ASV settings and tips

[SarcasticDave94]

You could if you so choose, but doing 4 edits you may likey lose the ability to know which went wrong or right. Maybe this doesn't matter to you though.

Is there a certain feeling you want to dial/edit out? Example trending to feel air starved? Not enough base air? Not enough on inhale? You give a decent shot at describing and I'll give a decent shot at telling you which 1-2 needs attention.

[jcp519]

There are times when when I'm breathing that it feels like there isn't enough air when I'm inhaling. I can barely feel the transition from EPAP to IPAP when the PS is low. I also get a minor general feeling of air hunger compared to the pillows. Its almost as if its not assisting my breathing as much as it did before.

[SarcasticDave94]

Sorry I've lost track, which pressure settings are you using now?

To affect inhale feel, it's going to be PS, exhale or your minimum pressure base will be EPAP Min.

[jcp519]

I'm currently on EPAP 7-10 with PS 3-8.

[SarcasticDave94]

OK next up on 20 questions...

Which is higher priority to you, inhale feel or the overall reduction with the full face swap?

If me, I'd target overall feel within EPAP. You may have to do both Min and Max EPAP sometime, but maybe push up EPAP min by somewhere between 0.4 to 1.0 added onto the min, making it 7.4 to 8. Pause and trial it a few hours, decide if it's good or not.

I think you're going to want/need to keep that min-max spread though, so if you target the min, the max might have to bump too. In my thinking anyway.

If you choose to add IPAP, maybe incremental bump to PS. I don't know that you'll need a PS min of 4 though, kinda why I'd focus on Max here, to give it more spread to select.

Whatever you choose, you don't need my approval. Just my musings.

A pointer too, any edit you do, note that last setting so you can revert back to it if the bump edit doesn't work like you wanted.

[jcp519]

The overall feel is definitely more important to me. I'm going to up my EPAP settings to 7.4-10.4 for tonight to see if it helps out. I might hold off increasing the PS max because as I get closer to 10, my aerophagia tends to get worse.

I actually feel like the full face mask was more comfortable due to my nose problems. I should have just started with one from the very beginning.

Appreciate your input Dave!

[Sleeprider]

The titration guide says increase EPAP for hypopnea, and it looks to me like 8.0 would be a better minimum. I would have no problem with PS 4.0 to 9.0 if that is more comfortable.

[SarcasticDave94]

Good catch, I missed the chart on page prior.

[jcp519]

I've switched back to the pillows and mouth tape for now. I had lots of trouble with leaks on the F20 so I'm waiting for a F&P Vitera to show up.

I've noticed something else on my data as well. Even though my leaks are very low it looks like every time I have a small leak, it leads to a sort of micro arousal. These leaks also usually cause the ASV to increase PS for a little while. Seems like even very small, short lived leaks cause issues for me. The small leaks even caused what the machine is labelling as a hypopnea. I'm wondering if even these are disrupting my sleep causing some amount of daytime sleepiness.

Am I getting too far into the weeds looking at these or is there something here?

           

[Jay51]

IMO, jcp519, you are doing a great job going through the "growing pains" of using ASV.  I have both an ASV and EVO ventilator.  Trialing other masks for less leaks was time well spent IMO.  Tweaks helped also (mask liners, different size headgear, etc.).  

I can relate to everything you have posted in your threads.  It seems like every once in awhile, I still wake up with a mask leak into my left eye for some reason that I have not figured out yet.  I simply readjust the mask, or use small strips of silk and stick them in the exact spot the leak is occurring.  I fall back asleep quickly.  Not sure if the leak wakes me up or I randomly wake up with a leak that has been going on for awhile.  

This can be part of the territory of using higher PS and pressure swings from EPAP to IPAP.  I hope you find a long term solution and wish you well.