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Mosleepy - Threapy Thread (ResMed ASV)
#1
Mosleepy - Threapy Thread (ResMed ASV)
I was put on cpap bc of memory issues and take home test showed ahi of 12. When using cpap that ahi went up to 15 to 18.  I did titration study at hospital and ahi went down to 2 with asv.  I finally have this resmed air curv and I feel like there wasn't that much thought put into the settings.  It is working and keeping ahi at 2 but pressure is way too high for me.  It blows off my mask a bit and makes me super bloated to point it hurts my stomach.  Also pressure wakes me up a lot.  The epap is set to min 9 and max 13. The ps is set from min 0 to max 16.  I changed it to max 14 but that didn't help.  Any suggestions?  I appreciate so much.  The mode I am on is asv auto btw.  Humidity is 4.
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#2
RE: ASV pressure too high. Please Help
Mosleepy, we have successfully coached many members to lower ASV pressure while maintaining efficacy. It will help if you're able to attach Oscar Daily Detail charts on the forum so we can track what's going on as we work through the process. What we will likely do is pull your EPAP pressure way back in ASVauto mode and use a lower range of PS to relieve the aerophagia. Mask problems require we know something about your mask. Your profile shows a Fisher Evolve, did you mean Fisher & Paykel Evora? Anyway, post up an Oscar chart so we know what we're working from, and I'll share some thoughts on setting that will let us explore lower pressures. Instructions on attaching files and images are linked in my signature links below.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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.
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#3
RE: ASV pressure too high. Please Help
Yes it is the evolve mask.  I actually think the fit is good as I usually have zero leaks registering on the machine.  It just feels like the thing is about to blow offf my face in the middle of the night.  Thanks so much for your response. Nice to know there is help out there.  My doctor could care less.  Will post the Oscar when I get home tonight.
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#4
RE: ASV pressure too high. Please Help
Welcome to being treated just like everyone else by Doctor Donothing and his family.

Agreed with Sleeprider, let's see an OSCAR chart. There's going to be a bit of flexibility moving EPAP and PS around to make this better.
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.
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#5
RE: ASV pressure too high. Please Help
My lazy useless doctor actually told me to stop treatment all together.  This is after I told him my whole reason for doing this is memory issues at the age of 45.  I know sleep apnea can cause that and I really hope it's the culprit.  I have been told even mild sleep apnea can do that.  Doc said the machine was causing what I now know are central apneas all night.  I had lankylefty look at my Oscar charts and he said it looked really bad and I should have checked out.  Thanks again.  Be back with Oscar files.
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#6
RE: ASV pressure too high. Please Help
It's beginning to sound like you have already had a titration test with ASV which resolved the events. Your doctor, instead of doing the obvious thing and writing a prescription for ASV to resolve central apnea, instead said to quit. Was this a sleep specialist or your primary doctor. I would hope your primary doctor would not do such a thing, and if you have documentation of these tests and titration, it's very likely you should get a prescription for ASV. Meanwhile, with an Aircurve 10 Vauto, we know the secret settings to help with CA events. So hope to see you back later.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#7
RE: ASV pressure too high. Please Help
Yes you are right I had the titration.  Then when that doc told me to quit I got a new doc and he wrote the prescription.  I hope I have the right machine.  I may have filled the info in wrong.  I am uploading a pic of it from the app.  It says aircurve 10 asv


Attached Files Thumbnail(s)
   
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#8
RE: ASV pressure too high. Please Help
If you were expecting the ResMed AirCurve 10 ASV, you got it. Up next is the OSCAR chart and 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.
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#9
RE: ASV pressure too high. Please Help
not sure how to upload.  do i just do screenshots?

one more night here...


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#10
RE: ASV pressure too high. Please Help
We finally have it, and this is an ASVauto device. Your settings are EPAP min 9.0, EPAP max unknown but at least 13, probably 15.0, PS min 0.0 and PS max 16.0 This tells us your cliniciian has no clue how to set up an ASV with maximum pressure of 25 cm. Smile

The answer to your question is that you have a significant obstructive component that arises from positional apnea. As you can see, most events are UA and H and they occur in clusters. Pressure and pressure support do not resolve the events, so high pressure is not the answer. You need to consider whether your pillows, sleeping position or the things covered in this wiki are applicable. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

We can drop your PS range, because higher PS does not resolve the type of apnea you are experiencing, and if you can take measures to avoid chin-tucking, inclined sleeping or other mechanisms of cervical misalignment, we can even reduce your EPAP pressure. That's a big "if" because it's going to take some work on your part. I will assume you will read the wiki and do what you can, and suggest these setting revisions:
Mode ASV Auto
EPAPmin: 7.0
EPAPmax 10.0
PS min 3.0
PS max 12.0

While these settings do not fully resolve the issues in these charts, unless you also deal with the positional issue, they do provide higher minimum pressure support which will be more comfortable and lower maximum PS which will let the machine let-up when it is pointless and the apnea is obstructive. We lower your initial EPAPmin, and hope you can compensate with positional therapy or aids like a soft cervical collar, but your machine will still increase pressure, but it's pointless to go a lot higher than 10 cm to fight positional apnea, so we stop there. Hopefully, we give you some relief from aerophagia. This is a first step. If you can control the positional apnea, this whole pressure chart shifts lower in dramatic fashion.

If you have a copy of the ASV titration, it may be helpful to see the test results with personal information redacted.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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