thank you in advance.

No. EPR and PS have *opposite* effects.

PS is a pressure RISE, EPR is a pressure DROP.

[Sleepless_in_Seattle]

Pugsy and Palerider, thank you both for taking the time to respond. Your explanations make things much clearer.

Let me reframe my question slightly. If one were titrated to the Air Curve settings in the first example (EPAP=5 IPAP-15 PS=3) can that essentially be mimicked with an Autoset? For example, if the Airsense min was set to 8 instead of 5 (min=8, max=15, EPR=3) would that then provide the same support that the Aircurve is providing?

If that would indeed provide the same theoretical pressure support, would there be any variation in terms of the machines algorithms and how it feels? The same speed of pressure increases or decreases? The same transitions between inhale and exhale? The same event identification?

I understand that if the PS is larger than 3 then an Autoset can never mimic what a Vauto is doing. But if the PS is 3 or less on the Vauto then it appears an Autoset can indeed accomplish the same or similar therapy. Is this correct?

Thank you for taking the time to read this and I look forward to further clarification.

[Pugsy]

Yes you can essentially mimic the AutoSet and have it auto titrate and if you want to have it be more exact that can be done also but your above settings examples were actually close enough as they were.

If you were using the AutoSet in apap mode with EPAP being 5 and PS of 3 and the nighest it could go to was 15...then you would set things this way.
Minimum pressure 8
EPR 3
max pressure 15
You would start the night with 8 IPAP (inhale) then EPR kicks in and drops the pressure by 3 ...giving you 5 EPAP.

So the same setting equivalent on the Bilevel in auto mode would be
EPAP 5
PS 3
max IPAP 15

Same event category identification...pretty much the same auto adjusting algorithm...
The transition from inhale to exhale is maybe the biggest difference and most people won't notice much difference unless they really try.
The VAuto bilevel ....has a little smoother transition...so that part is a little better IMHO but it's not like the transition using EPR is crap...it's still very comfortable. On the bilevel you can tweak it to make it even more smooth if you wish.

I told someone the other day...think of the AirSense 10 AutoSet as the base model Lexus...still a really nice care but the AirCurve 10 VAuto would be like the Lexus with all the upgrades to make it even more comfortable.

[salinas212]

In an effort to keep like/similar posts together I'll post my 1st night's AirCurve 10 Auto results here:

Old Machine: Started use 02-08-18
AirSense 10 AutoSet
Set to Auto
Min 7
Max 13 (Yes I struggled with superstition using this #. My OCD is alive, well and unaffected by OSA)
EPR Off

New Machine: Used last night 8-31-18 for the very first time.
AirCurve 10 VAuto
Set to VAuto
Min EPAP 7.0
Max IPAP 25.0
PS 4


Machine reported to the ResMed MyAir site via the cellular connection overnight as if it had been there all along (Thanks Pugsy!). Interestingly, I had the first 100% leak-free night EVER! .3 events total which is well within my usual range however I only had a single waking near 1am where I looked at the clock and went back to sleep until a little after 5am. Usually I'm awake several, if not many times and up between 3:45/3:50am. Yes I have SH but am reserving even a peek at it until I have a week's work of nights to compare due to that evil OCD thing. I know I slept very well and am well-oxygenated this morning. Easy to tell by how it feels tho a quick reading confirms it since I use O2 at night and awoke with a 97% saturation. I'm usually closer to 92-93% at same time given no change on concentrator's 3.0 L/min output settings.

I awoke refreshed, bright-eyed and bushy-tailed. I knew immediately I shoulda done this initially out-of-pocket instead of permitting the VA to do it for me. Not that I don't appreciate them. I do TOTALLY but should have followed my own initial gut-instinct on machine choice. After all it was them that gave me the sleep clinic and created the awareness of CPAP need within me just after Christmas 2017. And they coulda done a lot worse by me than providing an AirSense 10 to start! Oh but were masks as easy to choose!

I look forward to the challenges ahead. Heck as long as I'm well rested, experimenting, tweaking & fine tuning the numbers on this machine in baby steps sounds fun, challenging and an adventure I'll enjoy. Certainly anything but drudgery!

Its whole new day, great to be alive with so much to look forward to! Like perhaps turning O2 down to 2.5 or 2.0 L/min for a start

[palerider]

In an effort to keep like/similar posts together I'll post my 1st night's AirCurve 10 Auto results here:

Don't do that.

Keep YOUR OWN posts together. Make a thread of your own, and keep your stuff in that.

[palerider]

Pugsy and Palerider, thank you both for taking the time to respond. Your explanations make things much clearer.

Let me reframe my question slightly. If one were titrated to the Air Curve settings in the first example (EPAP=5 IPAP-15 PS=3) can that essentially be mimicked with an Autoset? For example, if the Airsense min was set to 8 instead of 5 (min=8, max=15, EPR=3) would that then provide the same support that the Aircurve is providing?

If that would indeed provide the same theoretical pressure support, would there be any variation in terms of the machines algorithms and how it feels? The same speed of pressure increases or decreases? The same transitions between inhale and exhale? The same event identification?

I understand that if the PS is larger than 3 then an Autoset can never mimic what a Vauto is doing. But if the PS is 3 or less on the Vauto then it appears an Autoset can indeed accomplish the same or similar therapy. Is this correct?

Thank you for taking the time to read this and I look forward to further clarification.

MinEPAP=5, MaxIPAP=15, PS=3 on vauto equals Min=8, Max=15, EPR=3, yes.

I can't tell any difference between how EPR and PS feel, if easybreathe is turned on (always on in vauto mode).
EPR vs PS:

[Sleepless_in_Seattle]

Pugsy and Palerider, thank you both for helping me understand the equivalent pressure settings on either machine. I really appreciate it. And it’s also helpful to know that neither of you notice much difference between the machines in terms of how it feels.

Pugsy mentioned that the Vauto (PS) may be a little smoother than the Autoset (EPR) which makes sense being a more sophisticated machine. But looking at the examples provided by Palerider it appears that EPR (top example) is actually smoother than the PS (bottom example). Am I understanding the examples correctly?

After reading the forum I was under the impression that the ideal waveform is closer to the EPR example and the “castle wall” example on the bottom (PS +) is not good. Sleepyhead is a great tool but it's almost like learning new language. Can one of you please elaborate on what the visual examples illustrate specifically? My next learning curve to overcome is how to interpret waveforms to evaluate my personal settings. Thank you both for your time and knowledge.

[salinas212]

Having completed my 5th night with the Air Curve VAuto last night I can say least for me it's a dramatic difference in how it feels even if I ignore its documented benefits. Its one of the first things I noticed/felt after strapping in on night 1. It felt immediately kinder/gentler the very first night and every night subsequent. I didn't have to do a thing but lie there and feel it... no effort to rationalize or justify the purchase. Jus "feel" and nothing more. I get huge percentage differences in my nightly events... on the order of almost 90% over the first machines results per night from one night to the next as they relate to AHI/Leaks! I remain a bit gape-jawed. Aced the MyAir nightly rating the hard way "0" events/"0" leaks 2 nights in a row... never happened previously, even once! In spite of matching settings from my AirSense 10 it simply feels different... LOTS different! Its felt smoother, more deft/adept, refined, sophisticated, kinder, gentler every single night. Those thoughts find me... no need to go looking for them. Its still so new to me I notice immediately after auto-on kicks in and smile because of what I know comes next. Its soooo much more comfortable. I sleep better, longer and more peacefully than I have since I was a much younger man. I feel better during the day... LOTS better. For me it's not just a "little" smoother or a "little" better, its night & day, acres and acres! To go from 4.5-6 erratic/fitful hours of sleep a night for over 30 years to 8+ hours of "continuous-out-like-a-light" sleep from one night to the next is livin LARGE at my house! The feelings experienced with donning the new machine each night reminds me a bit of the old Aaron Neville/Linda Ronstadt song; "don't know much but I know I love you... and that may be all I need to know." And yes I'll now be humming that all night, but only till sleep overtakes me.

[palerider]

Pugsy and Palerider, thank you both for helping me understand the equivalent pressure settings on either machine. I really appreciate it. And it’s also helpful to know that neither of you notice much difference between the machines in terms of how it feels.

Pugsy mentioned that the Vauto (PS) may be a little smoother than the Autoset (EPR) which makes sense being a more sophisticated machine. But looking at the examples provided by Palerider it appears that EPR (top example) is actually smoother than the PS (bottom example). Am I understanding the examples correctly?

Well, I wouldn't call it "more smooth", maybe my breathing was a little more ragged? (it's a little challenging to breathe smoothly and properly while awake... awake breathing is usually rather irregular... I had to find spots out of what I'd done that matched up nicely ) maybe the measurement of the machine is a little more sensitive? I can't *feel* any difference in the machines at an EPR of 3, or PS of 3.... not that I claim to be all that sensitive.

After reading the forum I was under the impression that the ideal waveform is closer to the EPR example and the “castle wall” example on the bottom (PS +) is not good. Sleepyhead is a great tool but it's almost like learning new language. Can one of you please elaborate on what the visual examples illustrate specifically? My next learning curve to overcome is how to interpret waveforms to evaluate my personal settings. Thank you both for your time and knowledge.

Those blue traces are the actual, measured pressure at the mask, after removing compensation for the hose, humidifier and mask type. whereas the 'pressure' trace is "this is what we want the pressure to be" the 'mask pressure" trace is "this is what the pressure was". So you can actually see how the pressure changes during the breath.

[palerider]

Having completed my 5th night with the Air Curve VAuto last night I can say least for me it's a dramatic difference in how it feels even if I ignore its documented benefits.

What were your settings on the airsense, and what are your settings on the aircurve?

[Sleepless_in_Seattle]

Palerider, Thank you for explaining. I appreciate your help. All the best.