Newbie with setup questions for AirCurve 10 ASV

[WildSteelhead]

SleepRider, my background and need for ASV is as follows. My sleep study showed I was just barely in the moderate range of sleep apnea with AHI of 16, which were mainly hypopneas and some treatment emergent CAs.  OSAs not really an issue.  Titration tests with CPAP and BIPAP did not treat the CAs, so did a second study and the ASV worked for the CAs. My oxygen level issue was only in the Mild range with 87%. 

Dave, thanks for the check of machine settings. 

So, should I try the PS range of 1-6, or 0-5?

Thanks.

[SarcasticDave94]

If we think lowering IPAP Max of 2 will get you the aerophagia help, there's 3 ways to get there that I can think of.

1. Edit PS to 0-5

2. Edit EPAP Max -2 of current

3. Edit PS to 1-6 and lower EPAP Max by 1

If you show little to zero obstructive events currently, option 2 would be what I'd do. I'd try it in this order #2, try it and if you get OA move EPAP Max up 1 then edit PS to 1-6. I do think PS is about as low as we can go to work on centrals.

Hopefully to clarify, let's go with EPAP Max down 1 or 2. Monitor everything closely. Note if aerophagia goes down and if any events go up. Consider "How you feel", did it change, and how it did change. This all helps decide if that edit works out. If it goes bad with big numbers increase or it feels bad, you could add back the EPAP Max. Update how it goes.

[WildSteelhead]

Dave,

I’ll go with option 2.

Thanks

[Sleeprider]

My recommendation for settings to mitigate aerophagia with the absolute minimum effective pressure is for EPAP min 4, EPAP max 6. PS min 0, PS max 7. I'd like to move PS max up, but you seem to respond to the 7. This will cut back the highest pressure you experience to 13 cm from the 17 max you have now, while not reducing your effective PS. I think the lower EPAP max will still offer efficacy against OA events.

[SarcasticDave94]

Makes sense. There's more range with EPAP as-is to juggle/edit and to minimize negatives. I'll defer in this as I may have inadvertently put in too much "what I'd do for my unique situation" in.

Additional thought: a more narrow EPAP range could go into the PS range now or later, where it may be better allocation given the IPAP cap goals.

[WildSteelhead]

Sleeprider, that makes sense. I’ll try that. Thanks.

[WillSleep]

I have attached below two nights of data.  What I seem to be experiencing consistently is the air being pushed into my stomach.  So, what happens is I get some going down, I feel like it is kind of stuck going down, and I have to force a burp to clear it.  Needless to say, that wakes me up and is preventing me from sleeping.  Seems like I need the pressured air to be able to do its thing, but not to the extent of causing this, which wakes me up and defeats the whole purpose of using this.  This is why I've only gotten about 3 - 3.5 hours the last two nights in using this because I'm just not sleeping well and need to be able to get SOME sleep before going to work.

Thanks.

Hi WildSteelhead,

I still think you might find some relief from Aerophagia by trying a nasal version of the DreamWare mask.  

I cant post links here for you but just checked Amazon to check on prices for the parts to also use parts of your DreamWare FFM mask as a Nasal Dreamware Mask.  

You would need to buy the Nasal version of the Headgear (the straps) .. saw that at $18.21

You would need to buy either the "Respironics Dream Wear" "Gel Cushion" or Gel Pillow" in the same size as your FFM.  So in Medium if your wearing a Medium FFM.   I saw both the Cushion and Pillow in Medium with free shipping for around $20.  
 
So for ~$40 you can have a Nasal version of the Dreamware mask. 

I wear a nasal mask.  Whenever I feel the pressure build that would have ended up in my stomach I just part my lips a little when the pressure is slight and I "just take a natural full relaxed breath through my mouth" if the pressure is large.  This has become such an easy ingrained habit I do not notice when it happens.    

WillSleep

[WildSteelhead]

WillSleep,
Funny you mentioned that. My DME called today and said I can get a new mask for free, so I will get the DreamWare nasal mask and try that.

Thanks

[Sleeprider]

The benefits of nasal therapy can't be overstated in the presence of aerophagia as it is much more difficult to swallow air when breathing nasally than orally. Air entering the stomach is essentially the pressure over-powering the lower esophageal sphincter (LES). The same thing happens in reverse with GERD where stomach contents or gases can enter the esophagus through the LES. Considering the relatively low pressures at which you are affected by this problem, you may be aware of a problem with GERD or reflux, or should consider having an evaluation to look for silent gastric disease or other underlying conditions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576329/
https://pdfs.semanticscholar.org/8229/d2...138ac9.pdf

[WillSleep]

WillSleep,
Funny you mentioned that. My DME called today and said I can get a new mask for free, so I will get the DreamWare nasal mask and try that.

Thanks

Cool!

Honestly, given that you can get the parts to make a DreamWare Nasal Mask from Amazon for only $40 I would use this opportunity to buy a completely different mask .. a lower risk path to making sure you will find a nasal mask that works for you. 

I would buy one of the four popular mask below.

The Bleep mask has some cool factor and possibly is the easiest mask to prevent leaks.  If I have the reading right a Bleep mask year's supply of all the 'dreamports' required could be worth hundreds of dollars.  

The P30i is a new DreamWare competitor.     

It has been said the N20 is the easiest mask for people to get used to.

The P10 is the mask that made Pillow masks popluar.  
 
WillSleep

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