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Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
#11
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
I’ve read it’s pointless to use tape with a FFM. Do you have any nights without it? 
Looks like some of your leaks coincide with the grassy spikes in your flow rate. Leaks are very important to control with ASV. So taping your mouth wouldn’t matter if you have air escaping your mask.  Do you know which mask gives you the least amount of leaks. I am not a OSCAR expert but I do have an ASV. So that’s where I’d start. I’d also look at your EPR stats for a 6 month time frame or so. I think you could possibly bring down your EPR max.
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#12
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
Has anyone ever said anything about your leak rate? It seems like you have consistent leaks. Maybe mask fit?
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#13
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
I speak not as an expert, or a doctor -- just a user of Resmed ASV. My success comes from my experience, without any help from the doctors or the DME.

Low AHI is real nice, but can still lead to issues if the pressure is not set right. Any AHI under 5 is considered good -- what counts more is "how do you feel". I've had plenty of 0.00 AHI's and still felt terrible the next day. If it was me, I'd make some changes to your pressures. I'd set them at:

EPAP Min 4.0
EPAP Max 8.0
PS Min 2.0
PS Max 9.0

From there, you have to see how you do with those pressures, and then adjust from there. Don't think it as breathing -- consider them separate. Such as How is my inhale, and How is my exhale. Excess air, bloating, headaches, burping, and leaks generally indicate too much air pressure. And your current settings are set high. It's possible your EPAP Min is set too high -- trial and error, to find out.
Also, get into a mask where you feel comfortable, and try to eliminate the leaks. I try to eliminate leaks completely because then I can trust the actual readings the graphs show. I use the N20 mask, and I tape my mouth shut (although that may be coming to an end, too early to tell). In my book, the idea is to get close to what you need and then make only small changes to zero it in.
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#14
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
Hi Rich, you mentioned EPAP min. I want to clarify something for myself. Should it be easier to breathe out when you decrease EPAP min from, say 5.0 to 4.0, on your AirCurve 10 ASV device? Thanks.
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#15
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
Basically, yes -- except if the machine thinks you need the higher pressure. Then it will adjust itself. I'm trying for the lowest pressures where I can still awake feeling like a normal human. I'm also looking to eliminate mouth farts, which I find disturb my sleep. And I think that EPAP settings can be part of the issue. I can't really say for sure on that because I ended the mouth farts when I made some serious changes (larger changes). It seems to me that having the EPAP Min too low does not hurt anything, since the machine will push the pressure up if it feels the patient needs it. And then it can lower itself back down if needed. Of course, each individual has to figure out what works for them.
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#16
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
You say that EPAP min can't be too low on our ASV devices. But when EPAP min is too low on APAP devices, say 4.0, people complain about a suffocating feeling and have to increase EPAP min to, say 7.0. Why is ASV EPAP different from APAP EPAP?
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#17
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
I don't know, I only speak from my experience. My first machine was a Phillips and it was not a good experience. I switched to Resmed and have been able to find success with it. I make no comments on other machines and how they perform, since I am not experienced with them. My thought is -- try it, see what happens, and adjust as necessary.
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#18
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
Rich, have you tried using a full mask instead of your Resmed nasal mask? With my F20 full mask, I get no leaks or disturbing sounds.
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#19
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
Yes, I have tried using a couple of FFM's. I tend to sleep on my side slightly turned toward on my stomach. I've always been a real light sleeper. So the less disturbances, the better. I dream much much more since being on BIPAP. I've darkened my room as much as I can. I even went to a car window tint place and got a scrap piece of window tint to help reduce the LED light glare on my clock. I've been taping my mouth for over a year now -- doing that is not bad. I even slept through a power outage for about 7 minutes.
My newest venture is to modify the exhaust port on the supply hose for my N20 mask. I'm moving it to the other end of the mask hose. My leak problems have reduced and I have spent the last few nights without taping my mouth. It's still too early to call it a success -- but I'm willing to try. I have found the stock exhaust location for that supply hose shoots the exhaust air onto my sheets or blankets, and then it blows back on me -- and that wakes me up. I try, I try, I try.
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#20
RE: Low AHI with Aircurve 10 ASVAuto Still tired/headache/waking up at night
I no longer use nasal masks or hybrid full masks. The F20 is far superior for me, and I don't have to tape my mouth, which I found to be potentially dangerous. If the power goes out, it's scary when both your nose and mouth are blocked and you can't breathe. The F20 has a safety valve that automatically opens up so that you can breathe easily without the air pressure.

I think that nasal masks are good for those who are not mouth breathers at all. Mouth breathers should use a full mask IMO.
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