Does anyone have an tips on self titration for the Resmed aircurve 10 ASV?

[sheepless]

I'm not reading concern about reaching or exceeding max epap so much as I read (and am similarly confused by) uncertainty about what the sentence means as an example of how vague these instructions are:

"if epap reaches max epap and upper airway obstruction persists, progressively increase epap until upper airway obstruction is eliminated."

as written it's impossible. unless, I guess, max epap is the set max that's lower than actual max epap, in which case it would have been nice had it said so. confusing at best.

btw, use of the term upper airway obstruction might be construed to include upper airway restriction syndrome; i.e., flow limitations and maybe snores and hypopnea. yet, using epap is contrary to the assumption that min ps is used to resolve those. of course the titration protocol doesn't say anything about ps.

following member guidance may be a practical and efficient means to the end but it's useful for others to understand this stuff while following that guidance. I count myself among the 'others'. so yes, good job refocusing in on what needs to be done as a practical matter. I just think it's also useful / helpful to clarify / explain if possible when and where a poster has questions / uncertainties.

I see two unanswered questions following the titration protocol in post #6. I might have stumbled on the answer to the first one (max is not max capability but set max if lower than max capability) but IDK the answer to the second.

sorry, not meaning to be difficult; just looking for information; trying to understand.

[SarcasticDave94]

Take note that even when it comes to ASV settings, I come out as a rare item. My settings are not classified as normal as I understand it, but for ME they work.

I think I started with ASV Auto (still use Auto) settings of 8 EPAP Min and 13 EPAP Max, with 3 - 12 PS. After some use, I moved my EPAP min eventually to 9.8 due to feeling I needed more baseline air, and there were no changes to the other 3 settings.

[SarcasticDave94]

FWIW

Here are the setting ranges I see available on my ASV running ASV Auto mode:

EPAP Min 4 TO 15

EPAP Max Equal to EPAP Min TO 15

PS Min 0 TO 6

PS Max 8 TO 25 Minus EPAP Min setting

[Michaely6]

Let's go one step at a time.  Try the default autoASV settings and let's look where that takes us.  Very few people need EPAP higher than 15 cm.  Post some results and we can modify the approach if needed.  We don't have any history on your case and what brought you to ASV or what your results were on CPAP or BPAP, so your concerns about exceeding the recommended default settings has no context.

After a few nights I will post my results and I started to use the ASV because I was developing Central apneas with CPAP Auto CPAP and bilevel and I just came to the ASV device from the V Auto curve

[Sleeprider]

That is a normal progression. Don't assume that the high pressure you experienced with CPAP and VPAP will be needed with ASV. The new therapy will eliminate CA immediatly, and this will include many events identified as mixed or obstructive on your previous machines. Once you get going we can fine tune EPAP min and the PS range to target any residual events and comfort issues. Be assured, the majority of new users to ASV adapt quickly and have a remarkably low event rate. It can be life changing. Good luck!

[SarcasticDave94]

That is a normal progression.  Don't assume that the high pressure you experienced with CPAP and VPAP will be needed with ASV.  The new therapy will eliminate CA immediatly, and this will include many events identified as mixed or obstructive on your previous machines.  Once you get going we can fine tune EPAP min and the PS range to target any residual events and comfort issues.  Be assured, the majority of new users to ASV adapt quickly and have a remarkably low event rate. It can be life changing.  Good luck!

This is true in my case. The ASV does allow lower pressures than would otherwise be acceptable because of how it responds very quick to that moments support requirement. I adapted better and faster to ASV than either CPAP or BPAP; but that could be in part due to both being absolutely wrong for me.

[Michaely6]

I just messed with my ASV aircurve 10 settings just to experiment. Can someone explain what is happening in my flow rate? I still dont quite understand how to understand the flow rate as far as inspiration and expiration. when does inspiration start and expiration begin?

[jaswilliams]

I just messed with my ASV aircurve 10 settings just to experiment. Can someone explain what is happening in my flow rate? I still dont quite understand how to understand the flow rate as far as inspiration and expiration. when does inspiration start and expiration begin?

Can you replace the pressure line with the mask pressure line as this provides more useful information in the ASV and we can then see what your machine is actually doing to support your breathing

[Sleeprider]

Seeing mask pressure would help. It appears that your machine may be applying IPAP prematurely in the sequence above. I am seeing a breathing rate of 16 bpm, with a fairly long expiration time, but the flow rate goes positive as expiration approaches zero and appears to be cut off, and an inhale is sometimes prematurely forced by the ASV at 02:20:00. Seeing mask pressure would show this better. In addition we really need to get rid of the pie chart or smilie face. Use the Sleepyhead menu File/preferences/appearance, and uncheck the pie chart option.

Have you ever tried a lower PS min, and if so, what was the problem?

[Michaely6]

Seeing mask pressure would help.  It appears that your machine may be applying IPAP prematurely in the sequence above.  I am seeing a breathing rate of 16 bpm, with a fairly long expiration time, but the flow rate goes positive as expiration approaches zero and appears to be cut off, and an inhale is sometimes prematurely forced by the ASV at 02:20:00.  Seeing mask pressure would show this better.  In addition we really need to get rid of the pie chart or smilie face.  Use the Sleepyhead menu File/preferences/appearance, and uncheck the pie chart option.

Have you ever tried a lower PS min, and if so, what was the problem?

Here you go. I added the mask pressure. Are you saying that something may be wrong with my machine? Yes i experimented with pressure support 3-15 for a few days. The flow limitation graph in sleepy head was very active and i heard that you should increase IPAP to get rid of flow limitation, snoring and hypopnea so I just experimented with a high pressure support.