CPAP Clinic Sleep Blog

Understanding your sleep health, sleep apnea and CPAP therapy

CPAP won’t give you sleep? Research the Aircurve option & get results now


CPAP won’t give you sleep? Research these options & get results now



The AirCurve 10 by Resmed is a series of Bilevel units of varying features and benefits which perform better than CPAP in many ways.


First, we will cover what the Aircurve Bilevel is and second, what this Bilevel series accomplishes for the user.


What is Bilevel?

Bilevel positive airway pressure (BPAP), commonly referred to by the trademarked names BiPAP and BIPAP, is a form of non-invasive mechanical pressure support ventilation that uses a time-cycled or flow-cycled change between two different applied levels of positive airway pressure.


When is Bilevel needed?

A Bilevel unit is required when a singular amount of pressurized air (i.e. CPAP)  is not tolerated by a patient, Two pressures may be required, which a CPAP unit cannot produce.. This means two pre-programmed airway pressures from a Bilevel unit may benefit the apneic patient more effectively.


How Bilevel Works

Bilevel is a unit providing air pressure delivered via separate volumes, where one volume of pressurized air is given with inhalation and a second volume of pressurized air is given with exhalation. The complete delivery of inhalation and exhalation is called ventilation. This means ventilation can be programmed and provided by a Bilevel unit.


What do the Bilevel Settings represent?

A Bilevel’s settings mimic breathing inward (inhalation) and outward (exhalation).

The inhalation and exhalation pressures have values called centimeters of water or the subscript, cmH20.

A setting for a Bilevel can look like this:

Inhalation – 16cmH20  Exhalation 10cmH20  or  I/E 16/10 on a prescription from a sleep doctor.

This means an air pressure of 16cmH20 is pushed into the airway during inhalation (to keep the airway open) and 10cmH20 is pushed into the airway during exhalation (to keep the airway open).

Ultimately when a Bilevel is programmed 16/10,  it will give these pressures for the user for every breath, thereby controlling sleep apnea.


How a Bilevel delivers pressures

Let’s examine how the user triggers or “starts” Bilevel ventilation using the unit’s algorithmic programming

Here’s what we know in simple terms:

A Bilevel can be “initiated via user breathing effort” to ventilate.

For example, the user gives an effort to breathe in and triggers the full Aircurve ventilation cycle. Therefore the programming puts the user in control of when ventilation occurs. This is how a user’s experience is customized.

There are two ways this happens and they are described below.


The Bilevel’s Program-ability Explained

The Aircurve series is equipped with various ways to be triggered by the user.

  • TiControl: Found in AirCurve 10 S, AirCurve 10 VAuto, and AirCurve 10 ST, TiControl lets providers program minimum and maximum time limits on either side of the patient’s ideal spontaneous flow cycling, creating control for the patient to cycle the breath. For example, Ticontrol can give two (2) seconds of inhalation pressure delivery and four (4) seconds of exhalation pressure delivery.
  • Other inhalation and exhalation time durations can be programmed.
  • Trigger Sensitivity: Adjustable trigger and cycle sensitivity settings TiControl, found in AirCurve 10 S, AirCurve 10 VAuto, and AirCurve 10 ST, can be used to optimize synchrony between the device and the patient.This means the effort to breath inward (i.e.  like a small gentle gasp ) tells the Aircurve when to start delivering pressures.


Bilevel Advanced Comfort Options Explained

  • Vsync: Advanced leak management technology, Vsync helps provide patient-ventilator synchrony for a natural `feel`to one`s breathing pattern. This means there is customized matching of the breathing cycle. Vsync is available in all AirCurve 10 devices.
  • HumidAir: Integrated heated humidification that affords simpler therapy, with fewer parts to set up and manage.
  • Easy-Breathe – Silent blower operation is in all units.


Now let’s look at each unit in brief and the differences between each Bilevel:

  • AirCurve 10 S: This is a Bilevel device ideal for those who require extra pressure support (more than 20cmH20) or find it impossible to adjust to fixed pressure continuous positive airway pressure devices. It features two different adjustable pressures that can help make therapy feel more comfortable.
  • AirCurve 10 VAuto: This is an auto-adjusting bilevel device for patients who need greater pressure support (to 25cmH20) to treat their obstructive sleep apnea. It uses the comfort of both the proven AutoSet algorithm and Easy-Breathe waveform in its VAuto algorithm (making the unit silent).
  • AirCurve 10 ST: A bilevel device with backup rate (a guaranteed rate of ventilating breaths per minute) that provides exceptional patient-ventilator synchrony, reducing the work of breathing so patients remain comfortable and well ventilated.
  • AirCurve 10 ASV: A bilevel device for central breathing disorders such as Cheyne-Stokes respiration, central sleep apnea, or obstructive events. The AirCurve 10 ASV recognizes the patient’s own minute ventilation (i.e. full inhalation and exhalation pattern per minute) It does this to treat breathing disorders with auto-adjusting (intuitive) pressure support, and upper airway obstruction with auto-adjusting expiratory positive airway pressure, the device works to rapidly stabilize breathing.

In conclusion, remember the process of obtaining a unit described above does require a prescribed order from a sleep physician. A sleep doctor will have access to your sleep study results and assess which Bilevel is right for you. Be sure to secure this part of the process so your sleep apnea treatment is optimal and you can say goodbye to CPAP.


Call 1.877.430.2727 for help.

Written and Edited by Bill Bistak B Sc.,SEO/SEM Spc, CRT

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