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

[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?

I just added the mask pressure

[jaswilliams]

I think I would have started with a lower mininimum epap of may be 6 rather than your value of 9, were the flow limitations bad ? In auto asv mode the machine will raise epap itself to treat flow limitations I see yours raises up from the minimum value to 9.5 anyway so 9 is probably fine.


But looking at your flow graph with the pressure you flow looks like you start to take a breath in and then stop so the asv gives its boost of pressure to continue your breath that is why to see the first blip above the 0 line your breath, then the second larger rise above the 0 line as the ASV provides pressure support to aid your breath.


I don’t know if that’s good or bad just explaining what’s happening.

[Michaely6]

I think I would have started with a lower mininimum epap of may be 6 rather than your value of 9, were the flow limitations bad ? In auto asv mode the machine will raise epap itself to treat flow limitations I see yours raises up from the minimum value to 9.5 anyway so 9 is probably fine.


But looking at your flow graph with the pressure you flow looks like you start to take a breath in and then stop so the asv gives its boost of pressure to continue your breath that is why to see the first blip above the 0 line your breath, then the second larger rise above the 0 line as the ASV provides pressure support to aid your breath.


I don’t know if that’s good or bad just explaining what’s happening.

I wish i was advanced at reading the flow chart the way that you and sleeprider are. Can you explain in a little more detail how you are able to come to this conclusion by looking at the mask pressure and flow graph? I need to get better with reviewing sleepyhead data in order to maximize sleep quality. How did you become good at reading the flow rate graph? Any tutorial? I read the manual by robysue but didnt feel like it explained how to actually interpret the graph in great detail.

Sleeprider would you like to chime in on this?

[Sleeprider]

I think I would have started with a lower mininimum epap of may be 6 rather than your value of 9, were the flow limitations bad ? In auto asv mode the machine will raise epap itself to treat flow limitations I see yours raises up from the minimum value to 9.5 anyway so 9 is probably fine.


But looking at your flow graph with the pressure you flow looks like you start to take a breath in and then stop so the asv gives its boost of pressure to continue your breath that is why to see the first blip above the 0 line your breath, then the second larger rise above the 0 line as the ASV provides pressure support to aid your breath.


I don’t know if that’s good or bad just explaining what’s happening.

I wish i was advanced at reading the flow chart the way that you and sleeprider are. Can you explain in a little more detail how you are able to come to this conclusion by looking at the mask pressure and flow graph? I need to get better with reviewing sleepyhead data in order to maximize sleep quality. How did you become good at reading the flow rate graph? Any tutorial? I read the manual by robysue but didnt feel like it explained how to actually interpret the graph in great detail.

Sleeprider would you like to chime in on this?

just based on the fact there are zero events, we can assume you are over-titrated and could tolerate lower pressure.  If it was my choice, I would dial you back to initial titration protocol defauits of Auto ASV at EPAP min 5.0, EPAP max 15, PSMin 3.0, PSMax 15.0.  Do you know why these settings are selected? Also, are you certain events are turned on in Sleepyhead? (lower left corner of graphs)

[Michaely6]

I think I would have started with a lower mininimum epap of may be 6 rather than your value of 9, were the flow limitations bad ? In auto asv mode the machine will raise epap itself to treat flow limitations I see yours raises up from the minimum value to 9.5 anyway so 9 is probably fine.


But looking at your flow graph with the pressure you flow looks like you start to take a breath in and then stop so the asv gives its boost of pressure to continue your breath that is why to see the first blip above the 0 line your breath, then the second larger rise above the 0 line as the ASV provides pressure support to aid your breath.


I don’t know if that’s good or bad just explaining what’s happening.

I wish i was advanced at reading the flow chart the way that you and sleeprider are. Can you explain in a little more detail how you are able to come to this conclusion by looking at the mask pressure and flow graph? I need to get better with reviewing sleepyhead data in order to maximize sleep quality. How did you become good at reading the flow rate graph? Any tutorial? I read the manual by robysue but didnt feel like it explained how to actually interpret the graph in great detail.

Sleeprider would you like to chime in on this?

just based on the fact there are zero events, we can assume you are over-titrated and could tolerate lower pressure.  If it was my choice, I would dial you back to initial titration protocol defauits of Auto ASV at EPAP min 5.0, EPAP max 15, PSMin 3.0, PSMax 15.0.  Do you know why these settings are selected?  Also, are you certain events are turned on in Sleepyhead? (lower left corner of graphs)

Here is from last night and yes I'm sure events are turned on. I lowered EPAP to 8.0 and pressure support to 2MIN-7MAX. I changed it to these settings prior to reading your post. in noticed that my tidal volume dropped quite a bit after reducing pressure support and EPAP min. I'm 6'1 200 lbs btw if that info is important for tidal volume

[Michaely6]

My flow limitation screen looks very active as well and I do not feel rested at all. These are a zoom in to my breathes. The last attachment looks pretty smooth for a few minutes. You can see my breaths shrinking a little in one of the screenshots as well.

[Sleeprider]

Respiration looks much better here, and I:E has normalized, but I think you should target tidal volume in the mid to upper 400s. You previously had 580 which is slightly high, but at the cost of disrupted looking breathing. There may still be room to lower EPAP min, but I think you will end up with PS min at 4-5 to reach ventilation goals. A PS min of 2.0 is too low, so increase in increments of 1.0 cm. Try EPAP min at 6.0 ans PS Min at 4.0.

[Michaely6]

Respiration looks much better here, and I:E has normalized, but I think you should target tidal volume in the mid to upper 400s.  You previously had 580 which is slightly high, but at the cost of disrupted looking breathing. There may still be room to lower EPAP min, but I think you will end up with PS min at 4-5 to reach ventilation goals.  A PS min of 2.0 is too low, so increase in increments of 1.0 cm.  Try EPAP min at 6.0 ans PS Min at 4.0.

Thanks! I will try that tonight. What should u set the PSmax to?

[Sleeprider]

PS max should be 12.0. You barely used more than 6.0 last night which tells us you had no CA to mitigate.

[Michaely6]

Ok thanks. Sorry i forgot to ask this. Should i be concerned about the excessive amount of flow limitations?