New to CPAP and the Apnea Board

[davedadiver]

Hi everyone, I am back with some questions.  I started using my ASV machine a little while ago and I was consistently getting good results and a full night of sleep.  Now after 90-120 minutes I wake up and I feel like I cannot tolerate the machine/pressure.  So, I would switch back to the AutoSet for the remainder of the the evening.  I would not be aroused at all (with the Autoset), but my sleep results were obviously not good.  So I feel like I am stuck between being nudged all night and sleeping all night with many Clear Airway events.  I read somewhere online that the AirFit p10 is best suited to pressures up to 18, but I have also read on this forum that members using this nasal pillow mask at pressures above 18.  

Is there anything I can do with the settings to make it a little more tolerable until I get used to the ASV?

Should I lower the highest possible pressure or should I leave it where it is?

Here are two graphs from the other night:  starting with the ASV and switching to the AutoSet.

Regards,

Dave

                

[Sleeprider]

Your results on ASV look very good with very little intervention from PS until the events after 01:00, and things settled down nicely at 01:25. What do you do when the machine disrupts your sleep with what seems like excessive pressure? Do you blow back or something else? Your therapy is clearly better on ASV.

[sheepless]

how long have you used asv? it took me a few nights to get used to the nudging. others take longer.

not sure what your settings are but you might try reducing max pressure support until you get used to it. the resmed asv uses ps to trigger a breath.

& of course there's the blow back method to reduce runaway pressure.

oh, & I used the p10 mask up to the asv max of 25cmw. I'd get lip leaks but few mask leaks as a result of pressure.

[davedadiver]

Hi Sleeprider, I did blow back for a while and the pressure seemed to stop it from waking me up for a while.  Then all of the sudden I was awakened night after night (from what I can tell my mouth was not open, the dry mouth thing stopped) but from a forceful blast of air.   Do you think it is a mask leak?  I did grow a beard this year, but I thought nasal pillows were best suited to facial hair.  I guess I gotta stay with the Varsity training for a while.

Am I correct to assume that I should leave all the settings "as is" and just "ride" it out?

Dave

[davedadiver]

Thank you Sheepless. You have me thinking it may not be the machine, based on what Sleeprider pointed out with my breathing before I woke up.  I bet it is Reflux from eating later and having a few "beverages" before bed.  I just started back to work after this COVID-19 lockdown.  During the lockdown, I would have dinner between 5-6pm and now I am eating between 8-9pm and hitting the rack around 10 or 10:30.  Being "retired" for 3 months was helping me sleep a lot better and now I work long shifts 3 nights a week.  I am going to try an experiment, eat earlier, no drinks and lower the PS Max.

If I were to lower the PS Max (which is set to 12) what setting would you choose?

Regards,

Dave

[sheepless]

12 isn't all that high, but it can be, as it's added to epap, especially if epap max is also high. if you want to limit max pressure you may have to reduce epap & especially epap max as well. if your oa doesn't increase too much by reducing epap you have more room to leave ps to address ca. it's a dance of trial & error. my preference is to adjust incrementally in the direction I want to go until I find where I get best results.

there are others much better at advising settings so watch for other opinions. the bottom line for this strategy is to keep max pressure (epap + ps) to a tolerable level, which you have to determine.

[Sleeprider]

You can try EPAP max of 9.0 and PS max at 10, however I would dial back PS in 1-cm increments. Sometimes it works, and for others it can leave unresolved events that are more disruptive than the pressure. There is no way to know unless you try and either succeed or fail in finding more comfort.

[davedadiver]

OK, thanks, I will give it a try.

I appreciate your help.

Dave

[davedadiver]

Hi everyone.  I am posting a follow up screen shot of my data because it has been three months since I started using the ResMed Aircurve 10 ASV machine.  I have to say I am pretty much used to it, but am wondering if I need to adjust anything in my settings.  I am very happy with my AHI results based on all the advice you have given me.  I usually feel pretty good in the morning, although some mornings I still feel a little groggy (I feel like I could sleep for another 2 hours after I slept 8 hours).  Maybe this due to 20 years of sleep deprivation.   Any thoughts would be greatly appreciated.  Thanks.


   

[Sleeprider]

Good to see a follow-up on this. You have continued to optimize the ASV for your comfort and there is little more I can add. Once the PS max got to a more tolerable level you seem to have done well.