Mask Fit on AirCurve 10 ASV

[RickEiben]

Does the mask fit "test program" go to the maximum factory setting of 25cm or does it go by the parameters that we set? I'm trying to limit the max pressure to 18, but it feels like 25.

settings are;  Min EPAP 8
                   Max EPAP 12
                   Min PS 4
                   Max PS 10

Thanks,
Rick Eiben

[Crimson Nape]

Having a Max EPAP of 12 and Max PS of 10, in your case it will be going to 22 (10+12). The Mask Fit option always uses the maximum set pressure. That way, you are adjusting the tension for no leaks in its complete set pressure range. That's one reason to limit the maximum pressure closer to actual needed values.

- Red

[RickEiben]

That's good to know. I also noticed the times were off on the OSCAR charts. I went into settings, noticed the time on the machine was 3 hours ahead of my time. The only way I could get the time to stay was to move the day ahead by 1. Seems odd.

Another question is which charts do you need to see in a snapshot? I think there is a total of 14. I haven't tried to send any in yet.

Last question is about pressure settings on the machine. I was on a ST bi-pap for 6 months and a Philips auto CPAP which I own for 2 weeks and manually charted all  the results, especially The AHI numbers. I've never had pressure over 18 to 19 for best results. The prescribed settings were; 4, 15, 4, 20 for the past week since starting on ASV auto. (min EPAP, max EPAP, min PS, max PS). The total AHI were; 1.6, 2.9, 6.2, 2, 2.7, 7.1, 7.2. Mask had to be too tight for comfort. I made a change last night after much thought to 7, 10, 3, and 11. The mask could be loosened to a more comfortable fit, and the initial AHI of 1.9 was encouraging. I will leave it here for 
at least a week. All these numbers were from 7 - 8 hours on the machine... so they are washed out a bit. No obstructive apneas, just breathing problems...Any comments?

Thanks, Rick Eiben

[Rich66]

I"m able to reset day and time with no issue -- you might try again.
As for charts, I use : Event Flags, Flow Rate, Pressure, and Leak Rate -- in that order. If other charts are needed, they can requested from you. Also, minimize the calendar, hide the pie chart, hide the right side of links. You can see other peoples links, it will help guide you. And there is plenty of readable information on this site as to how post -- and much more.
Good luck with your journey. Keep in mind that what is important is "how do you feel". Having the lowest score, such as 0.00 is great, but not if you still feel miserable. And yes, I have experienced that. From there, it takes a lot of trial and error and pressure adjustments.

[RickEiben]

Now that I’ve got the time set, I’ll try changing the date back to today and see what happens. Thanks!

[RickEiben]

Well, that didn't work. I can change one or the other, but not both. The time is more important. I'll call ResMed tech support tomorrow.

I noticed your setting are quite different than mine, which I've only changed recently from the standard factory settings. I'm curious what settings you started with, and how you ended up there. I put in the same numbers in  and was pleasantly surprised. It helped keep the RR a steady 11-12 BPM. If I stop breathing, mine drops to 6-7 but seems to want to come back up faster with your settings. I'll wait to hear back from you first before I try it. Most of my issues are mixed apneas and hypopneas - no obstructive ones.

[Rich66]

I started with EPAP Min: 8.0 -- EPAP Max: 15 --- PS Min: 2 -- PS Max: 12.

I've spent a lot of time with burp issues, mouth leaks, mask leaks, feeling terrible.  I found it helps to NOT think of it as "breathing".  Consider each aspect separately.  I've laid in bed, awake, and deciding if my exhale needs adjustment.  Then I thought about if my inhale needs adjustment.  Am I getting too much air, or am I struggling to inhale enough oxygen.  And I made changes as needed.  Slow and with purpose -- one change at a time to see what works and what doesn't.  I've paid attention to the graphs, I've changed masks until I found one that fits properly.  The doctor has not suggested any pressure changes, and the DME has not contacted me to make any changes.  Neither have offered any help.  And the original DME I had did a poor job of getting me a mask that fits properly.  I went to outside sources and figured out which one I prefer to use.
At one point I figured the pressure increases are preventing me from getting a good night sleep, so I started limiting those changes.  I've always been a light sleeper, seldom ever having dreams.  I have many more dreams now with the BI-PAP system.  Keep in mind that I have lung issues, so your therapy will have to be set for your needs.  
Also, I found paying attention to the Pressure Graph was important -- and eliminating leaks has been important to me because it helps me trust the graph settings.

[RickEiben]

I was doing the same thing just now. The ST machine I was on had way to many adjustments - this is much better in so many ways. I’ve ended up with 4/7 and 5/10 for tonight. I need a little more PS and slower exhale. Thank you so much for responding.

[RickEiben]

I just had the worst night ever...the settings were all wrong, with an AHI of over 21 that left me extremely tired. The settings were 5/15 and 3/13. You should have seen the charts! Almost a full hour in apneas. Before this, it was only 3 to 5 minutes of apneas with the AHI from 1.2 to 6.7 during the first 15 nights after getting this new machine. My biggest problem is an irregular breathing pattern - slowing down to 6 BPM and then stopping. The prescribed settings from the doc in the box were 4/15 and 4/20.

So, I took some time awake, making changes mostly to the EPAP min and PS. A PS of 1.8 seemed to even things out at 13-14 BPM. Too much pressure support = uncomfortable mask fit &  a continuous string of apneas. I ended up with 9/12 and 1.8/12. Depending on the results, the PS max may be lowered further. The biggest challenge was the PS min setting. I went all the way up from 0 to 2, up and down several times until settling on the 1.8 . 

Thanks for your insight in your journey - it helped me focus on several things. If this doesn't help, it will be time to ask for help on the main board with charts.