ASV flow limits, and what can be changed?

[prettykitty]

Heyas! My doctor got me started on an ASV trial for UARS. They said the only things that matter are how I feel and if I see any improvement of daytime sleepiness, not the numbers. I get that…but is there anything in here that could be improved? Is this okay enough? How long should I give anything - any machine, any changes - a try before deciding this isn’t helping?

It sounds like flow limits don’t seem to mean much with ASV, and that ASVAuto is largely set and forget. We never found out what would lower my FLs (if at all) because I was struggling with an atrocious number of CAs for months with CPAP and BiPAP no matter the settings, and we were trying to reduce those CAs first.

Whatever the issue, it was extremely clear extremely fast with the first two machines that my sleep was negatively impacted. With ASV it's no worse than not using the machine, but it's not improving anything either so far. Plus, nobody was really inclined to treat my UARS in the first place. Unfortunately the EDS I've had for over half my life has worsened, and there’s some newer health issues that messed with me during my MSLT and blocking a repeat MSLT for now, so we are trying anything and everything that insurance will cover in the meantime. I guess them paying for two new aircurves this calendar year is cheaper than any amount of xywav/lumryz/wakix…?  I just want to make sure I gave this a good shot before we give up on this particular solution, so thank you in advance for any insights!

[SarcasticDave94]

You have a rather high EPAP/exhale range of 5-15, while a somewhat low Pressure Support/PS range 0-10. I would suggest a swap of EPAP into PS like this: make EPAP 5-10, and then PS becomes up to min 3 and Max 15.

You possibly need higher PS as this is where the ASV gets the CA fighting power. Admitted you have few events under UA which are unclassified Apnea to the ASV.

No, this won't help the flow limits much or at all, but the ASV would be set probably more like it should.

Comfort may increase with the boost to PS Min, where you have none now. The differential of 3 between exhale to inhale might be noticable.

If me I'd edit this myself now. You'll know pretty quick if the edit is going to work or not, like maybe in one use.