Returning To Therapy with Startling Results

[OldMarineOceanside]

Well night #1 with new ASV machine was a heartbreaker for me. NO idea what I did wrong, or if it is just I am unable to do ASV? Just THINKING that does things to me I can't even admit to.  If that were the case I honestly could never face my wife again to tell her I made a mistake of that magnitude... But I just can't figure out WHY it failed me so badly? I set it up manually at:

Mode ASVauto
Min EPAP: 4.0
Max EPAP: 15.0
Min PS 2.0
Max PS 15.0. 
Ramp: off.

I also changed the setting to this for Manual use.

Went to bed with it set to "Auto" and for the first 4 or 5 minutes or so it was SO peaceful. But then it begin to maybe "test" me? It would suddenly push me with a very powerful, and L O N G  breath of air. SO strong I was barely able to push back against it to allow me to exhale. It did this 4 or 5 times I think? Each time a bit stronger, longer. By the last one I was truly scared of this machine but then as suddenly as it began, it went back to normal. I began to honestly panic after 3 or 4 rounds of this and began getting up, shutting down to get ME calmed back down. Without making excuses for my panic attacks lets just say I have very bad PTSD from Combat (USMC) and it felt like water boarding but with air. 

  Each time I got up I just turned the pressures down on  everything until I was down to almost nothing. In the end I just desperately wanted some sleep, it was after 1:45 AM and I was exhausted, depressed, terrified I had made a horrible mistake borrowing money for this and how was I going to face my wife in a few hours etc, etc. So this first night is a disaster. ALL I want to know is, WHY does an ASV Machine DO this? I thought at first it was just sort of testing me, gathering intel as it were on how I breath, test itself on pressures? I don't know. But this morning I have earaches in BOTH ears from all the times it literally felt like it was going to blow that full face mask right off my face. 

I was trying to find the old settings of the ST that seemed to work for me in the dark but never did. I was trying so hard not to wake my wife.  Odd thing was, initially this machine asked me for setting for EVERYTHING. Now I never see any setting for the IPAP or anything except the Min EPAP:  Max EPAP:Min PS Max PS  I think? Anyway, now all my settings are just cranked down to almost nothing and I have no idea how to make it now try to blow my head off when it senses me not breathing? I fully understand it NEEDS to make me breath, but my God, it just flat SLAMS me so hard and more full of air than my damaged lungs can endure. I hate to be a baby but it really is just too MUCH air for me. Not about "comfort" but about being able to even tolerate that amount of air & pressure. 

Anyone know what I did wrong? I pray I did some little thing wrong, some "little" thing and that this is NOT a faulty machine or faulty decision I made to buy this. I swear we will go under if I bought the wrong machine AGAIN. Anyone have any ideas? Sorry for the horror story of this graph, but I just HAD to crank everything way down to get the machine to not eat me alive :-(

Not a pretty graph and you can see how many times I had to shut down to lower pressures in every category tll it would behave.
 Night 1 with ASV

[OldMarineOceanside]

I just got up, took a 2 1/2 hour nap after increasing settings/pressure UP a bit. Did a lot better. I noticed something else too. I am unsure if thi has anything to do with it but with my  AirFit™ F20 Full Face mask, when I roll over on either side (which is how I sleep), if my air vent on the mask,if it blocks it in ANY way, it seems to literally act as a trigger because it immediately begins to zap me with a ton of air. Just weird. I back my face/mask away from my forearm of hand, whatever is up against it and the air immediately backs off again. So it must have something to do with this?

Really frustrated since I guess I just mistakenly assumed I would put this on my face and my entire world was going to be just perfect again. Well my sleeping world anyway.          With a little more pressure?


and:  https://imgur.com/a/tWObv

[OldMarineOceanside]

Since my sleep on night 2 was in 3 parts (went to sleep, up for bathroom break and up again with sick old cat) I was unsure what or how I am supposed to post graphs? So hopefully all 3 stats show up at: 
 https://imgur.com/a/u9yHy
https://imgur.com/a/hTjLE
https://imgur.com/a/LmRV2

Please tell me if I am doing this wrong? At least it looks like everything is now OK at under 5 on my AHI? I raised the pressures just a little and while it definitely made it clear to me it would NOT tolerate my not breathing, it never went SO far as to make me feel like I was literally choking on to much air this time. Have to admit, night 1 really got scary because it was not only so much pressure, but how L O N G the air came. Not a normal breath but seemed to never, EVER come to an end. When it refuses to let me exhale, it just became overwhelming if that makes any sense?

[Sleeprider]

Your current setup is EPAP min 4, IPAP max 14 with PS 2 to 7. The results are numerically good, and we want you to get comfortable. The low EPAP is doing a surprisingly good job of preventing obstructive events, and the machine is otherwise pretty busy working on the hypopnea and centrals. The settings are on the low side for most ASV users. You pretty consistently end up with an average EPAP of 5.4 and a maximum just over 6. That is not very high, and even your maximum IPAP pressures are under 14, so that part looks good. Keep in mind if you feel like the machine is fighting with you, just blow back and it should settle.

We can see by the red pressure line that you reach the maximum pressure support fairly often. Your tidal volume is an impressive 720 and your respiration rate is a relatively slow normal 9 breaths per minute. Overall, I think you will begin to feel some nice benefits from this therapy compared to where you were. There is plenty of time to get comfortable, and try some things if needed. The only thing I would consider is a bump in the PS max to 8.0 and IPAP max to 15. Don't rush into an changes.

When you were using the BiPAP ST you were using an EPAP pressure of 4 and PS of 8 for 12/4 pressure. Your results were very high hypopnea events. This looks a lot better.

[OldMarineOceanside]

THANK you Sleeprider.

I was going to raise the IPAP back up and even when I go into Clinicians menu, I no longer see any options for me to change IPAP? Maybe I need to tell it to reset/ERASE ALL data to get to that setting? Now that it quit trying to blow my head off, I am open to easing back up:-) A little at a time since I am still very freaked out at the severity and power of night #1. And it would NOT back off when I blew back and I blew as hard as I was able though I do have diminished lung capacity though not by any means dead. Well not yet.

I just have not found the way to access the setting for IPAP since I first lowered it so almost hit the Erase all data to see it that is what I had to do?

[OldMarineOceanside]

PS-
I did bump in the PS max to 8.0 no problem but just can't find HOW to bump IPAP max to 15? If anyone knows the trick, please let me know:-)