ASV Machine Pressure.

[LarryRapp]

I have a relatively new ASV machine.  Occasionally the pressure seems too high as in the enclosed shot.  What should I do?

WRONG SCREENSHOT.  Something screwed up.  Apple computer, did shift-command-4 then selected the picture then let go of mouse.  It clicked ok, but I can't find the damn screenshot. 

Found the screenshot.

[LarryRapp]

Here is screenshot

[Crimson Nape]

Larry,
You leak rate is so bad that this alone should be your primary concern.  Because of the major leaks, your data should be regarded as a "best guess" by the machine.  When was the last time your replaced the mask?  Have you recently lost weight?  Weight loss can make a previously good sealing mask start leaking.

[DeepBreathing]

Larry, your screenshot is showing you're in large leak territory over 60% of the time. Once leaks go over the red line the machine can't effectively pump air fast enough to keep up. It also can't properly diagnose or treat apneas, hypopneas etc. So the very first thing you need to do is get the leaks under control. If you feel the leaks are caused by higher pressures, you can reduce the peak pressure by reducing the PSMax - at 15 it's pretty high and probably not conducive to a sound sleep until you become accustomed to it.

[Sleeprider]

I would change PSmax to 12.0 and work on the leaks.

[sheepless]

what others said. in addition, have you tried lower min epap? you can afford a few UA and H if it helps reduce leaks. I choose settings that let my ipap range up to close to max of 25 but find I get more leaks with higher min epap and higher min pressure support. also when I end up on my back.

[LarryRapp]

Hi Red and others,  Thank you!  First of all, I changed the mask two days ago.  It's the same thing - a Mirage Quattro.  I will change the PSMAX from 15 to 12.  I haven't lost any weight - still around 186.

The numbers are good.  This happens every now and then.  My normal numbers are always under 5 usually under 1.  I think the pressure is the problem as that is what it seems to be.  IMPORTANT:  I have a beard.  There doesn't seem to be any leaks even though Sleepyhead looks like there is.

I don't know about EPAP.  Let me see where I am.

Sorry it took so long to post this but I was seeing a doctor (gastroenterologist) about 60 miles from here.

[LarryRapp]

I hope I can copy Screenshot.  In any event AHI is 0.85, hypopnea was only 6 events, large leaks are down to 40, and UA is only 1.  I lowered PSMAX to 12 and tightened the mask.  I slept the entire night - I don't know if it was because I was tired from the trip or because I lowered PSMAX.

[Sleeprider]

Larry, it looks pretty good. Let's try EPAP min 8.0 and leave the rest as-is. I think the PS max of 12 is much more suited to your needs, and we might be able to move that down a bit in the future. Lowering the EPAP is to see if we open the door to more hypopnea or UA, or if we can find a more comfortable minimum for you. Don't be surprised if we move back to 9.0.

[LarryRapp]

Ok, I will set EPAP min to 8.  Thanks!