Which mode is the best for me? ST or iVaps??

Hi... I am 59 years old..and a myositis patient. My respiratory muscles are really week.. Due to which it leads to difficulty in breathing and causes Co2 retention.

I am on bipap since last three years. I was at 6-12 pressure.... However recently my Co2 levels again got elevated... My AHI was around 30.. I did some googling and increase my pressure to 7.6 - 16. Also I switched to St mode.. My AHI is now down to zero with that pressure. Also I feel it's helping me washout my Co2.

I have resmed s9 ST with ivaps machine. I recently got one... I am thinking to switching to ivaps. I used it for two days with tidal volume set at 390 ml....however the pressure at night at times used to get as high as 19(ipap)... Which really caused me irritation. My resmed supplier suggested that it's the best mode for helping was out Co2. However more comfortable I feel is with ST mode. Can anyone pls help me with this. Which mode should I use...??

Regards
Girotra

But if what you're doing now is working, why fool around with something else?

iVAPS is to treat hypoventillation. ST mode may not treat hypoventilation. I presume you can set a maximum pressure even in iVAPS mode, but that limits its ability to treat hypoventilation.

Which mode is right for you will depend on what your condition is, and how it responds to the various settings on your machine.

archangle wrote:iVAPS is to treat hypoventillation. ST mode may not treat hypoventilation. I presume you can set a maximum pressure even in iVAPS mode, but that limits its ability to treat hypoventilation.

Which mode is right for you will depend on what your condition is, and how it responds to the various settings on your machine.

Maybe Resmed is different, but on the Trilogy, you can use both. I'm in ST mode with AVAPS (iVAPS on Resmed) enabled.

Thanks guys.. I have a titration study tonight. Lets see what mode is best suited for me..!!

For VAPS therapy you want the IPAP max to be at least 25cmH2O for the algorithm to work properly. A wide range can be beneficial because while awake you can fall asleep with a lower IPAP pressure and then hopefully you can stay asleep when the machine eventually revs up. I would make your IPAP min be EPAP +4cmH2O and your IPAP max be 25 (sometimes 30 depending on the condition of the underlying disease/disorder).