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I am new to the board and to CPAP therapy. I was diagnosed with Apnea at an AHI of 78 and put on a ResMed AirCurve 10 ASV. This is the start of my 4th week with the machine and I'm still struggling with a few things.
Mask leakage was very bad at first but I managed to make my AirFit 20 full face mask work for me pretty well using the Silent Night mask covers, which are just small cotton covers that go over the rubbery part of the mask on your face. I still would like to explore other more comfortable masks that avoid leakage at high pressures. Also note, I like to sleep on my side.
It feels at times like the machine is pushing just too much pressure at me and it wakes me up at night.
After a night when the pressures are very high, I have very load ringing in my ears for most of the day.
Worst of all, I still feel tired in the mornings and not like I've gotten a very restful night sleep.
I am attaching a screenshot of last night's session, which is fairly indicative of most nights so far and would appreciate an analysis and set of recommendations for setting my pressure levels. Note that I am in Auto ASV mode so I only have access to EPAP MIN/MAX and PS MIN/MAX.
Welcome to Apnea Board. Default settings for your ASVauto are EPAP min 5.0, EPAP max 15, PS min 3.0, PS max 15.0. Your therapy settings are very close to this with a limit of 9.0 on pressure support, and to me the results look excellent except for one thing. There are two clusters of apnea that make up nearly all the events. We call this "positional apnea", but it is usually just chin-tucking or misalignment of the cervical airway caused by flexing the neck. It's very common. We have a couple wiki articles that show how positional apnea can affect both CPAP and ASV users, and the articles show Oscar graphs that look a good bit worse than yours. If you can identify why you might experience chin-tucking such as extra pillows or sleeping on an incline, you might be able to adjust your risk easily. Many of our members use a soft cervical collar and completely eliminate the problem. Take a look at these articles.
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.
02-21-2022, 12:16 PM (This post was last modified: 02-21-2022, 12:20 PM by SarcasticDave94.
Edit Reason: mod info
)
RE: Adjusting ASV Pressure
If pressure edits are needed, I would consider backing down the EPAP Max and transfer that over to PS Max. Pressure Support seemed to be shorter, burst like in duration, and having higher PS range was better for me.
The clusters are Positional as mentioned.
And you'll need to get to a place where you can turn off the Ramp. It was a variable that always made therapy less than OK. You're limiting yourself to straight 4 cmH2O for 15 minutes every session start. Here it looks like 3 starts meaning you lost 45 minutes therapy.
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.
You might also check out the Mask Primer and look at some of the CPAP Mask Reviews posted here.
You mentioned that you are looking for a mask that may work better for you being a side sleeper. I am a side sleeper with an ASV machine too. I found the ResMed AirFit F30 works best for me. Others seem to really like the PR Amara View which is very similar to the F30.
Do you have any problems with aerophagia at the higher pressure levels? I have to keep my iPAP Max (EPAP Max + PS Max) below 17.5 to 18 or so, or I'll blow up like a puffer fish and can't sleep. And if I can't sleep, what's the point?
RayBee ~ Self-Treatment - via ApneaBoard experts. ~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door. ~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material. ~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h ~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2. ~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise. ~ Woof, woof.
I am new to the board and to CPAP therapy. I was diagnosed with Apnea at an AHI of 78 and put on a ResMed AirCurve 10 ASV. This is the start of my 4th week with the machine and I'm still struggling with a few things.
Mask leakage was very bad at first but I managed to make my AirFit 20 full face mask work for me pretty well using the Silent Night mask covers, which are just small cotton covers that go over the rubbery part of the mask on your face. I still would like to explore other more comfortable masks that avoid leakage at high pressures. Also note, I like to sleep on my side.
It feels at times like the machine is pushing just too much pressure at me and it wakes me up at night.
After a night when the pressures are very high, I have very load ringing in my ears for most of the day.
Worst of all, I still feel tired in the mornings and not like I've gotten a very restful night sleep.
I am attaching a screenshot of last night's session, which is fairly indicative of most nights so far and would appreciate an analysis and set of recommendations for setting my pressure levels. Note that I am in Auto ASV mode so I only have access to EPAP MIN/MAX and PS MIN/MAX.
02-23-2022, 10:12 AM (This post was last modified: 02-23-2022, 10:13 AM by SarcasticDave94.
Edit Reason: tablet cannot spell/autocorrect is crazy
)
RE: Adjusting ASV Pressure
There's a few things that may help. First, edit your OSCAR. Replace Minute vent and Flow Limit with mask pressure and Leaks. FL will look busy on ASV and acting to diminish these will be in opposition to treating Centrals. Minute vent also isn't normally needed unless specific issues require viewing.
On to the edits: Ramp needs to be turned off. It's a hindrance to therapy. It adds a bit of pressure swing that opposes CA treatment. I would increase PS Max and reduce EPAP Max, each by 3. It'll be the same IPAP as we're swapping settings around. Current IPAP should be fine.
There's no mode on this ASV to directly control IPAP. EPAP plus PS equals IPAP so edits to the EPAP and PS affect IPAP indirectly.
The suggested edits aren't to get you to zero events but to possibly smooth out the pressures a bit and lessen disruptions. Higher PS should disrupt you less than higher EPAP, as PS is short duration and EPAP is more constant. We exhale longer than inhale.
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.
Mlodge, I merged your two threads with the same title and Oscar data into a single thread. You had already received responses and it appears you did not know your original thread was replied to. You can find your previous posts by looking at your userCP in the upper right corner of every forum page.
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.
Thanks Dave. Sorry, I missed your reply earlier but I saw it last night and made the changes you recommended. I think the changes to the EPAP and PS made a big difference as I had a much more comfortable night sleep.
I've attached the OSCAR snapshot from last night. Flow limit looks a bit all over the place but I haven't really been able to wrap my head around that particular stat.
