[Pressure] Advice Needed: AirCurve 10 ASV Pressure Settings - First-Time User

[bruno.mosconi]

Thank you so much for your detailed guidance on the pressure settings. I really appreciate the time you’ve taken to align them with the Resmed ASV Titration Protocol and to analyze my chart. It’s incredibly helpful to have such specific recommendations.

I’ve already adjusted the settings on my machine exactly as you suggested: EPAP min at 5.0, EPAP max at 7.0, PS min at 3.0, and PS max at 10.0. I’m eager to see how these changes will impact my sleep quality and comfort. I’m also hopeful that the machine will be quieter with these settings.

I’m looking forward to sharing my results with you tomorrow. Your assistance has been invaluable, and I can’t thank you enough for your help.

Best regards,
Bruno Mosconi

[bruno.mosconi]

Hi everyone,


I hope you're all doing well. I wanted to share an update following the adjustments I made to my ASV machine based on your suggestions. I've attached my results from last night for you to see.
There are a couple of points I'd like to bring to your attention:

1. For some reason, I woke up this morning without the mask on. It seems I took it off during the night and didn't remember to put it back on. As a result, I only have about 2 hours of data to share. Unfortunately, I didn't feel rested this morning, which I suspect is due to the lack of continuous therapy throughout the night. However, on the positive side, I didn't experience any headache, and the machine was much quieter. I'm planning to give it another try tonight before considering any further adjustments.
   
   
2. I've noticed something else that might be important. Sometimes, it feels like I'm "fighting" against the machine for control over my breathing. This sensation is a bit unsettling, and I also observed that my snoring seems to have returned.
   

I would greatly appreciate any thoughts or advice you might have on these issues, especially regarding the sensation of fighting against the machine and the return of snoring. Your insights have been incredibly helpful so far, and I'm eager to hear what you think about these new developments.

Thanks again for all your support and guidance.

Best regards,
Bruno Mosconi

[Sleeprider]

Bruno, were you diagnosed with central sleep apnea? It makes a difference. You only had 2.5 hours of therapy, and at no time did you experience a combination of the maximum EPAP plus max PS. From the brief period you were using the machine, we see EPAP drop from 7.0 to under 6.0 suggesting zero obstructive events or resistance. The variation in PS could be controlled by changing the PS range down to PS min 3.0 and PS max 8.0. It does not appear you need more. I had previously recommended PS min 3.0.

Let's try again with a lower PS range:
Mode: ASVauto
EPAP min: 5.0
EPAP max 7.0
PS min 3.0
PS max 8.0

[bruno.mosconi]

Thank you for your response and the suggested settings. I wanted to mention that I was diagnosed with Hypopnea (Hypo) and Obstructive Apnea (OA), with an AHI of 35 in the lab. However, during my last 30 days using the AirSense 10 AutoSet, the majority of my apnea episodes, 50-60%, were classified as Clear Airways (CA).

I’ve adjusted the settings on my ASV machine as you recommended: EPAP min 5.0, EPAP max 7.0, PS min 3.0, and PS max 8.0. I’m looking forward to seeing how these changes will impact my therapy tonight. I’ll be sure to share my results and observations with you tomorrow.

Thanks again for your help and guidance.

Best regards,
Bruno Mosconi

[SarcasticDave94]

Those Central Apnea reported in the AutoSet were very likely treatment emergent Central Apnea. Those alone would not require an ASV. Now, it may be with the ASV you're going to be over treating your actual events, and hindering comfort as well.

With treatment emergent CA, we can guide how to minimize and avoid most.

[bruno.mosconi]

Thank you for your response and for pointing out the possibility of treatment-emergent Central Apnea (CA). I’m not entirely familiar with this term. Could you please explain a bit more about what emergent CA means? Is it different from regular CA?

Since I currently have only the ASV machine, would you recommend using it in CPAP mode instead? The first night I used the ASV mode, I experienced a significant improvement in my sleep quality, despite a very slight headache. I woke up feeling more rested than I have in a long time.

I’m eager to understand more about treatment-emergent CA and how it might affect my therapy choices. Any further information or advice you can provide would be greatly appreciated.

Thank you again for your help and guidance.

Best regards,
Bruno Mosconi

[SarcasticDave94]

Treatment emergent Central Apnea can appear as a result of the increased airflow from CPAP, AutoSet, etc. that enhances your exhalation of CO2, above what your brain considered normal for you. Due to a lower CO2 level, the signal for the next breath isn't present within the breath rhythm timing. Basically lower CO2 in this causes a breath pause, which the CPAP machine interpreted as CA.

The CPAP mode within the ASV may be tried if you choose. It's limited to a single pressure setting, much like older static CPAP machines. You set the single pressure and that's it, no variation.

[bruno.mosconi]

Thank you so much for the detailed explanation about treatment emergent Central Apnea. It really helps to understand how the increased airflow from CPAP and AutoSet machines can affect CO2 levels and breathing patterns. This information is incredibly valuable for someone like me trying to navigate through sleep apnea treatment options.

Regarding the use of my ASV machine, I’m inclined to continue with the ASV mode. It seems to me that using it in CPAP mode, with a static pressure setting, might be a step back from the more advanced capabilities of the AirSense 10 AutoSet. The first night I used the ASV mode, I noticed a significant improvement in my sleep quality, which makes me hesitant to switch to a simpler CPAP mode.

However, I’m open to your advice. If you think using the CPAP mode on the ASV machine is a better option for my situation, or if continuing with ASV mode might be detrimental to my treatment, I would really appreciate your input. I want to ensure that I’m using the most effective treatment for my condition.

Thanks again for your help and guidance.

Best regards,
Bruno Mosconi

[SarcasticDave94]

You're welcome,

I'm thinking probably we should consider setting edit to lower PS if you've not already done so.

I'm not saying this is the correct PS range for you, but the lowest you're able to get with ASV is a 0-5 PS range.

[bruno.mosconi]

Thank you for your continued guidance and suggestions. I’ve just updated my ASV machine with the latest settings you recommended. I’m eager to see how these adjustments will impact my sleep tonight.

I really appreciate your help in fine-tuning these settings. It’s reassuring to have your expertise as I navigate through this process. I’ll be sure to share my experience with the new settings tomorrow.

Thanks again for all your support.

Best regards,
Bruno Mosconi