Resmed ASV: Lowered AHI, but High Aerophagia

[Sleeprider]

If you want to try PS max at 10.0, give it a try and let's see if it increases hypopnea events. If it is par with your past experience with PS max 12, then we have a win.

[ar10]

Thanks very much, I'll give it a try!  I may sneak up on it by trying 11 first.

[Sleeprider]

I have seen good results as low as 8.0. The ASV gives the cue to breathe and spontaneous breathing tends to take-over for most people. Don't sneak up on it. It will work or not, and we reverse course to 11 cm PS max. I'm pretty sure you have this.

[ar10]

Thanks, once again!  I'll do it exactly as you suggest.  I'll try dropping to 10 for a while, and if it doesn't work I'll try 11.

[Sleeprider]

Good plan!

[ar10]

           

As suggested, I dropped my EPAP to 5/7 and my PS to 3/10, giving me an IPAP of 8/17, and tried it for about a month.  The change reduced the aerophagia somewhat, and didn't reduce the effectiveness of the treatment.  Thank You! However, the aerophagia is still a daily problem. 

I've attached the last 3 days of OSCAR, which are pretty typical.  (Last night it took quite a while to get a new cushion adjusted correctly, as shown in the much higher than usual early leak rate.)

I'd definitely like to try adjusting the settings a bit more, but I don't which makes the most sense to reduce, EPAP or PS, and which limit, Min or Max, is likely to give the most relief.  It looks to my novice eyes like I rarely hit the IPAP Max of 17 or the EPAP Max of 7.  However, it also looks like I'm usually above the Minimums for both.

Thanks in advance for any help.

[Sleeprider]

Your results are very encouraging for using lower pressure settings. You still have some hypopnea and UA events with the lower pressure, so I'm going to suggest lowering PS max to 8.0. This change will take you to the lowest possible PS range that ASV offers, however we can still use settings as low as PS min 2, PS max 5, so hang in there.

[ar10]

Thanks very much!  I'll give 8 a try for a while and see if it helps.

[Sleeprider]

You have been exceptionally patient with the therapy and give all new options plenty of time to evaluate. You have no idea how much your approach is appreciated.

[DevinJones]

Your results are very encouraging for using lower pressure settings.  You still have some hypopnea and UA events with the lower pressure, so I'm going to suggest lowering PS max to 8.0. This change will take you to the lowest possible PS range that ASV offers, however we can still use settings as low as PS min 2, PS max 5, so hang in there.

If an ASV user has some hypopneas and UA events, does lowering the PS max help decrease those events?