Sinus Swelling Preventing ASV Use

[NM Kaz]

I was recently diagnosed with Central Sleep Apnea (30/hour). I have been using a Resmed Airsense 10 ASV for about 3 weeks and have yet to actually sleep while wearing my mask. After lowering the pressure and increasing humidity, I seem to have arrived at settings that might work. However, I now experience severe swelling of my sinuses that prevent me from breathing through my nose. This occurs after my 45 minute ramp cycle. I end up taking off my mask after 60 - 90 minutes once my nose has effectively shut down.
Today, the respiratory tech suggested lowering the tube temperature or turning off the heater to see if breathing cooler air prevents the swelling problem. Currently the temp is set to 81 degrees. Has anyone had a similar experience with sinus swelling? If so, what did you do to fix it? 
I am extremely frustrated with my experience thus far and would really appreciate any advice to consider. 
Thanks

[Sleeprider]

Getting humidity right can be a challenge, and too much or too little can lead to congestion. I'm guessing in your case it might be too little humidity if you are using the automatic mode. Climate Control Auto is the default mode. Switch to manual and try a setting of 4. The settings are 1-8. Your tube temp looks fine.

Yourr machine will work with #Sleepyhead software, and that can help you optimize therapy. Default settings are ASV Auto mode, EPAP 4.0-15.0, PS 3.0-15.0. I'm curious what you are using now. We have a lot of members that use this machine, and can help you get adjusted.

[SarcasticDave94]

Can I suggest trying no ramp. I only tried it the first night I owned my ASV, and I thought I needed it. But it really messed up my sleep ability. I cannot be certain why or what it was doing to me. But I turned the ramp off once and for ever that second night, and never looked back.

Try without or reduce the time, it may prove to you to be better for you without as well.



PS with the ramp on in any setting, it delays true ASV therapy, you really don't want to delay the ASV in doing what it wants/needs to do...

And a follow-up to Sleeprider's post, certainly do Manual Mode humidity. I like the manual control better, it does mean more settings you dial in, but I found I needed it to remain more a constant than a variable for my comfort. It's your choice though.

[SarcasticDave94]

BTW what are your current settings? Which Mode as well?

[NM Kaz]

Here are my current settings:
Mode: ASV
EPAP: 4.0
Min PS: 2.8
Max PS: 15.0

Ramp: 45 min
Start EPAP: 4.0
Climate: Manual
Tube Temp: 69 
Humidity: 8 (started at 4 and increased to 6 and then 8)

Last night I kept the mask on for almost 2 hours. I had to take it off when my sinuses started to act up again. I used Nasocort spray before bedtime and did slightly better than the night before when my tube temp was 81. 

Appreciate any help you can offer. This shouldn’t have to be so difficult.

[NM Kaz]

Thanks Sarcastic.

I’ll try turning the ramp off and see if that does anything. It seems to me that I am running out of things to try.

[Sleeprider]

NM, any chance you might tolerate a nasal pillows mask? The direct pressure to your nostrils helps, but the big difference is no pressure on your sinuses. The full face mask presses on your face in a way that can cause congestion.

[NM Kaz]

OI haven’t tried the nasal pillow yet. If turning off the ramp doesn’t work, I will give that a whirl.

Thanks

[SarcasticDave94]

I'm not so sure of what to edit pressure-wise, but for myself, I would change the Mode to ASV Auto. This makes EPAP a 2 setting Minimum and Maximum range. The ASV seems to function better this way, offering better therapy results IMO.