Air Pressure Issue

[Vako]

@Sarcasticdave94 any suggestion ?

[SarcasticDave94]

Maybe try a few things, go without Ramp, EPAP Max down to 10 and 1 off the PS Max. No offense meant, but since we're flying blind, we don't want big edits to the controls or we risk crashing the plane.

[Vako]

Maybe try a few things, go without Ramp, EPAP Max down to 10 and 1 off the PS Max. No offense meant, but since we're flying blind, we don't want big edits to the controls or we risk crashing the plane.

 Ok here's where my confusion is and I will put charts.
Back in 03 for example I was using mode ASVAuto and my FFM without any issues whatsoever as you can witness at a PS min/max of 3/16.

Coming now to this date there is NO way I can use mode ASVAUTO at PS min/Max 3/16 not even 3/11 without getting darn leaks that won't let me sleep at all.

I found out that changing it to mode ASV I can sleep with my FFM mask without having leaks though I'm getting AHI in the 6's with Hypopneas and Centrals which is my diagnosis. 

Back in 03 I was having 0. Nothing at all. I'm wondering am I having AHI because of the setup I have right now which is the one I was trying with ASVAuto mode but failed? Ps min/max 4/12?

Should I put it at 3/16 to see if my AHI gets cleaned up?

Still flabbergasted at why back in 03 I was fine using my FFM in ASVAuto mode without issues ???.

P.S in the last chart if it says Nasal it's because I'm using  suggestion of setting as nasal when on FFM if you don't have a 19 or 22mm hose. I have one but at hospital atm.

https://sleephq.com/public/d4d5c530-2df1...66de6bfd57 FFM 03 at ps min/max 5/16

https://sleephq.com/public/d67196cf-f0aa...e1fbee6f80 Bleep Eclipse at ps min/max 3/16

https://sleephq.com/public/0e7ca7fc-efac...6aceca736c FFM at PS min/max 4/12

[SarcasticDave94]

From what I can gather in those charts, you're doing OK by the numbers if EPAP was a range. Static EPAP 4 on ASV mode had events.

I'd try ASV Auto, EPAP 6-12, PS 3-13 to see how that goes.

Myself, I'm more familiar with the OSCAR charts. I'm able to pull more data out of them.

As for why things are different now, our therapy needs change in various ways. I really don't know what exactly changed, just that it seems like something did

[Vako]

From what I can gather in those charts, you're doing OK by the numbers if EPAP was a range. Static EPAP 4 on ASV mode had events.

I'd try ASV Auto, EPAP 6-12, PS 3-13 to see how that goes.

Myself, I'm more familiar with the OSCAR charts. I'm able to pull more data out of them.

As for why things are different now, our therapy needs change in various ways. I really don't know what exactly changed, just that it seems like something did

Wish I can do the darn ASVAuto to be more safe since I have both centrals ? but I can't. I had it at PS 3-11 it was blowing my mask away I don't know why. On ASV mode it's just fine but I'm having episodes and don't like it. From 0 episodes to having episodes and huge leaks is driving me nuts. And I don't want to go back to nasal, taping all day has my lips are cracked. 

So P*ssed. When I get home I'll see if laptop still works and feed it onto Oscar.

[SarcasticDave94]

Then this may be partially a mask need issue. When I had ASV, the last mask I used was the Fisher and Paykel Vitera, a full face. It took IPAP 25 while giving about 10 L/Min leak. Below that pressure, leaks were less.

In cases of masks being a problem, first determine that the mask actually fits right, is the right size, right adjustments and in the right order. If you can use successfully a pillows mask, leaks are easiest to fix due to least sealing areas. Next a nasal mask, finally the full face and hybrid. Of those, try to get the most minimal you can make work consistently.

If the mask is worn out, replace parts as needed.

Never wear a mask adjusted too tight. This will increase leaks not diminish.

[Vako]

Then this may be partially a mask need issue. When I had ASV, the last mask I used was the Fisher and Paykel Vitera, a full face. It took IPAP 25 while giving about 10 L/Min leak. Below that pressure, leaks were less.

In cases of masks being a problem, first determine that the mask actually fits right, is the right size, right adjustments and in the right order. If you can use successfully a pillows mask, leaks are easiest to fix due to least sealing areas. Next a nasal mask, finally the full face and hybrid. Of those, try to get the most minimal you can make work consistently.

If the mask is worn out, replace parts as needed.

Never wear a mask adjusted too tight. This will increase leaks not diminish.

It's not a mask issue. Like I said in 03 everything was working fine using only my Airtouch f30. Now nothing works, I have hanging next to me ( Nova Micro, Brevida, Mirage Quattro, Mirage Quattro FX, Simplus, Lena, Nova Micro, AirFit F40, F&P Evora Full )

It's all the same if it's on ASVAuto, if it's on ASV it works but I'm getting events like you could see whilst in 03 I was getting none and on ASVAuto ???. 

I can do fine with nasal problem is have jaw drop so there's no ands ifs it buts about it I need to tape and I'm disable with no functional use of my hands to tape myself AND my lips get cracked and irritated because of the tapes. The one that works greatest is the Bleep but again I can't tape my mouth let alone cut and place the nose strips and angle them etc etc. I depend on someone else and that's something to avoid ??

[Jay51]

If I'm understanding this correctly, the only major difference between ASV (mode) and ASV (auto mode) is the static, fixed EPAP in ASV (mode).  The ASVauto has the EPAP range.  Both have PS ranges though.  Is this what is causing the problems (the differences in their EPAP algorithms)?

[SarcasticDave94]

Jay has the difference correct. ASV mode is static EPAP, ASV Auto has EPAP range.

Quote of your sentence:

"From 0 episodes to having episodes and huge leaks is driving me nuts."

You said there's a huge leak. It might not be a mask issue, however. This must be addressed, period. ASV doesn't tolerate large leaks.

PS, the sleep HQ charts do not show the huge leaks. Commence beating dead horses. We can track this better in OSCAR.

[Vako]

If I'm understanding this correctly, the only major difference between ASV (mode) and ASV (auto mode) is the static, fixed EPAP in ASV (mode).  The ASVauto has the EPAP range.  Both have PS ranges though.  Is this what is causing the problems (the differences in their EPAP algorithms)?

ASVAuto mode is more dynamic and makes automatic adjustments to both EPAP and PS based on real-time feedback, while ASV mode uses fixed EPAP and only adjusts the pressure support.
Won't touch Epap at all.