[Treatment] ASV settings for treatment of complex sleep apnea

[JoeyWallaby]

Following on from thread here http://www.apneaboard.com/forums/Thread-...hing-space

First night on ASV, no special stuff like cervical collar, EERS or anything. Lots of aerophagia, gave up for the night after waking up a few times and pain from aerophagia. Min EPAP 4 Max 15, Min PS 3 Max 15. Changed min epap to 7 after waking up (you can see in chart), didn't help.

[Geer1]

Thanks for sharing the detailed images, it is pretty cool seeing how ASV works to keep your breathing normalized.

This is just a theoretical question, I am sure others more experienced already know the answer but perhaps limiting the max PS initially would help avoid the aerophagia and give the body time to adapt (I see you initially had aerophagia on APAP as well)?

[JoeyWallaby]

Yea I had aerophagia with CPAP that went away after about five days of treatment, I haven't used CPAP for over a week now so I might just have to get used to it again.

I'm mostly wondering right now if I should increase min PS to make flow less limited 

[jaswilliams]

Flow limits on ASV are different, I see no need for the epap raise nor did the machine that aerophagia might be helped by limiting the max ps to 10 as a starting point

[JoeyWallaby]

How is flow limit different on ASV?

[Sleeprider]

I have no problem with a higher PS min, but I'd wait a day or two before making changes. Based on your history PS 4 sounds like a good idea.

[JoeyWallaby]

I don't really feel any significant support using these settings when awake, I've used up to PS 5.6 on the bilevel but that was with Min EPAP 7.6.

[SarcasticDave94]

Congrats on getting that ASV. Whatever is the proper time for setting changes, I'd probably go with PS Min to 4.0 and possibly pull in EPAP range a bit. If Aerophagia is an issue, cut back both EPAP and PS MAX down a few clicks until you're adjusted or if events start to show up. Example EPAP range 7-12, PS 4-11 or 12. I'm basing info on my AirCurve 10 ASV, in the presumption that your 9 Series is otherwise similar than looks, and that you're running ASV Auto mode.

[JoeyWallaby]

Yes, it's set to ASV Auto and as far as I'm aware, S9 36037 and Airsense 10 ASV are functionally equivalent. 

Is there some ASV magic I'm missing? Isn't the flattened inspiratory curve concerning? I know ASV is meant to deal with a lot of this stuff automagically but you know...

[SarcasticDave94]

It could be several things. I'd want to look again, but it may just be down to machine - person sync on inhale to exhale timing. Certainly keep an eye on it to see if it's a continuing thing or if you and ASV get synched and it disappears.

Oh yeah, be ready to enforce Blowback. It'll need it sometime.