Is my ResMed AirCurve 10 working correctly?

[oldfart59]

I noticed that my AHI values appear to range from 0.23 to over 13,  I thought the ASV is to keep you breathing!

When I look at the sleepy head data, it appears that at times I stop breathing ( See attached screen shot.) The chart shows I stopped at 7:59:10 and did not start up again until 8:00:05. Why did the machine not start me going again? The screen shot is from last night, and today I had to take a nap at 1:00pm

I will be seeing a new sleep doctor, Is there something I should look into on the settings?

[Sleeprider]

Based on this example, I don't think things are too bad. I'd like to see mode ASVauto with EPAP min 5.0 PS 2.0 to 12.0, IPAP max 19. That is nearly the same except for a more supportive EPAPmin. the objective here is mainly to limit hypopnea. We only have the one chart, but that's where I would go for the moment without better information.

[DeepBreathing]

The chart shows I stopped at 7:59:10 and did not start up again until 8:00:05. Why did the machine not start me going again?

You can see on the mask pressure graph that the machine is trying to get your breathing going. However, there's not enough top end to overcome the apnea. Your machine is maxing out at IPAP = 19.0 on several occasions. While I agree with SleepRider that the min EPAP needs to be raised, I would also increase EPAP max to 10.0, PS max to 15.0 and IPAP max to 25.0. You need to give the machine the capability to overcome those long-lasting apnea events.

Note that that Resmed literature recommends that PS max should always be set at 15. While I think that's excessive in most cases, with results like your I think you should give it a go.

[ajack]

agree with get your max epap and max ps being opened up, to give the machine room to move. You have been on it long enough to get use to the pressure rises. The algorithm is a lot cleverer than I am. I would just follow what was said about raising the epap to 5 ..see the results, if there are still ua/h, raise it to 6..etc. Your breath rate and tidal volume are fine, so I haven't a min ps recommendation, use PS2 as suggested and see how it feels for breathing out comfort. After the machine has been used for a few nights, it would be interesting to see the charts, to see how it is progressing.

[oldfart59]

Thanks all, I will make these changes and see how things go

[Sleep2Snore]

That Avatar cracks me up!  

It's brilliant.

[Matt00926]

As starting levels for an ASV titration, the ResMed guide suggests the defaults of:



Min EPAP: 4

Max EPAP: 15
Min PS: 3
Max PS: 15
Ramp: Off

Page 31 here: https://www.resmed.com/us/dam/documents/...er_eng.pdf


For any obstructive events such as hypopneas, obstructive apneas or RERAs, the guide states to increase the min EPAP until they are eliminated.

[oldfart59]

thanks, Matt for the information. I tried the setting (I think) that sleeprider suggested ( see screenshot), but the pressure is too much. the mask would leak when the pressure went up. No matter how tight I made the mask, it leaked, and would wake me up. I have to reduce some number. I see that the machine did make my flow rate continue. So It looks like I just need to 'tweek' until I get the best results.

Also thanks for the link to the manual, I will do some reading.

And BTW, I picked to Avatar as my wife said that's how I look first thing in the morning, after removing my mask, and before my coffee  Plus the air causes me to pass gas first thing in the morning, thus the old fart name. Some wake to a Rooster crowing, she wakes to me blowing. 

[ajack]

Have you tried a $10 foam collar yet, your max IPAP pressure seems to be around 24 when the obstructive hypopnea happened. 24 was also insufficient to give good flow rate. I would rule out an air passage positional obstruction.

I see you have min ps 5, I'd keep the min ps on 5 and max 15, swapping around too much will only mess the chart average, when adjusting epap. I would lift the min epap to 6, the median epap was 7, but I think you were having a rough night and higher than your first chart. You may need more min later. I'd clean up the obstructive and then look. That chart was too rough with the 900 median TV, to say much else, It needs it to settle down more. I don't know why the min ps5 drops off during a hypopnea and it goes down to epap only, yet the mask pressure shows a min ps5?? I would clear up the obstructive stuff first, before I moved on.

The leaks were probably uncomfortable and woken you up. I don't think they weren't too high, to discard the chart completely

[Sleeprider]

Based on this example, I don't think things are too bad.  I'd like to see mode ASVauto with EPAP min 5.0 PS 2.0 to 12.0, IPAP max 19. That is nearly the same except for a more supportive EPAPmin.  the objective here is mainly to limit hypopnea.  We only have the one chart, but that's where I would go for the moment without better information.

thanks, Matt for the information. I tried the setting (I think) that sleeprider suggested ( see screenshot), but the pressure is too much. the mask would leak when the pressure went up. No matter how tight I made the mask, it leaked, and would wake me up. I have to reduce some number. I see that the machine did make my flow rate continue. So It looks like I just need to 'tweek' until I get the best results.

Also thanks for the link to the manual, I will do some reading.

And BTW, I picked to Avatar as my wife said that's how I look first thing in the morning, after removing my mask, and before my coffee  Plus the air causes me to pass gas first thing in the morning, thus the old fart name. Some wake to a Rooster crowing, she wakes to me blowing. 

My suggestion was EPAP min 5.0, PS min 2.0, PS max 12.0 and IPAP max 19.
Some how that became EPAP min 5.0, PS min 5.0, PS max 15.0 and IPAP max 25...That did NOT come from me.