Trouble with new ASV machine

[Rich66]

The micropore tape I've seen says it is breatheable.  I'm using Cover-roll stretch tape from Amazon, it adheres good and is removeable without much issue, and it says it is "air permeable" -- I still have air leaks out my mouth, but just not as much when without the tape.

[GaspForAir]

Thank you for the suggestion Rich66. It's not very expensive on Amazon so it's worth a try!

[Rich66]

For what its worth -- I put mine over a mustache shaped like a horseshoe, not very bushy, and I use chapstick on the lips to prevent adhesion to the actual lips.

[GaspForAir]

The air leaks and dry mouth continue for me. I tried the tape suggested by Rich66 and even with three layers air is continuing to leak through my mouth! I am going to try a neck collar and chin strap but I also thought of something else.
Perhaps the pressure is too high from my Air Curve 10 ASV.?.
It would be easy to change the settings and try it. If someone could look at my OSCAR print out and suggest some lower setting I would appreciate it. I don't understand the settings for an ASV machine or I would do it myself.

Thanks!

[SarcasticDave94]

You must be running ASV Auto as EPAP is represented as a range of Min to Max.

Currently your using:
EPAP 6-9
PS 5-15
This gives IPAP 11-24 by way of adding EPAP to PS.

Your event numbers are really low, so you can try and edit this some and see what improved and what gets worse.

EPAP doesn't have much to play with so I'd suggest editing PS. Let's move that entire range down a bit and try taking a bit off the top.

Go into your clinical menu via pressing and holding both Home and the Dial in for about 5 seconds. Click into settings and scroll to PS Min. Edit this to 3 from 5.
PS Max edit down from 15 to 11. You will have to highlight what value you want to change, click the Dial to enter the edit function, turn dial to change numbers to what you want, click dial to lock it, and then you may edit the next. After that, click the Home button, then exit at the top of the menu.

EPAP 6-9 same as before
PS 3-11 editing to these
Now your IPAP will become 9-20.

Try the edit one night, then post OSCAR results and tell us if it helped.

[RayBee]

I had lots of similar issues when I started with my ASV as well. The more I learned about sleep apnea, what my body could tolerate, and the generous help here on AB, the more I was confident in searching for the best therapy parameters for me.

I eventually discovered that if I could maintain IPAP max pressure under 17, I would keep aerophagia in check. So there was a piece of the puzzle - EPAP max + PS max had to be 17 or less. I also felt starved for air if IPAP min was less then 5 - so I had to maintain EPAP min + PS min to 5 or greater.

I found that comfort in my settings was paramount to staying asleep, and high enough pressure for efficacy in therapy was secondary. If I can't stay asleep, what's the point? So I played with the settings within the parameters above quite extensively. I would maintain any combination for two weeks to get a good gauge on those numbers and kept copious notes.

My current IPAP min is 8.6. I am very comfortable inhaling normally to deeply, and feel slightly starved, well, almost never. I bumped IPAP max down from 17 to 14.6 which seemed to mitigate mask leakage when I switched to the F&P Vitera. Not listed on my sidebar since I am calling this a comparative test. I plan on using the F&P Vitera for a few months and then write up a review like I did on the F30. Next on my review list will be the PR Amara View.

I found that delta 6 cmH2O doesn't allow much wiggle room, so I leaned towards giving more of that wiggle room to PS rather than EPAP - Yes, almost booted myself out of ASV Auto mode. But this seems to work well for me for comfort, staying asleep and efficacy in CA therapy. My numbers remain good and I feel great. You might tweak your EPAP and PS settings based upon the reasons stated above. I discovered my limits and never changed any given setting more than 2 points at a time. Always gave myself two weeks to determine if the adjustment was a positive thing, and always keep notes.

On another note... I find myself chin-tucking too. That resulted in higher AHI's, looser mask fit, and mask leaks (face farts) - mostly problematic with the F&P Vitera. I found soft cervical collars to be very uncomfortable and can't use them. Didn't like the idea if any of the other alternatives either. So, what I found that works is to simply scrunch up some the blankets under my chin. It seems to work quite well, is simple, and is completely adjustable for comfort.

I hope you can try some of these ideas and I hope you can find a good balance of comfort and efficacy.

[GaspForAir]

Thanks for all the great responses. Going on a week's trip and will try these suggestions when I get back.

[GaspForAir]

I have changed the AirCurve 10 ASV settings as suggested by SarcasticDave94:

Setting   Old       New
min EPAP  6.0       6.0
max IPAP  24.0      20.0
PS        5.0-15.0  3.0-11.0

Also I started taking Trazodone 25 mg to help with sleep. The first 3 nights I was able to record are:

Friday
   
Saturday
   
Monday
   

Day    AHI   Hrs Slept
Fri    0.0   8:12
Sat    1.15  6:06
Mon    0.76  3:58

My takeaway from this is that the new settings are compatible with low AHI and that leakage depends a lot on my ability to sleep. I feel like I have less leakage until I start to get very restless and start waking up.

I would appreciate comments.

Thanks!
 

[SarcasticDave94]

Data looks excellent except the leaks. Did seeing setting edits change how your feel? Or in other words, do you feel well treated? Yes then just run with it. Like I say data of events is about perfect.

[GaspForAir]

Yes I do have a lot of leaks. I believe these are mostly do to my poor, restless sleep. I think this is what I must work on next.

Thanks!