ASV settings and tips

[robbob2112]

My Oscar from last night - I seem to have found my sweet spot.  It includes the spo2 and flow limits between the two of them.

I did get up early this AM to clear snow - I got around 5ft (60in, 1524mm) over the last couple of days.  Heavy wet spring snow is the worst and my driveway is about 150ft long.  Good thing I have a beast of a snow blower.

[rosebladepat]

Robbob2112, I just took a look at most of thread. That's great; it looks like you're really doing well with all of your adjustments.

I'm also on an ASV with very similiar level settings as you and also wear a nasal mask.
I'm just wondering, in which position(s) do you sleep?

I sleep in a semi-fowler's position, from a 35-degree to a 20-degree angle (depending on where I find myself when I wake up...).

[robbob2112]

Hi, I wear the f&p Evora full face version.  It is like the F30 but a slightly different size.  I do use cover-roll tape along the bottom edge to keep is sealed.  All ofmthat said, I sleep on my left side mostly,  and rotate to the right when I can.  If I spend anytime on my back at all it causes major events because of my jaw slipping back.

[jcp519]

So I've had an interesting observation on how I feel. It seems like the nights that my EPAP is higher, I seem to feel better during the day and especially in the mornings. It looks like the nights that my EPAP went up to 8-10 cmH2O I felt better during the day and had some more energy. The other thing I noticed is on the nights where the EPAP was higher, I seemed to dream more.

I'm wondering how good the ASVAuto algorithm is at finding where EPAP should be? I'm not having any OA, but I'm wondering if the higher EPAP is opening up my airway more.

[Sleeprider]

The algorithm can only rise based on flow limitations, events and flow/volume inputs from its sensors. It may not optimize your therapy if you require a higher pressure than that. We often use a higher pressure than needed to stop obstructive apnea, in other words, if it feels better, do it.

[SarcasticDave94]

I don't think it would be too terribly bad if you just plug in the EPAP you feel best with. Then you're not waiting for the algorithm to help, which it maybe won't do much anyway. It's waiting to combat centrals.

My own therapy, I ran 7-12 EPAP, I did have a moderate amount of OA to deal with.

[jcp519]

I might try putting my EPAP range at 7-10 or even 8-10. My epap rarely goes above 9.5 so I don't think I'd need to up the EPAP max, but a slightly higher pressure might just be better for me. I've brought my PS range down to 3-8 which helped with comfort a lot, way less aerophagia to deal with. I've been feeling pretty good lately and most of this stuff is just fine tuning the settings so I feel great every day.

[Sleeprider]

Trial and error is a good teacher as long as you have a plan, and your's sounds very good.

[stevew168]

So I have a few questions about using the ASV and how its dropping my respiratory rate when the PS increases.

This is not a problem. The key is maintaining a stable minute ventilation, which is what the ASV does. When I changed from an Autoset to an ASV the same thing happened -- higher tidal volume and lower respiratory rate. The minute ventilation stayed about the same. That means your ASV is causing your breathing to be more efficient. Here's an overview showing the change:

[stevew168]

I'm wondering how good the ASVAuto algorithm is at finding where EPAP should be?  I'm not having any OA, but I'm wondering if the higher EPAP is opening up my airway more.

EPAP is increased in ASV Auto mostly based on obstructive apneas occurring (called unclassified on the ASV). If you find EPAP not returning back to near your minimum starting value, it suggests you could raise EPAPmin to a bit higher value, as long as it is comfortable starting out.