Pressure Blasts

[Danno75]

This is my first post. I'm a 75 yr old with a new Resmed aircurve 10 ASV.  Had it about 30 days. Use it every night but I've really only had maybe 3 nights of decent sleep.

After 1-2 hours the pressure ramps up and I can never catch up.  I've tried blowing back but maybe not enough?  The excess air slips out the sides of my Resmed F30 mask like flatulations.  I've messed around with the settings but nothing seems to change the outcome.  

I'll attempt to upload my OSCAR report. Not sure if I need to screenshot them or print them?

Shortly after 1 am I seemed to have an AHI that set off the machine. I couldn't get it to come down so Moved to another bedroom and fired it up again. Seemed to be fine from about 2:15 on. Took me a while to get back to sleep obviously. 



       

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Settings:    

[quiescence at last]

can you post the SleepHQ dashboard link so we can looks closely at your beathing? Thanks.

QAL

[Danno75]

There's a link for sharing links but it goes nowhere? I'm gonna need some tech assistance?

[Sleeprider]

Don't need Sleep HQ and won't look at it anyway. The Oscar chart tells us what we need to know.  You say during the first hour the pressure ramps up and you can't catch up.  The pressure is increasing because of those UA events that actually represent obstructive apnea.  I suspect that is perhaps positional.  It may be more tolerable to deal with the obstructive apnea than the pressure increases that the machine is programmed to deliver in this case.   I'm going to suggest limiting changes in EPAP to minimum 5.0 and maximum 8.0.  If you are chin-tucking from sleep position or using too many pillows, the IPAP will rise and attempt to equal out your vent rate.  You are only using a PS max of 10.0, but your  might be able to cut back on PS to using PS min 3.0 and PS max 8.0.  I would rather see more PS max than 8.0 if your real problem is complex or central apnea, but some people are okay with lower PS if it stimulates breathing. Your minute vent does in fact rise, in spite of the double cluster of apnea at 01:20.  So part of the solution is to minimize the rise in EPAP and start PS at a lower threshold of 3.0 to 8.0 instead of 5.0 to 10.0.  I really think your high minimum PS is causing more central apnea and higher pressure than you might experience with a PS min of 3.0.

Recommended settings: EPAP min 5.0, EPAP max 8.0, PS min 3.0, PS max 8.0.

[Danno75]

Thanks for getting back to my post so quickly, both of you.

Usually my unmanageable air pressure increases happen about 2-4 hours into my sleep.  Looking forward to trying the new settings. 

I do have a sleep study coming up on the 2nd of March.  Seems like this practice wants to help. I had 3 other studies by a different practice in the last year but their equipment failed the last 2 times. 
 

Dan

[Danno75]

Well, you're either very knowledgeable or lucky cuz I had the best sleep last night in a month.  No air pressure blasts, no reason to wake up till my bladder insisted.  Thanks so much. Of course I know I need to monitor my numbers but don't fear, I'll be back if needed.

I've attached last night's data reports so if I need to make any changes let me know. 


           

[Sleeprider]

This looks much better. I'm going with knowledgeable in this case because my batting average with coaching members seems better than luck would deliver. When I see someone experiencing excessive events with ASV, I will nearly always ask for a reduced minimum PS., A PS min of 5.0 is pretty high for most and can cause problems. Your current chart looks much more comfortable and the new minimum pressure support gives you more room for spontaneous breathing. I would let this settle in as it seems to be pretty effective.

If I was to suggest something to try later on, it would be an increase in the PS max to 9.0. Keeping or rejecting that change should be based on comfort. Keep going as-is for now.

[Nightynite]

Well, you're either very knowledgeable or lucky cuz I had the best sleep last night in a month.  

Sleeprider is the Josey Wales of cpap. You’re in good hands now unless you start whistling Dixie.

[quiescence at last]

outstanding that you got best sleep.