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I am using an AirCurve 10 ASV with a ResMed P10 Nasal Pillow Mask over the past 6 months or so. I have had success compared to without any therapy.
However, my body feels tense in the morning as if I have been under pressure. I feel "normal" after about 30 minutes of being awake and moving around and I don't experience it at all again until the next night when I wake up in the morning or when I wake in the middle of the night.
I am also consistently experiencing aerophagia.
Something is telling me that my flow limits are too high so I'm looking for some guidance on how to reduce.
My Settings are:
Mode: ASV Auto Min EPAP: 5 Max EPAP: 7
Min IPAP: 8 Max IPAP: 15
PS Min: 3 PS Max: 8
Attached are a few nights for reference. The 9/7 I slept good and had plenty of energy the next day. The 9/8 it was difficult to fall asleep and even more difficult to stay asleep. I took the mask off in the middle of the night and today I am tired. I originally posted these here about leaky mask help
Any help is appreciated so I can play around with settings to try to get good rest while also not feeling tense and experiencing aerophagia.
09-29-2024, 02:05 PM (This post was last modified: 09-29-2024, 02:09 PM by SarcasticDave94. Edited 1 time in total.
Edit Reason: Edit
)
RE: How do I lower flow limits on my ASV?
The flow limits can't really be addressed on the ASV. It's seemingly a two part issue. 1) Flow limits act like artifacts as in a byproduct of how the ASV works to treat the Central Apnea. 2) flow limits will be on the opposite end of the treatment teeter-totter therapy requirement than are the CA. If you try to address flow limits, CA will increase because the settings to act on FL are in opposition to CA treatment, and vice versa.
On the aerophagia, I would try a slight modification to EPAP, add 1 to both Min and Max, giving a 6-8 range. Why I'd add one? This may reduce that admitted slight Hypopnea, but may edit the PS curve requirement slightly, by pushing therapy just a little.
Also, continue to try to minimize the leaks. The median leak isn't bad, but those occasional blown seal areas are a hindrance.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(09-29-2024, 02:05 PM)SarcasticDave94 Wrote: On the aerophagia, I would try a slight modification to EPAP, add 1 to both Min and Max, giving a 6-8 range. Why I'd add one? This may reduce that admitted slight Hypopnea, but may edit the PS curve requirement slightly, by pushing therapy just a little.
Also, continue to try to minimize the leaks. The median leak isn't bad, but those occasional blown seal areas are a hindrance.
Regarding EPAP modification: Will it be pretty obvious to me if this helped or made it worse after a few days?
Regarding minizing leaks: I agree. It doesn't help that little noises will wake me (and always has even when I was a child). So just a little hiss from leakage wakes me up, has me move around a little to try to fix it, fall back asleep only to wake again a moment later. This is also a small reason why I felt compelled to open this thread because I figured the leaks were taking place because the pressure was more than I can take.
Are there any guides, tutorials, hints and tips about mask fitting, reducing leaks, etc? I've noticed that with the Resmed P10 pilllows, which I find very comfortable, that it is always my right nostril that leaks. I have two P10's and I've used both and consistently it is my right nostril. I suspect it may be slightly larger or it is simply how I tilt my head or something on my sleeping position that effects the right side versus the left.
The EPAP edit result should be evident fairly quick. What I think it should do for you is get up into PS and back down a bit more quickly. In theory it may help you. Try it and if it's not suitable, just revert back to the current settings.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
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Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Your 95% flow limitation is 0.00, and spikes of flow limitation are associated with higher pressure support. This is normal, and there is no therapeutic reason to pursue it further. With the Vauto, we raise PS, but with ASV, flow limits are usually the result of passive response to higher IPAP.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
