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I have been on ASV (Aircurve 11) for about 1 year. In-lab sleep study showed an AHI of 22 with 7 centrals. I tried cpap but centrals went to over 100; thus asv was recommended. I can easily get my AHI below 1.0, but sleep quality continues to be a major issue with multiple arousals throughout the night leading to near insomnia. I have experimented across the ranges of EPAP and PS with no substantial success. Mouth leaks are one major issue for which I have tried chin straps and mouth tape, but I blow right through them. Also tried a cervical collar and saw no change. I have switched between a P10 and an F20 and not detected any real difference in sleep quality. I should note that I also have afib and bradycardia, so higher pressures and pressure swings concern me.
I wanted to share some data and see if anyone can provide insight regarding possible causes and cures.
Sorry we didn't see your thread. Things have been busy. As usual the Resmed ASV is capturing most of the events and your AHI is lower, but sleep quality is poor. We don't have a lot of examples of your therapy alternatives, but EPAP min 7.0, PS 2-7 looks better than EPAP 6.0 PS 0-6. I think we need to use a higher PS min in your settings. Even with lower PS max, the ASV does stimulate spontaneous breathing, so it looks like we can edge up the PS min and work with EPAP to prevent obstructive events. Let's try EPAP min 6.0, EPAP max 9.0, PS min 3.0, PS max 9.0 and see what that does. The higher PS min will help with flow limits and prevent the respiratory effort related arousal, while the other settings should avoid any apnea. We need to learn what disrupts your sleep, and so-far it's not very easy to identify a cause.
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.
One surprising little silicone device drops leaks dramatically. It's called Somnoseal, and you wear it inside your mouth and over the fronts of your teeth. For some people, it stops their leaks entirely. For me, my pressure is rather high, so it does not work alone, but with mouth tape over it, my leaks are zero. It also keeps my mouth from drying out. For people who need less pressure, like you, it may well work to stop leaks without mouth tape! I know it has for some here.
You have to buy it directly from Somnoseal. I know because I looked extensively.
Best wishes for whatever you decide to do to improve your therapy and comfort!
Machine: ResMed AirCurve 10 Vauto
Mask: Bleep DreamPort Sleep Solution and F&P Nova Micro
Thank you Sleeprider. I will give those settings a try. Attached is another night where I used a wider range in an effort to identify the upper limit, along with some closeups of the flow rate. AHI was 0 but arousals were significant. However, even when I subsequently narrowed the range using Pressure Med and 95% as thresholds, I could not stay asleep.
And Deborah K, I have tried Somnoseal and two similar devices with and without mouth tape. They help with dry mouth, but I still have constant sleep disturbances. As I noted, I have tried virtually everything I have read about on this forum and been surprised and very disappointed that I cannot achieve the quality sleep I know some users have.
Thank you very much for your time and suggestions.
05-15-2025, 07:14 PM (This post was last modified: 05-15-2025, 07:15 PM by SarcasticDave94. Edited 1 time in total.)
RE: Poor sleep quality
The wider settings look closer to your needs, we just need to identify disturbances to get you to a more rested place.
ASV Auto mode is shown. You should have EPAP Min and Max, and the PS 3-15 shown. Is that EPAP 4-15, as in full default? If me, EPAP is probably where you can edit things a bit, maybe a slight increase in Min to 5, EPAP Max 15 probably isn't required. Maybe a 5-12 EPAP, or similar.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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.
Sleeprider, I went with your recommendation last night. I think the slight increase in PS was helpful, and that my pressures are about right to control the apnea. I have tried the lower EPAPs of 4-5 but still have issues. For me, it may all just be due to mouth leaks.
Last night using the P10 with Somnoseal and mouth tape I continued to have multiple arousals due to mouth leaks. I have tried the F20 and F30i previously, but cannot seem to tolerate them; something about the airflow is disruptive. I can go to sleep fine with the P10, the mouth leaks just fragment the night. I wonder if a nasal pillow that also covers the mouth might work. The only one I can find is the Sun Med Hyb500. Are there any others of which you are aware that might help me get the mouth leaks under control given that tape, chin straps, and collars have not been successful?
