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[Symptoms] clear airway
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67badger Offline

Members

Posts: 4
Joined: May 2016

Machine: resmed vpap auto s9
Mask Type: Nasal mask
Mask Make & Model: resmed mirage fx
Humidifier: resmed h5i
CPAP Pressure: 13.4
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #11
RE: clear airway
Thank you, I will try these settings for a week and see what happens
05-24-2016 08:37 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #12
RE: clear airway
Basically, The ASV is used to treat central sleep apnea, usually when lesser machines were unsuccessful.

Most medical practitioners consider an index of 5 or higher to be the threshold. In other words, an average of 5 events per hour.

Sleepster
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www.ApneaBoard.com


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.
05-24-2016 09:10 PM
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palerider Offline

Preferred Members-

Posts: 440
Joined: Nov 2014

Machine: s9 vpap auto
Mask Type: Nasal pillows
Mask Make & Model: p10
Humidifier: none
CPAP Pressure: 18/13+
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Dallas(ish)

Post: #13
RE: clear airway
(05-24-2016 07:45 PM)rozenbob Wrote:  What determines need to consider ASV?
Percentage CA or number of CA per night

number, percentage is meaningless.
05-24-2016 09:34 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #14
RE: clear airway
(05-24-2016 07:45 PM)rozenbob Wrote:  What determines need to consider ASV?

In USA, some insurance companies require the CAI (CA Index, number of CA per hour) to be at least 10 or even 15 to be eligible for coverage of an ASV machine, but I think most are like USA Medicare, which (if memory serves) allows ASV coverage if the patient with non-ASV treatment has a CAI of at least 5 (yours is) and if the CAI is larger than the OAI (yours is), and if the patient is still having symptoms of excessive daytime sleepiness, and if an ASV titration shows that ASV therapy is able to reduce the AHI or RDI to acceptable levels (which your ASV titration will likely show).

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 05-27-2016 12:46 AM by vsheline.)
05-27-2016 12:39 AM
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67badger Offline

Members

Posts: 4
Joined: May 2016

Machine: resmed vpap auto s9
Mask Type: Nasal mask
Mask Make & Model: resmed mirage fx
Humidifier: resmed h5i
CPAP Pressure: 13.4
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #15
RE: clear airway
(05-24-2016 04:26 PM)Sleeprider Wrote:  Hey 67badger, the numbers are not too bad for someone early in their therapy. Let me explain your settings. You have an auto bilevel machine and are using it in a fixed pressure mode. The TiMAX of 2, TiMIN of 3 and rise time are defaults. You are using IPAP at 13.4 and EPAP at 9.4 which means you have a pressure support of 4.0 cm.

Your OA+H are pretty acceptable, but you have somewhat excessive CA. It's not enough to justify ASV, so we will not go there for now. The CA may go away without any changes or intervention, but I know it could be reduced with slightly modified settings. If I was setting it up, I'd recommend mode Vauto, IPAPmax 15, EPAPmin 8.4 and pressure support 3.0. This would start your therapy at 11.4/8.4 (IPAP/EPAP) and would allow it to go as high as 15.4/12.4. So the starting pressure is only 1-cm lower than your current prescription, but the Vauto mode will increase pressure as needed to respond to obstructive events. This lower pressure and pressure support should reduce CA events, but may slightly increase OA. If we find OA is unacceptable, the next step would be to increase EPAPmin by 0.6 to 9.0. If H is too high, we might go back to pressure support of 4.0. It will take some time, and trial and error to fine-tune.

This is nearly the same as your prescription, but lowers pressure and allows the machine's auto algorithm to respond to OA and will reduce the stimulation from pressure support that is the likely cause of CA. Feel free to run that idea by your doctor, or just try it out. You can always go back.
Thank you Sleeprider, I have been using your suggested settings for a week now and have had a high AHI of 2.6 and a low last night of 0.9 (best ever in almost 8 years of CPAP use).
05-31-2016 09:31 AM
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