ASV Settings?

[PavlovsCat]

Assuming everything goes to plan, I should have my new Resmed 9 Adapt this week. My question is regarding settings- currently I am using (with my APAP):

Minimum Pressure: 5.4
Maximum Pressure: 12.0
Optional: EPR on Full-Time setting 1. 
Ramp Off

Are ASV machines set up the same way? What adjustments should I make, if any? Thanks!

[SarcasticDave94]

Not exactly the same. There's some different terms for settings that will be similar in action, but you won't find EPR. PS will be in place of EPR with a larger range than 3. It's found in ASV and ASV Auto modes only here, and it's only full time.

Here's what there likely will be on the 9 series if it's like the 10 series ASV I had:

Mode - CPAP, ASV, ASV Auto

CPAP mode - you get a single static pressure setting, no EPR, no nothing else

ASV mode - EPAP single pressure, PS Min and Max, IPAP is the sum of these and not a direct adjustment

ASV Auto mode - EPAP Min and Max, PS Min and Max, again IPAP is the sum and not directly adjusted

You might want default settings in ASV Auto mode a night and see what OSCAR tells us.

Default EPAP 4-15 PS 3-15

[Sleeprider]

Congrats on getting ASV therapy going. Your settings are not applicable to ASV. My recommendation is that you start with default ASVauto mode settings of EPAP min 4.0, EPAP max 15.0, PS min 3.0, PS max 15.0.  We can help you to optimize after looking at  your first night of data.  Based on your previous therapy thread, your problem seems to be therapy onset central apnea. There was no indication of a need for high EPAP pressure to control OA events.  This is the way to go for starters and will result in the lowest pressures once we optimize.

[PavlovsCat]

Thank you so much, Dave and Sleeprider! I’m hoping this is the answer I have been looking for, and I appreciate all the support along the way.

[Sleeprider]

Be sure to request a copy of the clinical manual for the Resmed S9 VPAP Adapt from the forum. Follow instructions here https://www.apneaboard.com/adjust-cpap-p...nual#THREE

[PavlovsCat]

I was able to make it about two hours with my new ASV machine before waking up with reallyyyyy bad stomach pain. I’m guessing aerophagia? Any suggestions on adjustments that need to be made based on the attached Oscar capture would be greatly appreciated. Edit: if it matters, I was using nasal pillows and a chin strap.

[SarcasticDave94]

Physically, some aerophagia can be diminished by a left side down sleep position and adding some head of bed elevation.

As for ASV settings, in light of aerophagia, try this:

Drop both EPAP and PS Max by 2 or 3 each. If this was default ASV Auto, this edit makes each Max a number 13 or 12.

Later, I think EPAP Min will go up to about 6 to catch the Hypopnea.

Next OSCAR chart, click the arrow on the calendar to hide it. It's hiding needed info.

[Sleeprider]

Pressure support really took-off early in this session starting form 20:00 to 20:20. That is probably where you got most of the air in your stomach. EPAP remained low, and there were no events. Based on this experience, you should probably cut PS max significantly. I don't normally suggest a radical change in settings this early in therapy, but given your discomfort, let's set EPAP max at 5.0 and PS max at 8.0. This wlll result in a maximum pressure of 13/5. You will still be stimulated to breathe, but hopefully this will avoid forcing air into your gut.

[PavlovsCat]

Attached are a few more nights of charts. I’d appreciate any feedback. I’m having a really difficult time sleeping more than an hour or so with my machine on. I haven’t been waking up with stomach pains, but I am still waking up after an hour or so feeling very full and burping, which is definitely not normal for me. I’ve been side sleeping and using P10 nasal pillows.

Also, getting a CPAP has really brought to my attention what a shallow breather I am while awake and how often I hold my breath while awake… how unusual is that?

[Rubicon]

Your original sleep study was done on a device called ApneaLink.  It doesn't measure sleep so events could be scored when you're not even asleep.  The scoring was done automatically and it is not even known if the raw data was reviewed by a qualified individual so that could be simply SWJ.

If those 28 centrals are evenly dispersed throughout the study you could simply have bad sleep.  

On the 8 hour study there's <5 hours of analyzed data.  This suggests to me that your overall sleep quality is poor.

IMO every sign points to you trying to fix a problem that doesn't exist.

http://www.apneaboard.com/forums/attachm...?aid=39639