Does ASV "Fine Tune" itself in ASVAuto mode? First night...default settings...

[jjrjr]

It's my first night of ASV after APAP caused tons of CA's and I had many, many sub 10 sec breathing pauses every night.

I'm looking to improve UA's, breathing pauses, and waveform shape (I seem to experience all 7 classes of waveforms...lol...).

I hope ASV is a means to that end.  ENT says I'm fine on APAP b/c AHI was under 5 and didn't want to look at misshapen waveforms and unflagged pauses.

Does ASV "fine tune" itself as therapy progresses when in ASVAuto mode?  Or have I got this wrong.

My sleep study also revealed Hypoxia (64%).  Any feedback is welcomed.

I can't seem to attach a SleepHQ link, so here's Oscar...

       

[SarcasticDave94]

Welcome to Apnea Board,

The ASV does adjust between the parameters for EPAP / exhale Min to Max and then PS Min to Max. This also means IPAP / inhale will have a range. IPAP is also not directly adjusted.

I would use the ResMed Titration guide as an assist to settings. I'll attach it below.

On OSCAR, use the same charts as the first except add leaks under the mask pressure, instead of tidal volume.

What feel aspect do you want to address? Numbers look decent. If you want, edit EPAP Min to 5 or 6 if you feel you need a bit more base air. And you can access the clinical menu to edit for yourself. ResMed 10 series access is hold both Home and click dial for 5 seconds to enter clinical menu.

[jjrjr]

Thank you for the welcome and reply!

I'm trying to improve overall breathing and have fewer pauses.  My waveforms are...gnarly....and my sleep is filled with 7-9 sec pauses that aren't flagged.  My flagged apneas often last from 15-20 secs.  I'm getting an o2 ring in a day or two because Hypoxia was diagnosed.

My "feel aspect" is ok, I'm used to changing pressures and can take higher pressures.

I'm wondering whether or not ASV will help my breathing become more stabilized/efficient on ASVAuto w/default settings as far as waveforms, labored breathing, and pauses are concerned.

It's only my first night.  I will change Min EPAP to 5.   New Oscar with Leak graph and wonky waves attached.  Thank you for helping me!

         

[SarcasticDave94]

It may or may not help with what you're after. We'll just tune it and see if it gets better for you.

2 EPAP and 2 PS settings is all there is if you keep the same ASV Auto mode. That's what I used when I had an ASV.

[jjrjr]

To clarify, you used the default ASVAuto settings and let the machine do its thing without having to "dial in" tighter settings over time?

[SarcasticDave94]

Not me. I went with my own settings based off the ResMed Titration. I found that EPAP 7-12 and PS default 3-15 was just enough to make it work well.

I did run PS min 4 for a while but no improvement over min 3, so I changed it back.

Regardless, the ASV will run within the 3 ranges of pressures, EPAP PS and IPAP.

[jjrjr]

Thanks so much.

I'll let it do its default thing for some time, collect data, and go from there.

[SarcasticDave94]

If you would like, after a night we should have something to help tune it. If all's well however you might be OK.

[Sleeprider]

The UA events at about midnight are positional obstructive events. I think your EPAP min would be better around 7.0, and it looks like EPAP max at 12. Your PS range can probably be limited a bit, but I have no problems watching it for a bit. The ASV learns your breathing rate and volume from the moment you mask up, and looking at your chart we can see you are breathing deeply at the very beginning of the night at 22:00. The ASV is trying to target this high minute vent before you went to sleep by raising pressure support between 22:15 and 23:00 at which time a leak starts to grow. Try to settle a bit before masking up and starting therapy.

[jjrjr]

@SarcasticDave94

"If you would like, after a night we should have something to help tune it."

Yes please.  I'm trying a new mask tonight.  I'll post results here tmrw (06/07/2025)