(01-21-2016 08:15 PM)SheNeedsSleep Wrote: It seems that the respironics one, might start blowing pressure before I am done exhaling, aND make it very difficult on me. Also the seems the Resmed has more adjustability, like with the min/max pressure and the rate of breaths.
1. I think adjusting the Ti (inhalation time) setting longer (can be up to 3.0 seconds) would extend the time your machine allows for you to inhale. In addition, I'm not sure but I think also turning off Bi-Flex may allow more time to finish inhaling before the pressure starts dropping to help you exhale.
2. In general, the ResMed ASV model is FAR LESS adjustable than your Philips Respironics ASV.
The ResMed ASV is kinda like a "one size, fits most" machine, which works well for the average user. To me, you don't sound like an average user.
The ResMed ASV machines have no adjustability on the respiration rate (RR). None. When ResMed ASV machine needs use the "backup" RR to breathe for you, it will start at your recent breathing rate and then will gradually move toward 15 Breaths Per Minute as best it can, which is good for most people. Maybe that would be good for you, gradually helping to speed up your RR. Or maybe that would be problem for you, gradually becoming bothersome. Either way, it is not something you can adjust if using a ResMed ASV. But on the Philips Respironics ASV the backup RR can be set to Automatic or can be manually adjusted.
Pressure Support (PS) is the boost in pressure added when we are inhaling. Whenever the machine determines we have stopped or reduced our breathing, the ASV will automatically adjust the PS higher to help us breathe more deeply. We set a Min PS value and a Max PS value, and the machine will automatically adjust itself within these limits.
With ResMed ASV the pressure is less adjustable, because the Max Pressure Support (Max PS) cannot be set less than 5 higher than the Min PS.
For example, if the pressure during exhalation (EPAP) is 4, and the Min PS is 3, and Max PS is 8 (must be at least five higher than Min PS if using ResMed ASV), the min pressure during inhalation (IPAP) would be 7, and as we exhale and inhale the pressure would cycle between 4 and 7. When the ASV machine automatically raises the Pressure Support value to help counteract a sudden decrease in our breathing, it may raise PS to 8 (the Max PS in this example), and as we exhale and inhale the pressure may cycle between 4 and 12. If you find that high pressure causes you problems, on a Philips Respironics ASV you could turn down the Max PS by 1 (for example) and leave Min PS at unchanged at 3. But on a ResMed ASV the Min PS needs to stay at least 5 lower than Max PS, so you would need to reduce Min PS, too. The lower Min PS is, the less easy it it is to exhale.
On a ResMed ASV, if you discover that when first starting ASV therapy, you cannot tolerate higher IPAP than 9, turning down Max PS to 5 (the lowest it can be on a ResMed ASV) would mean you would need to lower Min PS to 0 on a ResMed ASV, resulting in sometimes getting no pressure relief when exhaling, which could be uncomfortable while trying to fall asleep. If Min EPAP is 4, Min PS is 0 and Max PS is 5, while trying to fall asleep the pressure during inhalation and exhalation would be the same, unless the machine automatically raises PS because it senses a sudden drop in your breathing.
Also, your Philips Respironics ASV has many settings for which the ResMed ASV does not provide any manual adjustability.
There is a chance that you may prefer the ResMed ASV, but there is also the chance that you can adjust your Philips Respironics ASV machine to be more comfortable for you than a ResMed ASV would be.
Can you use the instructions in the setup manual (Provider Manual) to look at the settings for your machine and let us know the present settings? You can request by email the Provider Manual for your machine by carefully following the directions given here:
Definitions for the settings (as listed in 2010 version of the Provider Manual):
• Max pressure - This screen displays the current Maximum pressure setting. You can adjust the setting from 4 to 25 cm H2O in 0.5 increments.
• EPAP min - This screen allows you to modify the Minimum EPAP setting. The setting specified here will be the minimum level of pressure applied during the expiratory breath phase. You may adjust the setting from 4 cm H2O to the Maximum pressure setting.
• EPAP max - This screen allows you to modify the Maximum EPAP setting. The setting you specify here will be the maximum level of pressure applied during the expiratory breath phase. You may adjust the setting from the Minimum EPAP setting to the Maximum pressure setting.
• PS min - This screen allows you to modify the Minimum Pressure Support setting. This setting is the minimum difference that is permitted between IPAP and EPAP. You may adjust the setting from 0 cm H2O to the difference between the maximum pressure setting minus the maximum EPAP setting.
• PS max - This screen allows you to modify the Maximum Pressure Support setting. The maximum pressure support is the maximum difference that is permitted between IPAP and EPAP. You may adjust the setting from PS min to the difference between the maximum pressure setting minus the minimum EPAP setting.
• BPM - This screen allows you to modify the Breaths Per Minute setting. You can choose between Off, Auto, or 4 through 30 in 1 BPM increments.
Note: This setting only displays if PS max is greater than zero.
• Ti - This screen allows you to modify the Inspiratory Time setting. You may adjust the setting from 0.5 to 3.0 seconds in 0.1 increments. This setting only displays if PS max is greater than zero and BPM is not set to Off or Auto.
• Flex type - This screen displays the comfort mode setting. You can select None or Bi-Flex.
• Bi-Flex - You can modify the Flex setting (1, 2 or 3) on this screen if you enabled Bi-Flex. The Bi-Flex comfort feature allows you to adjust the level of air pressure relief that the patient feels when exhaling during therapy. The setting of “1” provides a small amount of pressure relief, with higher numbers providing additional relief.
• Rise time - Rise time is the time it takes for the device to change from the expiratory pressure setting to the inspiratory pressure setting. This screen allows you to adjust the rise time so you can find the desired setting. A setting of “0” is the fastest rise time, while “3” is the slowest. This is only available if Flex type is set to None and PS max is greater than zero.
• Ramp time - This enables you to modify the Ramp time setting in 5 minute increments. The range for this setting is 0 (off) to 45 minutes.
Note: This setting only displays if EPAP min is greater than 4 cm H2O.
• Ramp start - You can increase or decrease the ramp starting pressure in 0.5 cm H2O increments. You may adjust the setting from 4 cm H2O to the EPAP min setting.
Note: This setting only displays if Ramp time is not zero and EPAP min is greater than 4 cm H2O.