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New to me, ASV, Initial Questions
#1
New to me, ASV, Initial Questions
Hello, all,

I'm a 10+ year Cpap user who still struggles greatly with daytime fatigue and fog due to a variety of factors: Local Sleep Docs and providers minimal to zero support and follow through, Masks that don't fit my non standard face, and additional issues related to the results of an auto accident decades ago.

I can't say I've tried "everything", but I can say I have scoured user groups and implemented many of the tips, tricks, and advice that the folks who have success have utilized well for themselves. I had an inlab sleep test and titration study 11 years ago which started my quest for better quality sleep through a fixed pap machine, then an S9 Autoset,  and S10 AutoSet, and recently I acquired a Resmed Aircurve 10 ASV machine which is my reason for posting this thread.

My diagnosis is mild to moderate and a year ago I did a home sleep test thanks to a caring primary care doc who listens to his patients and has begun to screen his flock understanding the extreme importance of sleep to ones health. The test suggests a 12.5 AHI with obstructives, centrals, and hypopneas and my breathing is shallow, perodic, and at a rate of around 11. Lowest oxygen desaturation was 87%  I am nearly 100% compliant due to the fact that a single night without air pressure takes me to my knees.

I never consistently broke the 5 AHI barrier after years on my Resmed Autoset 10, but I can't say I have ever had a Mask that didn't leak unless I cranked the headgear to the point it moved my teeth and of course has been rough to put on each night. If there were a custom Cpap face mask company in the US I would love to know it but let me stop here and ask my question.

The ASV was gifted to me and I have used it in a limited parameter manner thus far to avoid leaks, but can say it sure feels very natural in how it "breathes me" each of the last couple weeks. It has 3 modes of Fixed, ASV, and ASVauto and I have tried each. Sleepyhead shows only Hypopneas and UA's (unidentified Apneas)
and I have noted it shows no OA, Obstructives which I always had the most of with the Autoset 10.

After joining this group  I did review some ASV threads where folks were  strongly suggesting the Resmed Aircurve 10Auto  (1 of 3 in the "Aircurve lineup) and am interested in feedback as to whether the one that fell into my lap is most appropriate for me or not. I know it works on a breath by breath basis and I do love the feeling of it kicking in with a breath when my normal breath is not so consistently driven.

My Cpap DME has immediately been uninterested in advising me on it, perhaps due to the fact they didn't make any money on it, or the fact that I have seen some older study that warned about ASV use for specific heart problems which I do not have. Either way, I have come here knowing you folks get that the current medical sleep system is broken when it comes to us users who want to benefit from it.

Current settings for tonight are MIN EPEP 7  MAX EPAP 13 WITH with "Pressure Support levels" of MIN PS 0 AND MAX PS with my understanding being that the maximum inspiration pressure levels should be THE 13 PLUS THE 5 so 18 max. Previous trials in auto mode seem to show an 10 to 11 to be my 95% EPAP

I am not very knowledgeable on reading the SD data but do have the capability to share once I know how to present it here.

I'm hoping that my renewed interest spurred by this gift can motivate me to take this all the way to (or at least further)  what I have been desperately needing for so long.

Jim
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#2
RE: New to me, ASV, Initial Questions
(02-19-2021, 04:08 PM)Whitenoise Wrote: Current settings for tonight are MIN EPEP 7  MAX EPAP 13 WITH with "Pressure Support levels" of MIN PS 0 AND MAX PS with my understanding being that the maximum inspiration pressure levels should be THE 13 PLUS THE 5 so 18 max. 

I don't understand. What is your max PS?

You should probably set it to 15, and set min to 3, for a few nights, and post the results.
Caveats: I'm just a patient, with no medical training.
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#3
RE: New to me, ASV, Initial Questions
(02-19-2021, 04:34 PM)slowriter Wrote:
(02-19-2021, 04:08 PM)Whitenoise Wrote: Current settings for tonight are MIN EPEP 7  MAX EPAP 13 WITH with "Pressure Support levels" of MIN PS 0 AND MAX PS 5 with my understanding being that the maximum inspiration pressure levels should be THE 13 PLUS THE 5 so 18 max. 

I don't understand. What is your max PS?

You should probably set it to 15, and set min to 3, for a few nights, and post the results.

Ah, It's missing, The MAX PS = 5   So an additional max of 5 beyond whatever the max EPAP is at any point in time.  So far my end of night 95% EPAP seems to hover near 11 after a night of Auto mode. I have it reigned in as I begin so I don't get the full 25 units, due to the mask leak limitations I live with.

I agree a results post will be needed eventually after I acclimate and know how to do that properly.
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#4
RE: New to me, ASV, Initial Questions
Hi and welcome,

Post the data chart and I'm sure we can get you on the right path. This ASV is very capable of dealing with your therapy needs. Tell us exactly what settings you're using just in case we don't see them.

Even without seeing data, I'd suggest a titration redo back to defaults or nearly so.

Try ASV Auto mode
EPAP 5-15
PS 3-15

Your mask and humidity can be whatever, they're more comfort items BTW.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#5
RE: New to me, ASV, Initial Questions
(02-19-2021, 06:20 PM)Whitenoise Wrote:
(02-19-2021, 04:34 PM)slowriter Wrote:
(02-19-2021, 04:08 PM)Whitenoise Wrote: Current settings for tonight are MIN EPEP 7  MAX EPAP 13 WITH with "Pressure Support levels" of MIN PS 0 AND MAX PS 5 with my understanding being that the maximum inspiration pressure levels should be THE 13 PLUS THE 5 so 18 max. 

I don't understand. What is your max PS?

You should probably set it to 15, and set min to 3, for a few nights, and post the results.

Ah, It's missing, The MAX PS = 5   So an additional max of 5 beyond whatever the max EPAP is at any point in time.  So far my end of night 95% EPAP seems to hover near 11 after a night of Auto mode. I have it reigned in as I begin so I don't get the full 25 units, due to the mask leak limitations I live with.

I agree a results post will be needed eventually after I acclimate and know how to do that properly.

I suppose I should state clearer,, my primary question to start with is,,,,,,,,,,,,, "Is there any reason this Aircurve 10 ASV machine would not suit my needs?"  as Resmed's site info on the 3 different Aircurve Models says "The Aircurve ASV is for Centrals"  and "The other 2 are for Obstructives"
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#6
RE: New to me, ASV, Initial Questions
The ASV is to treat Central Apnea, that's the niche for it. If you don't have an issue with CA, this will be the wrong machine.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#7
RE: New to me, ASV, Initial Questions
(02-19-2021, 06:27 PM)SarcasticDave94 Wrote: Hi and welcome,

Post the data chart and I'm sure we can get you on the right path. This ASV is very capable of dealing with your therapy needs. Tell us exactly what settings you're using just in case we don't see them.

Even without seeing data, I'd suggest a titration redo back to defaults or nearly so.

Try ASV Auto mode
EPAP 5-15
PS 3-15

Your mask and humidity can be whatever, they're more comfort items BTW.

Thank you Dave,

So this machine will take care of all the different Apnea Events we encounter? Not primarily Centrals as Resmed seems to be indicating? I was surprised not to see any OA's in the Data ever since starting use with it, then read the site, want to be sure am ok with it. Can you point me to a link or post to get me started on what Data would be captured for a post?
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#8
RE: New to me, ASV, Initial Questions
If you update your Sleepyhead to the latest version of OSCAR we can probably improve your data and your therapy. It sounds like you tolerate ASV very well, but the details from the data are invaluable in troubleshooting and optimizing. Here is the software https://www.sleepfiles.com/OSCAR

You can post screenshots, and we will start from your current settings. The ASV is an amazing machine, but it is intended for complex and central apnea. It is possible that you will have excellent therapy with the ASV. It usually resolves nearly 100% of apnea and hypopnea. Some people find the pressure fluctuations distracting and damaging to sleep. You seem to tolerate it, and it will be interesting to see the charts.
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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#9
RE: New to me, ASV, Initial Questions
If set right, the ASV can take care of all Apnea events. You've got the hard part done, you've got the ASV in hand. So let's look at the chart and see where you stand on the Apnea map. We can get you well treated quickly.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#10
RE: New to me, ASV, Initial Questions
Excellent Dave,   I'll install Oscar and upload the data.

Just knowing this machine will do it all gives me some hope.

Knowing there are folks like you here to guide me, doubly so!

Jim
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