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ASV questions
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richb Offline

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Posts: 526
Joined: Jun 2015

Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Built in
CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #31
RE: ASV questions
I see the same thing as Vaughn . Get the Obstructive events under control first.

Rich
05-08-2016 05:21 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #32
RE: ASV questions
Vaughn, thank you so much for your input. It makes sense to me and does not contradict anything I am experiencing and/or already tried. And most of all you did not just tell me to "get used to it". For me it is real and very disturbing.

Looking at sleepyhead I see:
average EPAP 5.14-5.97
min EPAP 4.02
max EPAP 11.00- 11.48
90% IPAP 12.08
Min IPAP 8.02
My machine is set at Max IPAP 15, Min EPAP 5, and PS 4

Please help me clarify:
In sleephead I see IPAP=8.07, PS=4, and EPAP=4.07 which all adds up, but I don't understand how I can get EPAP of 4.07 if my Min EPAP is set to 5?

I don't see a 95% EPAP so... okay so now I have no idea what to do. I assume to leave IPAP unchanged. PS also unchanged? EPAP move from 5.0 towards???

Hit me over the head with it. seriously, I want to get this right.
05-08-2016 05:55 PM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #33
RE: ASV questions
Thinking more:
if my IPAP 90% is 12 and EPAP should be IPAP - PS are you suggesting that I walk my EPAP min up to 12 - 4 -1 = 7?
05-08-2016 06:12 PM
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Sleeprider Offline
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Posts: 3,331
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #34
RE: ASV questions
I think 12/7 is the goal to prevent obstructive hypopnea which is basically the PB your are seeing. As far as any minimum values on the Aircurve 10 in Sleepyhead, I don't give them much attention or credibility. The minimums, other than settings, are not particularly useful, and I actually reported them as a bug to Mark at one time. I was told that these are values the machine actually reports. Nevertheless, they have almost no useful meaning.

______________________________________________
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05-08-2016 06:33 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #35
RE: ASV questions
After two nights: upped EPAP by 1 cm and the breathing pattern is almost gone, about 80% reduction. Silly me I thought that 1 cm would be a piece of cake, and is turning out a little more difficult to get used to than I thought, what a surprise Smile

Planning to continue the next 1cm in steps and not one jump, maybe, but it sure seems to be working finally.

Thanks to all who have helped me with suggestions and not a single "just get used to it"
Love this board and the people here!
05-10-2016 11:46 AM
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richb Offline

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Posts: 526
Joined: Jun 2015

Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Built in
CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #36
RE: ASV questions
(05-10-2016 11:46 AM)PoolQ Wrote:  After two nights: upped EPAP by 1 cm and the breathing pattern is almost gone, about 80% reduction. Silly me I thought that 1 cm would be a piece of cake, and is turning out a little more difficult to get used to than I thought, what a surprise Smile

Planning to continue the next 1cm in steps and not one jump, maybe, but it sure seems to be working finally.

Thanks to all who have helped me with suggestions and not a single "just get used to it"
Love this board and the people here!

I'm glad things are working out.

Rich
05-10-2016 01:31 PM
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #37
RE: ASV questions
(05-10-2016 11:46 AM)PoolQ Wrote:  After two nights: upped EPAP by 1 cm and the breathing pattern is almost gone, about 80% reduction. Silly me I thought that 1 cm would be a piece of cake, and is turning out a little more difficult to get used to than I thought, what a surprise Smile
A lot of us have what can be thought of as a "maximum pressure" in terms of comfort. And even a modest 1cm increase when we're near that level can take a while to get used to.

That's why it's important to give your body a chance to fully adjust to any change in settings before making another adjustment.

Quote:Planning to continue the next 1cm in steps and not one jump, maybe, but it sure seems to be working finally.
If need be, increase the pressure by 0.4cm steps instead of 1cm steps.

Questions about SleepyHead?
See my Guide to SleepyHead
05-10-2016 05:39 PM
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vsheline Offline

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Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #38
RE: ASV questions
(05-08-2016 05:55 PM)PoolQ Wrote:  My machine is set at Max IPAP 15, Min EPAP 5, and PS 4

Please help me clarify:
In sleephead I see IPAP=8.07, PS=4, and EPAP=4.07 which all adds up, but I don't understand how I can get EPAP of 4.07 if my Min EPAP is set to 5?

Perhaps on at least one night covered by the SleepyHead report you were using the Ramp with a Start Pressure of 4?


(05-08-2016 06:12 PM)PoolQ Wrote:  Thinking more:
if my IPAP 90% is 12 and EPAP should be IPAP - PS are you suggesting that I walk my EPAP min up to 12 - 4 -1 = 7?

Yes, exactly.

But no need to increase Min EPAP all the way up to 7 unless the obstructive events continue to be the main problem while slowly walking the pressure higher (meaning, while making small incremental adjustments once a week or less frequently, before incrementing again).

Sometimes higher pressure causes its own problems, and a compromise needs to be made between raising the Min EPAP high enough to avoid obstructive events versus keeping the pressure low in order to avoid excessive air swallowing, or whatever.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 06-11-2016 04:41 PM by vsheline.)
06-11-2016 04:35 PM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #39
RE: ASV questions
Well it looks like I may have it dialed in.
I first changed TiMax to 4.0, the longest possible because I was feeling that my inhale was being cut off too soon
I then change both the trigger and cycle to very high from high, better but something was still wrong. I changed the cycle back to high and this was better still.

I had now decreased my nightly arousals by 50%

With the advice above I increased my EPEP by 1cm to 6 from 5, better still
Increased EPAP to 6.8 and took a step back on this, not so good here
went back to 5.2 and stepped it up one notch at a time with 2-3 days on each step.
I looked at sleephead and counted how many time I had gotten out of bed and got a nice curve if decreasing and the increasing, minimum was at EPAP set to 6.4 and yes it was that sensitive, typical for me.

I now only wake up when I need to use the bathroom! So very nice. I am so glad because I looked at the ASV machines and from what I can tell they have fewer adjustments than my VPAP, no Timin, Timax, cycle, trigger so I was not sure where I would have gone from VPAP if I could not have gotten it dialed in.

Thanks to all who have helped me finally get a good nights sleep (my wife can tell right away in the morning). For those that are having trouble dialing in a good nights sleep, they might want to consider these VPAP settings.
06-25-2016 03:43 PM
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PaytonA Offline
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Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #40
RE: ASV questions
There is something that I do not understand. Could you explain why you increased the cycle sensitivity to very high when it sounds like you have felt that your inhale was being cut off too soon. Just curious because increasing the cycle sensitivity looks like it should cut off your inhale sooner according to Resmed's chart on page 5 of the clinicians manual.

Best Regards,

PaytonA
06-25-2016 05:24 PM
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