Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

new to ASV, Aircurve10 question
#21
RE: new to ASV, Aircurve10 question
Quote:Sleeprider:
Thanks for the setting suggestions, but I see there are only:
PS Max
PS Min
EPAP

The max and min EPAP settings will become available if you change the mode from ASV to ASVAuto

Quote:Currently set to:
PS MAX 19
PS Min 4
EPAP 4 ( was 7 originally, and when I said the pressure was too high, that is what they changed)

That seems a bit arse-about. They've tried to correct a too high pressure by setting the low end to a figure which won't work for most people, but haven't directly done anything about the high end. Setting the EPAP so low will indirectly limit the maximum IPAP, but it also leaves you open to obstructive apneas and hypopneas. In my experience, if you get the EPAP right then the amount of pressure support (and hence IPAP the machine applies) will reduce somewhat.

Quote:Are you saying change
to autoASV
and set EPAP back to 7
PS MAX 15
PS MIN 0

Almost...  Change to ASV Auto and enter a min EPAP of 4 and a max EPAP of 7.  Then set the Min PS to 0.0 and the max PS to 12.

Quote:I would like to try this, but not sure if I will have issues with the insurance company if I start changing settings.

From what I understand the insurance company won't care one way or the other. You might get a "talking to" from your DME and doctor, but (again as I understand it) you're within your rights to make adjustments to optimise the treatment. Remember the DME is basically a hardware supplier who also gets paid for interactions such as adjusting your machine. If you learn to do it for yourself that is a small revenue stream taken away from them.
Post Reply Post Reply






Donate to Apnea Board  
#22
RE: new to ASV, Aircurve10 question
Thanks, I will give this a try tonight and report back tomorrow,  Sleep-well
Post Reply Post Reply
#23
RE: new to ASV, Aircurve10 question
Hi '59,

1 PSI equals around 70 cmH2O.

I think it is not uncommon that respiratory therapists and doctors may set the EPAP too low in ASV therapy mode, or may set the Min EPAP too low if in ASVauto therapy mode.  In ASV modes we still tend to need about the same pressure while exhaling that we needed when we were exhaling using CPAP mode, APAP mode or standard bilevel mode.

For example, if what worked best when we were using an APAP machine to treat our obstructive events was Min Pressure of 10 and we were using Pressure Relief to lower the pressure 2 cmH2O while exhaling, that means we were getting a minimum of 8 cmH2O while exhaling (because 10 - 2 = 8).  If we are switched to an ASV machine operating in ASVauto mode, to avoid obstructive events we would still likely need at least 8 cmH2O while exhaling, so our optimal setting for Min EPAP would likely be 8 (or higher).

To avoid air swallowing I think it would likely be best to lower the Max PS setting.  But most people need the Pressure Support to automatically raise itself to 10 or higher when a Central Apnea starts, in order to do for us all the work of breathing. If the Max PS is lowered too much, the PS would not be able to raise itself high enough to do for us all the work of breathing. So the settings are usually chosen such that Max PS is at least 10.

Personally, I very much like to use a Min Pressure Support setting of 4 or 5 or 6, which does for me about half the work of breathing. This makes it easier for me to relax and fall asleep.

If a central event begins, the PS will automatically raise itself to 10 or so, to do for me all the work of breathing.

Or, if an obstructive apnea starts, the PS will automatically raise itself as high as it can (limited by the Max PS setting), in an attempt to treat the obstructive apnea.

Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  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.
Post Reply Post Reply
#24
RE: new to ASV, Aircurve10 question
I updated my settings as indicated by Sleeprider, and now this mornings readings say my AHI is down to 2.03 and my headache went away, and no bloating!  like
While this is only one night, I will continue with this setting.

I wonder if I can get this lower by other changes, perhaps what Vaughn talks about setting the min PS back to 4?

Thanks again for all you assistance. now to figure out how to sleep through the night

[attachment=3734]
Thanks
Post Reply Post Reply






Donate to Apnea Board  
#25
RE: new to ASV, Aircurve10 question
I'm glad the results turned out positive for you.  I would not move the minimum PS to 4.0, however, 2.0 may be a good minimum PS based on your median IPAP/EPAP results.  Getting the minimum PS too high can cause more respiratory instability (centrals), and you can see that with the zero PS minimum your machine was much less busy compared to this previous example.  Look at the mask pressure in particular.  The big diference here was not the maximum PS, but the minimum.  By not causing so many central events, the zero minimum PS avoided the need for higher support to counter CA and H events.  My preference would be that you continue with the 0-12 PS for a while to get a baseline, then try 2-12 and see if that is better or worse.  Don't be tempted to do dial-wingin' until you have enough baseline to spot important trends from any changes.

The other big difference in your new results is that by using ASVauto mode, your EPAP increased as needed, so far fewer UA events, which were obstructive. This makes a huge difference in your comfort and efficacy.

[Image: attachment.php?thumbnail=3730]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#26
RE: new to ASV, Aircurve10 question
(07-30-2017, 08:32 AM)oldfart59 Wrote: I updated my settings as indicated by Sleeprider, and now this mornings readings say my AHI is down to 2.03 and my headache went away, and no bloating!  like
While this is only one night, I will continue with this setting.

I wonder if I can get this lower by other changes, perhaps what Vaughn talks about setting the min PS back to 4?

Thanks again for all you assistance. now to figure out how to sleep through the night


Thanks

were you titrated on epap 7 and min PS 4, then reduced because of the pressure. Titration is normally for the oa/h, the o2 levels and tidal volume. I would imagine when you get use to the ASV, you would return to a similar initial pressure and PS, even in auto mode. This should be talked through with your doctor, who would have the titration stats on which the epap and min PS were set.
This titration link is well worth reading on how the basics are done for an overview.
https://www.resmed.com/us/dam/documents/...lo_eng.pdf
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
Post Reply Post Reply
#27
RE: new to ASV, Aircurve10 question
Quote:This titration link is well worth reading on how the basics are done for an overview.
https://www.resmed.com/us/dam/documents/...lo_eng.pdf

There's a good description of how an ASV works starting on page 27.
Post Reply Post Reply






Donate to Apnea Board  
#28
RE: new to ASV, Aircurve10 question
to clarify my comment:
Thanks,I will read this, not sure what titrated means
This was the first time I heard that word.



Moderator note:  Post edited.  Remember this is a family oriented forum.
Post Reply Post Reply
#29
RE: new to ASV, Aircurve10 question
Here is a definition of Titration:

Titration-A method of determining optimal CPAP (continuous positive airway pressure) treatment parameters for sleep apnea. This involves automatic or manual adjustment of the CPAP device to a level that eliminates airway blockage.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Resmed AirCurve10 VAuto Bi-pap SD Problems? Grammy25 6 252 09-22-2020, 08:36 PM
Last Post: Grammy25
  Aircurve10 VAuto Settings Drexette 30 1,279 05-29-2020, 01:26 PM
Last Post: Sleeprider
  Resmed AirCurve 10 vaAuto vs AirCurve10 Dman 13 2,657 11-26-2019, 01:26 PM
Last Post: jaswilliams
Ohmy [Pressure] AirCurve10 vauto s- Lowering pressure babag1 30 2,115 02-04-2019, 05:24 PM
Last Post: babag1
  [Equipment] ResMed AirCurve10 VAuto blockage bfrakes256 54 3,976 06-12-2018, 07:48 AM
Last Post: Sleeprider
  Flow rate question and clock question The Rog 8 1,415 04-02-2018, 07:29 PM
Last Post: DeepBreathing
Question Anyone know the difference? [between AirCurve10 BiPAP ST and the ST-A] zzzZorro 18 2,035 11-21-2017, 10:52 AM
Last Post: zzzZorro


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.