Transitioning from Dreamstation ASV to Aircurve 10 ASV and having a hard time

[S. Manz]

I am new to this board and boy am I glad to have found it because getting my underworked and overpaid medical team to answer simple questions has been more painful than -self-performing a front tooth root canal without anesthetics.
That being said, I was quite happy with my Dreamstation Auto SV, until the recall came in and I had to go drop some pretty coin on a Aircurve 10 ASV, because we have no idea how long it will be before Philips decides how to solve this issue. Meanwhile I thought investing a few pennies on a resmed ASV might save me from inhaling carcinogenic foam bits and pieces, unless it is already too late for me.
I have had a severe form of CSA for years but only diagnosed last january.

So now I have been trying to get some shut eye with my fancy new machine, using its factory defaults:
Min EPAP 4
Max EPAP 15
Min PS 3
Max PS 15
...which sets the IPAP min at 7 and IPAP Max at 30 in Auto ASV mode....not surprising therefore that sleeping with these settings has been like sticking my head out the car window at 60 MPH, while trying to sleep...It simply ain't happening.

So after reading the entire 2 years worth of discussions here in another similar thread about ASV settings, I'll be setting my pressures down as follows, which should be closer to my Dreamstation settings....and yes, I too thought that the AIRCURVE 10 ASV would learn "MY" breathing pattern and then deliver therapy as needed, based on ":my" pattern...Just like my Dreamstation ASV does, but after reading some of the comments here, I understand that this may not be the case...Am I correct?

Anyway, this will be my settings for tonight, hoping that I will get some shut eye instead of being up all night with this thing blowing hard air into my face:
Min EPAP 4
Max EPAP 7
Min PS 2
Max PS 10
This should set the Min IPAP tp 6 and max out at 17 and (HOPEFULLY) cut me some slack and relief.

Here's a screenshot of how miserable it was last nighthad to shut it down between 4:40 and 5 am.)

[Sleeprider]

Not sure where your screenshot was linked, but the URL was about 125 lines long and failed to produce an image. Check the tutorial on Attaching an Image or File in my signature links. I think you are on the right track to optimize the Resmed ASV by cutting EPAP max, PS min and PS max. Another trick with that machine is the "blow-back technique". If the machine just seems to increase pressure uncontrollably, you can reset it by forcefully exhaling. The machine uses the previous 90 seconds of respiration rate and volume to set a ventilation target, and it can be especially disruptive if your are breathing relatively heavy just as you mask up. It is much faster to respond to changes in spontaneous effort and flow than the Philips, so will feel different until you get used to it, but will eventually result in much a lower event rate. Given your first-time experience cutting PS max should be helpful. If you have any charts using your retired Philips we can take a look at that and compare with what you are getting from the Resmed.

[S. Manz]

Thanks so much for your fast response.
Now I know that simply pasting a screenshot may not be a good idea in these posts and thanks for cleaning it up.
I have attached a screenshot of my last night results that shows quite a few Hypopnea events. I never had hypopnea before, so I think this may just be noise, but not sure.
I will try and figure out how to post the dream mapper files later.

Thanks again fpor the response and I will post the results tomorrow.
FYI, I followed an entire 2 years worth of another similar discussion here that was initiated by a member new to Resmed ASV and learned a whole lot from it.
Its a great board and you folks are doing a great job moderating it.
Thank you.

[SarcasticDave94]

FWIW the items in OSCAR I've monitored most while on my ASV were in this order Events, Flow Rate, Pressure, Leaks. Sometimes others like mask pressure, Respiratory Rate, inhale, exhale, etc. may be called upon.

Here's the ASV titration chart if it'll help.

[attachment=33926]

[S. Manz]

Thank you.
That titration guide pretty much suggest the exact default values that kept me up all night, however it also has info that I did not know about ASV therapy.
Thanks again, and I will be posting my OSCAR charts tomorrow. Let's hope there will be some improvement.

[S. Manz]

I slept better last night and think that I may even dreamed a couple of dreams too, however I am not sure it was because of reduced pressures or that I was just exhausted from not sleeping the night before.
When you get a chance, please review my screenshot attached and let me know how I can improve the settings. Being new to this I am trying to absorb as much as I can .
Many thanks

[SarcasticDave94]

OK well events are under control. Sleep was improved it seems.

Do this next OSCAR shot, no pie chart (I think there's a menu option for this) and collapse calendar via the black triangle in the date text rectangle box. Also maybe reorder the charts, Events locked at the top, Flow Rate, pressure, and leaks. The other charts aren't as useful to myself unless breathing issues occur and we then look at inspiratory and exhalation, etc.


PS if you want a bit of tutorial for OSCAR charts, my link on standard OSCAR chart order in my signature may help.