[CPAP] Newbie ready for guru input

[SarcasticDave94]

Copy that and thanks Sleeprider.

I'm adjusting it ASAP. Since I've been off PAP therapy for about 3 months, it feels like I'm starting all over again, regardless of the ASV portion. I love the machine already and I really love the ClimateLineAir hose. It DOES make a big difference to me.

BTW do I have it right regarding ResMed AirCurve 10; EPAP plus PS equals IPAP? Because I only see settings in clinical of EPAP min/max and PS min/max. (there are other settings, such as humidifier, date/time, etc. of course) I am guessing as well all these ResMed AirCurve 10's have mostly similar basic settings regardless of mine being ASV.

Settings edited as suggested

PS First night was just JUNK data, spent only 1 hour using last night, mostly trying to get mask to fit without leaks. DME said they're getting AirTouch F20's in soon and parts for them. Her suggestion is I could swap AirFit silicone seal with memory foam of the AirTouch, will be trying that. I am reviewing the mask primer to get it to stop leaking, still in process to victory with this one.

And 1 more thing: Apria LOCAL office so far is very good. The corporate level not as well, not terrible either. As is, I bypass corporate communications via email with what I'm guessing are RT's at the local office. I no longer regret choosing Apria. AND this RT has had ISSUES with my specific duck...imagine that!

[Sleeprider]

Your IPAP constantly varies on ASV and so it's pointless to include a setting. EPAP+PS=IPAP, or IPAP-EPAP=PS, or IPAP-PS=EPAP. Your algebraic permutation may vary.

I want to add, that since we are working with imperfect data, if the lower EPAP is not appropriate, it will show up as excessive UA, which is how your OA will appear with ASV. I just don't think the higher pressure was beneficial in your bilevel attempt, adn the idea here is to use only as much pressure as necessary to eliminate OA, then let the PS take care of H, CA and periodic breathing. Since you will be in ASVauto mode, the EPAP should move higher as needed, and this gives you more room to resolve CA and avoid really high IPAP pressures.

[SarcasticDave94]

Thanks & copy including your edit of new info. RT Melissa I worked with yesterday stated she likes working with patients that know what they're talking about BTW. Wanna guess where this patient got his knowledge?

BTW using current settings of EPAP 7-12 PS 0-15 in ASV Auto; won't edit these until otherwise suggested. I'll view data daily, probably see results over weekend then post it Monday for review. If better to do daily I can. I despise starting over like it feels now but I did win the battle of getting all on the machine list. So I am not complaining.

[SarcasticDave94]

I know this is a junk post but just making sure I got it set as suggested. Funny how habits die when you stop doing some act for a few months. DEMO post with ASV. Bad settings were used and will be the last.

[Sleeprider]

Dave, when you start posting real charts, be sure to include the summary data in the left column of the daily details. Just use the F12 key and the screenshot should be saved in My Documents/Sleepyhead/Screenshots. With all due respect to the screenshot wiki guide in your signature, I might have to rewrite that to look more like the first two links in my signature. Your screenshot is small and almost unreadable, lacks important data from the left side.

I saved the image from the Aircurve 10 ASV Review in Imgur, and this is what we are looking for:



P.S. be sure to shorten that Ramp time. No more than 10-15 minutes. Less is more for you, and the machine will not counter those hypopnea during ramp. Auto Ramp is a good feature on your machine, and it detects sleep breathing. I also want to say, your chart confirms the lower EPAP minimum is appropriate for you.

[SarcasticDave94]

OK got it. Thanks. Just figured I'd clear that signature area out for now with the link. No issues but I think for now I'll go simpler. As for ramp, I was considering about the length as well. I'm not even sure I'll need to activate it at all like I did with the PR BiPap I was on.

[SarcasticDave94]

Quick update of night 2 on ASV: (will post image report later) Using settings shown on profile via suggestion of Sleeprider with one edit that is I used no ramp; I logged 3 hours 45 min usage and AHI of 2.9

[SarcasticDave94]

I logged 3 hrs 45 mins on day 2 of ASV. I'm running settings suggested by Sleeprider of EPAP 7-12 and PS of 0-15. I tried a 0 for ramp but I am strongly considering adding up to 15 mins of that. I learned that ResMed automatically starts on the ramp in whatever the time it's set to. This differs from PR DreamStations that have a ramp button to start the ramp whenever you want. "Normal" timing for falling asleep after lying down is 30 min. plus.

I thought I had the mask adjusted fairly good using the mask fit feature and followed the steps in the wiki, but it's obviously not dialed in yet according to sleepyhead. When I was falling asleep, I did not note any leaks, but they were there regardless. I'm not sure if the AirFit F20 gets better like a break-in period. When available, I will also get the AirTouch seal to have that as an option. I still state it feels like I'm starting all over again, but I'm still swinging at the pitches.

[ajack]

I think the advice will be to lift the min epap for the UA/H

It's early days and I don't want to confuse you. I think the first thing is to work on the leaks, these need to be under control for the high pressure. I saw you got a f20, I also use this one. As you have said, you have a bit of COPD. Are they going to titrate you on the ASV or do you have a knowledgeable doctors to set up the ASV for your COPD?

The machine max pressure seems to be choked at the beginning of the chart and was able to go higher when the epap rose enough.

[Sleeprider]

Not too bad, but we need more hours and wow, that is a busy ASV. In future charts, I think it would help if you can fit in the mask pressure. We can see exactly whether it is worth preserving that 0 PS min, or if the 2.0 PS min is going to be more comfortable. The only reason to keep zero on PS min is if you have some evidence of spontaneous breathing.

I agree with ajack that EPAP min might come up a bit, but nowhere near your original prescription. Once again, a higher resolution would help. Please use the "huge thumbnail to post, or provide a direct link to the Imgur image.