Obst & Central Apnea - on ASV. why do most say- resmed vs dreamstation auto sv?

[My3rd3y3]

Ended up finding my CMS-50D pulse oximeter and recorded my sleep last night. Now just to find the cord that connects to it....... I have the app for it downloaded and as I remember, sleepyhead has a nice import feature for it and really does a neat job meshing it up with reports. Slept from like 11pm-3:45am

[Justbreath]

Are you still using the resmed 10 asv? I have the same machine and my settings can go as high as max Epap 15 max ps 20 . I saw you posted that your max was only 25 for your IPAP. Just curious if it was the same machine since you’re constantly at 25.

[My3rd3y3]

Are you still using the resmed 10 asv? I have the same machine and my settings can go as high as max Epap 15 max ps 20 . I saw you posted that your max was only 25 for your IPAP. Just curious if it was the same machine since you’re constantly at 25.

Yes,   I just received a new Resmed Aircurve 10 ASV last week.   This is my second one,  I started with my old Resmed Aircurve 10 ASV about 3-4 years ago.   I have diff insurance and my Dr said I could get a new one so why not lol.  

My Ipap is showing 30 I thought in Sleepyhead

My Epap stays in the max ranges  on asvAuto it will only let me turn the Epap max to 15

so with the settings of min epap 13 / max 15     tthe max PS it will let me turn it too is 12.0

[Sleeprider]

We have been talking about trying ASV mode and using higher EPAP pressures. I think it is worth a try. This suggestion may have been missed, but as long as we're dealing with obstruction, that's the protocol. As I said, I'd like to understand the obstruction better, but going to ASV mode allows higher pressure.

[My3rd3y3]

Ok let me know what I should set her at ..... Emailed my sleep dr asking about pulmonary things, and also the asv tritration sleep study and a few others.

[My3rd3y3]

How can it got higher then it is lol i mean wow my heads going to be blown off lol. why does reg asv allow for higher settings?

[My3rd3y3]

Last night I upped my Min Epap to - 13.6
min ps to 6.0 with a max at 11.4

screens of that to follow

Someone in a diff forum had this input, not sure bout it lol
This is likely off the wall but may be worth a try...

Set Min EPAP 9 and PS 2 - 8. This will limit Max IPAP to 17. The reason for this is to see what happens when the pressure cannot go up too high.

On Feb 2 you had a couple of periods that looked better than the rest of the night. (20h10 - 20h50, 22h40 - 23h20, 24h10 - 1h00, 3h30 - 4h00). In these periods the pressure is between 9 and 11 cmH2O for the first 2 events and below 9 for event 3 and 4.

Just a thought.

[My3rd3y3]

Well I thought I would try out the large pillow vs the medium last night and this is what happened,   i think a ton of leakage overnight

screen 1


screen 2


screen 3

[My3rd3y3]

ugg, Seems my CMS-50D won’t work / transfer data without using the orig cable it came with. I tried using a diff mini usb to usb and my comp did not see the pulse ox. Going to have to dig deeper or buy another cable.

I guess I will have to find both an ENT dr and a pulmonologist this week. I also requested another sleep study from my sleep doc - however I doubt that they will be able to properly tritrate me with the pressures I seem to need - maybe.

Thanks again those that have been helping along the way!

Let me know what I should set my asv to on the reg asv settings vs auto. Wonder why the pressures can go higher if not on ASVauto? Is there a diff brand besides philips or Resmed that is able to go higher? Wonder if Resmed or anyone could mod mine to go higher and damn it on me for being an odd ball that needs so much pressure. Getting so frustrated

[Sleeprider]

Last night I upped my Min Epap to - 13.6
min ps to 6.0 with a max at 11.4

screens of that to follow

Someone in a diff forum had this input,  not sure bout it lol
This is likely off the wall but may be worth a try...

Set Min EPAP 9 and PS 2 - 8. This will limit Max IPAP to 17. The reason for this is to see what happens when the pressure cannot go up too high.

On Feb 2 you had a couple of periods that looked better than the rest of the night. (20h10 - 20h50, 22h40 - 23h20, 24h10 - 1h00, 3h30 - 4h00). In these periods the pressure is between 9 and 11 cmH2O for the first 2 events and below 9 for event 3 and 4.

Just a thought.

I think keeping the pressure support in a higher range is important to ensure a breath is delivered when needed. The idea of enforcing a lower EPAP is perhaps valid.  My inclination is to get out of ASVauto mode, and go to ASV mode.  Let's start at EPAP 13 with PS 3-15 or whatever maximum is allowed, and try that.   ASVauto is increasing your pressures to the maximum regardless of what the minimum setting is. ASV will simply give you a fixed EPAP pressure but allow the machine to respond normally to apnea and hypopnea. From your charts, it appears you have fewer events at lower EPAP pressures, but we can't tell if the higher pressures are causing events, or events are causing higher pressure.  Most likely the latter, but let's take the auto algorithm out of the equation. I have no problem with trying the lower minimum PS.  So in summary:
ASV mode
PS min 2.0
PS max 15.0 (or maximum available).