ASV waking and hypopneas

[SarcasticDave94]

I'm not sure everything the Philips Respironics rise time will affect. It appears it's merely a timing for transition from exhale to inhale. It's a slow to fast initiation effect depending on the settings.

Flex is introducing pressure relief, which is similar to what your ASV PS setting can already do. Flex possibly reduces exhale even more than the differential PS already had.

If this were me, I'd turn off flex and trial the rise time maybe starting in the middle setting 3 or 4. Rise time range is 1 fast to 6 slow.

Here's what I had pressure wise on the ResMed ASV in ASV Auto mode. Yours is more or less similar.

EPAP range of 7-12 with this mode. This in the base, exhale but much like a CPAP. PS or pressure support it's a differential between exhale EPAP and inhale IPAP. ResMed PS had to be a range minimum 5 like 0-5 or 3-8, I ran default PS of 3-15.

In ResMed ASV world, my settings again

EPAP 7 min, 12 or 13 EPAP Max
PS 3 min 15 max
IPAP (equals EPAP plus PS)
10-27 or 28
Max IPAP was 25 mechanical machine limits. But despite that, you can set EPAP and PS combos that'll go over the limit mathematically, and ASV would vary things, sometimes higher EPAP was called for. Other times higher PS was needed. It'll shuffle things a bit based on need.

Just my opinion, you may want to open up the top just a bit in your machine. Translation from Dave's world, edit PS Min and Max slightly to see if it can help meet your needs. You have now PS 3.5-5. I would try PS Min 4 and pushing of Max to between 6-8. In my ResMed PS was the power area to combat CA, but this also made IPAP inhale stronger.

Have an idea what you're doing by using OSCAR as a guide, but maybe try edits a bit and see if you can make this machine provide more comfortable therapy.

Also use Apnea Board resources, we have your machine clinical manual available upon request. You might as well have it in hand to know what your machine can do, using it to the fullest ability.

[Zzzs please]

Wow, thank you! This is so helpful. And answers some other questions I had. I'll make some changes and see how it goes. It looks like this could really improve my sleep.

[SarcasticDave94]

You don't have to increase this a lot at once if you prefer not. You can edit incremental if you need to for any of these edits.

[Zzzs please]

Yes, for sure. I'll make small changes at a time and use Oscar to check progress before making other adjustments.

I'll start with increasing epap min and ps max each by 1, and decrease biflex to 1.

I've got a plan now and am looking forward to seeing what happens. Thanks!

[SarcasticDave94]

You're welcome and hope it'll help

[cexer]

thank. probably i missed some interesting aspects of your thread-starter.

with my resmed asv i still have centrals, which go as unclassified apneas, there.
you with the phillips seem to have moved them into hypopneas.

so dave might be right and your condition is more treatable with asv.

if you finished setting it up and there is still something left,
i would be interested how a close-up of an hyponea-cluster of yours looks like,
given that you wanna post it. the interplay with the machine and everything.

btw. your old resmed 10 is still a good device and maybe you could keep it. who knows ?

in case you would like to participate in my survey about getting help,
you could click and "vote", there. i had the impression cause you mentioned a duration,
but the votes did not increase. that's why i tell you.

so much for now. i hope you get a good improvement
by tweaking the settings of your device and wouldn't wake up any longer.

[Sleeprider]

Cexer, you might want to post some charts from your ASV in your therapy thread. UA events are most often obstructive.

Zzzzs, I can't imagine the deception that was foisted on you by the hospital. Resmed invented ASV and has always had superior results and comfort as compared to the Respironics BiPAP SV. The Philips devices have been recalled and discontinued in the U.S. and are only being sold outside of the U.S. in compliance with a consent agreement. They may eventually be authorized by FDA for U.S. sales, but the surplus created by the consent decree means discounted Philips machines are being sold in international markets including Canada. CPAPspecials sells the Resmed Aircurve 10 ASV for $2290 USD and the Aircurve 11 ASV for $2490 USD. They are sort of a gray market provider and only sell out of the U.S. to international customers, so they are not on our Supplier List.

With the Resmed BiPAP Auto SV the EPAP and IPAP pressure is delivered as a square-wave pressure change that is altered or softened with BiFlex or rise-time. A longer rise time or higher Flex setting slows the time for the device to move from EPAP to peak IPAP pressure. This is generally less comfortable than the Easybreathe™ algorithm used by Resmed. The advise you have gotten from SarcasticDave has been very good, although none of us has as much experience with the Philips product as Resmed.

[Zzzs please]

I've been sick, so not able to respond/update. I'll do a proper one when I can. But I wanted to say thank you for the great advice. I am seeing improvements with my sleep already! I've been making most of the changes talked about earlier, as well as increasing the max settings even more. Each time I raise a max setting, the machine goes there. So it seems it was needed. Thanks again.

[Sleeprider]

Another member Addysman recently changed from the Philips BiPAP Auto SV to the Resmed Aircurve 10 ASV. I think he agrees with your conclusion. https://www.apneaboard.com/forums/Thread...#pid545401

Raise pressure if it improves your comfort and efficacy, but we often limit the pressure of the Resmed ASV if it becomes overwhelming or disruptive to sleep.