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Max pressure on Aircurve ASV
#1
Max pressure on Aircurve ASV
The high pressure setting on my machine is to the point I can't use it. I'm getting little sleep. The DME people tell me that the settings menu doesn't control the max pressure and only a tech can change it. It that true?
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#2
RE: Max pressure on Aircurve ASV
you will get use to it, in a couple of weeks you won't notice the pressure. What are your leaks like, that will wake you up more than the pressure, too.
you can change max pressure, through the epap and ps settings, it will probably increase your AHI, but you can adjust back to original setting in a week or so.

get the setup manual from the top of the page.
post your sleepyhead chart for advice.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#3
RE: Max pressure on Aircurve ASV
(07-05-2017, 11:54 AM)DannyG Wrote: The high pressure setting on my machine is to the point I can't use it. I'm getting little sleep. The DME people tell me that the settings menu doesn't control the max pressure and only a tech can change it. It that true?

The maximum pressure settings can be limited in several ways.  First it would help to know what your current settings are, including mode, Min EPAP, Max EPAP, Min PS, Max PS and max IPAP.  If you would like to post data using the instructions in my signature, we can see exactly what is happening and find a comfortable alternative. If the settings in your signature are correct: 15/5 PS 3 to 15/11 PS 5, you are not using settings that would be effective for central apnea, and you might want to consider something else. Also would help to understand a bit more about your ASV titration.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#4
RE: Max pressure on Aircurve ASV
it could help if you say the pressure this way,
I think you are using asv auto mode
Min EPAP
Max EPAP
Min PS
Max PS

asv mode has 3 numbers
EPAP
Min PS
Max PS
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#5
RE: Max pressure on Aircurve ASV
(07-05-2017, 11:54 AM)DannyG Wrote: The high pressure setting on my machine is to the point I can't use it. I'm getting little sleep. The DME people tell me that the settings menu doesn't control the max pressure and only a tech can change it. It that true?
You can't control the max pressure (or any of the other therapuetic) setting(s) from the patient settings menu.

But you can control them from the clinical settings menu.  The DME won't tell you how to get into that menu, but you can get hold of the clinical manual here and learn how to get into that menu and change the settings yourself.

What changes you should think about making, however, depend on what the data shows.  Since you say the max pressure is "to the point I can't use it.", we need to see data before making recommendations about what to do.
Questions about SleepyHead?  
See my Guide to SleepyHead
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#6
RE: Max pressure on Aircurve ASV
SleepHead data from last night said

Average EPAP 10.76
Min. EPAP 5.44
Max EPAP 11.00
Average IPAP 17.20
90% IPAP 20.30
Min IPAP 5.54
Max IPAP 23.40

My AHI last night was 1.72
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#7
RE: Max pressure on Aircurve ASV
What are your minimum and maximum pressure support settings? My best guess is 0-15 cm.

AHI is great, but your complaint is the higher pressure. It may be possible to limit maximum EPAP, which appears to be 11.0, and your average EPAP is very close to that. The question is, what is driving that pressure increase to 11.0. There may be a few events that get through if you do that, but comfort counts. It's also possible you could get by with a slightly lower maximum pressure support, as long as you have enough to treat centrals and hypopnea. Again, seeing the charts would be a big help.

You are well-treated by your ASV and I'd be reluctant to make big changes, but it's also important to feel rested and to tolerate the therapy.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Optimizing Therapy
Organize your OSCAR Charts
How To Attach Images And Files to your posts
How To Deal With Equipment Supplier
Mask Primer
Beginner's Guide to Sleepyhead

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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#8
RE: Max pressure on Aircurve ASV
The 5 to 11 is not the issue, it's the 17.20 average the rest of the night. The machine does this while I'm awake, I'm can't be having centrals while I awake can I ?
It's to the point that I'm getting some quality sleep but little of it. I told the DME today if I have to be awakened multiple times a night with dry mouth the benefit's aren't worth it with the current therapy. My doc is out of the country until the 18th with no backup. Wouldn't it be worth trying lower max numbers rather not using the treatment?
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#9
RE: Max pressure on Aircurve ASV
(07-05-2017, 08:46 PM)DannyG Wrote: The 5 to 11  is not the issue, it's the 17.20  average the rest of the night. The machine does this while I'm awake, I'm can't be having centrals while I awake can I ?
The machine cannot tell that you are awake. There is something in your normal wake breathing that is being misinterpreted as the beginning of a potential string of sleep disordered centrals. And so the machine reacts by jumping up the IPAP in order to "trigger" you to breathe.

Since this is happening when you are awake it may help to look at the data: There may be something in your flow rate data that someone here can point to and say, "That's what's triggering the increase in IPAP while you are awake."

Can you post a screen shot that shows a zoomed in picture of the machine increasing your pressure(s) at a time when you are pretty sure you are awake?

Quote:It's to the point that I'm getting some quality sleep but little of it. I told the DME today if I have to be awakened multiple times a night with dry mouth the benefit's aren't worth it with the current therapy. My doc is out of the country until the 18th with no backup. Wouldn't it be worth trying lower max numbers rather not using the treatment?
Without looking at the daily data graphs, and in particular the daily event chart and the daily flow rate and pressure graphs, for a typical night, it's hard to say whether reducing the max PS (which would reduce the max IPAP) would result in ineffective treatment for you.

It would also help us help you if we knew why you were prescribed an ASV. What's your official diagnosis? Central sleep apnea? Complex sleep apnea? Something else?

It would also help us help you if we knew whether you have other health problems.  Any respiratory problems other than the sleep apnea? Any heart problems?
Questions about SleepyHead?  
See my Guide to SleepyHead
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#10
RE: Max pressure on Aircurve ASV
be assured that in a few weeks it won't matter..you will get use to the pressure..until then..
How you get to 17 to 25 is through the low numbers/// and while awake, the ramp function which turns the pressure down till you are asleep

can you check on the machine, going by your avatar and sleepyhead, I think your settings are
Min EPAP 5
Max EPAP 11
Min PS 3
Max PS 15

others know more, but I'll put this out there for consideration.
With these settings I would expect your AHI to go up, but to dumb the machine down and keep a more tight pressure change. I would switch out of auto to just the 3 number asv mode,
EPAP  8
Min PS 5
Max PS 12
that will run the machine, Epap 8 max Ipap 20
the reasons I'm thinking this is because your 90% is 20 and that will reduce the max by 3
a max ps 12 should give a reasonable ventilation for centrals
a epap of 8 could cover a lot of the OA, what was the cpap pressure you were using?
I would also consider epap10 ps5 min ps10 max. if you have too many oa.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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