ResMed AirCurve 10 ASV settings for first night of treatment: Do you agree?

[DevinJones]

Hi Dani, I've used the DreamWear hybrid, which is similar to your F30i, but found that I had a better seal with the AirTouch F20.

I look forward to seeing your progress here with your ASV and some good data you share later. 

I hope to have success with my ASV too. 

[DevinJones]

Attached are my OSCAR screenshots for last night, while I was using my ResMed AirCurve 10 ASV device.

With my current lower pressure settings (ASVAuto, Min EPAP 4.00, Max EPAP 8.00, PS Min 2.00, PS Max 8.00) and my new ResMed AirTouch F20 full mask:

• I can now sleep for six to eight hours without a lot of disturbing high-pressure surges.

• I had just three flagged hypopneas and no other flagged events last night.

• I had an AHI score of 0.50, which is down from my AHI score of 19.0.

• Once I am asleep, my breathing feels natural and rhythmic. 

• I sometimes wonder if my ASV device is even on when I don't feel unnatural pressure surges and out-of-sync respiration rates.

• Because of my new full mask, I can now sleep on my sides without any major leaks.

However, I still hope to resolve my ongoing problem with nocturia, which can cause me to wake up several times at night to urinate, disturbs my sleep, and increases the likelihood of briefly experiencing some flagged events while falling asleep again.

[Llort]

What a great update, Devin!  It sounds like you've got your pressures dialed in for comfort as well as low AHI.  That's great that it's still effective at those lower pressures.

[DevinJones]

Thanks a lot, Dani! I'm still dialing in the pressures and will see if I can very gradually increase the maximum pressure support just a little more without experiencing frequent pressure surges. Gonna make this work! 

[JCW888]

HI Devin, how is your progress of dialing up the pressure setting ?
I remember you set EPAP min 4 , Max 5 and PS min 0 , Max 5 and doing ok.
How about now and how is the dialing up scale, do you still adpat ok ? Or just stick to original above.

[stanleyjack]

Inspired by this thread I just put in an order for an AirTouch F20.

I am currently using the Dreamwear with silicon pillows which I really like, but I am getting the same issue now where I wake up and the pressure is overpowering the nasal cushions and I cannot contain the leaks.

[JCW888]

Hi Stanley,
Hope to see your experiences with F20 soon. I am not used to FFM, so I need to stick with nasal or pillow masks. I think ASV is not particularly friendly with nasal or pillow design due to PS pressure surge maybe too strong only through nostrils.

[DevinJones]

Hi JCW888, yes, I decreased EPAP to 4.0/6.0 and PS to 0.0/5.0 to give myself some more time to adapt to my ASV device's normal but sudden pressure changes during the night.

I've been very gradually increasing my pressure settings to see if I can get increased therapy effectiveness without a lot of runaway high-pressure surges. My settings are now EPAP at 4.0/6.6 and PS at 1.6/6.6.

You can see in the attached OSCAR screenshots that I now get a couple of sleep-wake-junk events, which don't even count, at the very beginning of a session while I'm wide awake and getting ready for sleep. I then get, maybe, one or two legitimate events the rest of the entire night. 

I'm pleased that I can now sleep without the runaway high-pressure surges, get AHI scores under 1.0, and eliminate all my previous oxygen desaturations. 

One practice that helps me is starting an ASV session only when I'm tired enough to fall asleep pretty soon and I've relaxed enough to get my respiration rate to a lower level.

This practice is important due to the AirCurve 10 ASV algorithm, which learns your recent minute ventilation and then increases your pressure support when your minute ventilation drops below the dynamic target minute ventilation.

You're more likely to struggle with ASV high-pressure surges, get a cluster of many sleep-wake-junk events, get frustrated, and stay awake at the beginning of a session if you try to use your ASV device when you're not relaxed and ready to fall asleep.