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Bi-Level, S, ST, ASV??
RE: Bi-Level, S, ST, ASV??
Been experimenting for a few days... back is worst (AHI in 30's), right side better (AHI in 20's), left side best (AHI in teens).  Interesting.

Also experimented with everything from 150 to 900 ms rise time while awake... settled on 500 ms.  MUCH more comfortable.  I can't understand HOW "min" would be the best default setting for this device.  I read that a fast rise time can also induce additional centrals.  First night with 500 ms rise time took centrals (or unclassified) from high 20's down to 18 AHI (right side).  We will see if it is consistent.  Really battling mask leaks with the Quattro Fx.  Waiting for Amara View to see if that helps and makes any difference in numbers.

I am also questioning the default Ti min setting of 0.3 sec.  I see chopped off waveforms now and then, since anytime after 0.3 seconds, if the unit senses exhale, it switches.  Not sure if that is good, bad or does not matter in the grand scheme of things.  May be default is for best synchronization, and should only be changed if you need to guarantee sufficient inhalation time or secure exhalation time.  Anyone know?  With a 4 second average breath, 1:2 ratio gives 1.3 inhale, 2.7 exhale.  It appears the inhale time Ti min includes the rise and plateau portions of the wave, and Ti max also includes the fall portion or cycle window.. so i wonder if Ti max is smart enought to start the downward cycle at Ti max - fall time?  So with Ti min = 0.3, and 500 ms rise time, if it senses exhale you may never get to full inhale.  And with a lot of mask leaks, it could induce exhale too soon.  Am I right?
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RE: Bi-Level, S, ST, ASV??
With regard to Ti Min, the default 0.3 is a non-therapy timing, and if the start of inspiration is weak or fails, the breath will not be supported. For those with CA and that need help with inspiration, I will often suggest a time of 0.8 to 1.0. Basically, once inspiration begins, IPAP will continue for that length of time, even if effort stops. With a default of 0.3, that is sensed as the start of expiration. All you can do is try the longer Ti Min and see if works and is comfortable for you.
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RE: Bi-Level, S, ST, ASV??
(11-21-2019, 02:38 PM)jtech1 Wrote: Really battling mask leaks with the Quattro Fx.  Waiting for Amara View to see if that helps and makes any difference in numbers.

Full Face masks have more surface area touching skin that Nasal and Pillow masks and struggle to get a good fit around the bridge of the nose so tend to leak more than Nasal and Pillow masks.  

If he can learn how to handle (no mouth breathing) a Bleep or Nasal or Pillow mask will be less claustrophobic and less trouble with leaks, especially the Bleep mask.

WillSleep

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Bi-Level, S, ST, ASV??
What is, generally, the upper pressure that works well through nasal mask?

Also, for bilevel with backup rate, is there a minimum level of pressure support needed to make the backup rate work properly when it kicks in?  ie. where below x level of PS the backup rate does not properly ventilate?  I suspect that my dad does not need the full range of 7/16, and the 16 may be exacerbating his leak issues and driving some of the centrals.  After a few more dats of data collection at 16/7 I am going to ask Dr about testing some lower levels.
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RE: Bi-Level, S, ST, ASV??
Given ideal sealing conditions, I think any regular xPAP nasal mask should handle the top pressure an ASV can create which is 25 in ASV or ASVAuto modes.

I'm lacking current knowledge on how PS would/could affect Backup Rates on the ASV, I do know these ResMed 10 ASV's lack manual Backup Rate settings.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Bi-Level, S, ST, ASV??
A minimum PS of 9 is usually used to encourage a breath which matches the current machine settings, the biggest issue I had with a nasal mask was mouth breathing but it settled down after some time as I got used to the pressure changes.
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RE: Bi-Level, S, ST, ASV??
Is your dad's ASV the ResMed 10? Assuming running in ASV Auto, he should have 4 pressure settings as follows: EPAP Min _ and Max _, then PS Min _ and Max _. Fill in those blanks please, AKA what pressure settings are used to get the 7/16?
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Bi-Level, S, ST, ASV??
AirCurve 10 ST.  So only settings are 16/7 and BR 14.

Has anyone on here used BR with less than PS=9?  Trying to gather all the facts during first couple weeks of usage... since titration study only spent a few minutes at different levels.  Bottom line is, if a lower pressure level without BR (ie. 7/11, 8/12, etc.) gives him better sleep and better numbers, then that would be a better option than the current 16/7 with BR 14.  I just don't want to leave any stone unturned, especially if it means better treatment with more comfort.  There should be no drawback to trying lower, regular Bi-level pressures or even CPAP mode with EPR to make sure he would not be better served with less therapy.  Because if that is the case, and he really does not need BR, then we can use a machine that gives us EasyBreath and Clear detection like VAuto.
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RE: Bi-Level, S, ST, ASV??
Sorry on the mix-up, somehow I had him on ASV. Elderly man Dave memory crash.

I have yet to do hands on of an ST type, so I am no help.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Bi-Level, S, ST, ASV??
(11-23-2019, 04:39 PM)jtech1 Wrote: AirCurve 10 ST.  So only settings are 16/7 and BR 14.

Has anyone on here used BR with less than PS=9?  Trying to gather all the facts during first couple weeks of usage... since titration study only spent a few minutes at different levels.  Bottom line is, if a lower pressure level without BR (ie. 7/11, 8/12, etc.) gives him better sleep and better numbers, then that would be a better option than the current 16/7 with BR 14.  I just don't want to leave any stone unturned, especially if it means better treatment with more comfort.  There should be no drawback to trying lower, regular Bi-level pressures or even CPAP mode with EPR to make sure he would not be better served with less therapy.  Because if that is the case, and he really does not need BR, then we can use a machine that gives us EasyBreath and Clear detection like VAuto.

The problem is the higher PS is required to encourage a breath. That what an asv does is dynamically increase PS to encourage a breath. An ST is dumb it provides pressure support all of he time and switches to ipap if a breath is not started before it’s backup rate timer is triggered. It kind of works as a treatment if pressure support is sufficient otherwise the CA’s just become Hypopnoeas as the PS doesn’t encourage a full breath. Do you have any more recent charts for you DAD how’s it going ?
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