Trouble Adjusting to ASV, UARS

[5931044786]

I have been reading threads on here and finally decided to make an account.

A few days ago, I received my AirCurve 10 ASV from Secondwind.
Diagnosis following in-lab study: UARS (AHI: 1.5, RDI: 21.7)

I am experiencing challenges adjusting to the ASV. I find it hard to fully inhale sometimes, like there is resistance, and then sometimes also feels like it continues too long on the inhale, pushing me further than I’d like. Hard to explain, but does that make sense?

I am using the Swift FX nasal pillows and like this mask best so far out of the multiple I’ve tried. My issue is that no matter what I’ve tried on this machine and the AirSense 10 AutoSet, I’ve never been able to fall asleep with any PAP therapy running.

I had a call with a well-known sleep specialist ENT this past week and he thinks I may have Epiglottic Laryngomalacia or Expiratory Palatal Obstruction (in addition to my confirmed deviated septum) and that I should keep trying with the ASV, but may not see real lowering of RDI with PAP therapy alone unless I ultimately get surgery.

These are the current settings:
Mode: ASVAuto
Min EPAP: 5.0
Max EPAP: 15
Min PS: 3.0
Max PS: 20
Mask: Pillows
SW Version: SX567-0302

Any suggestions on changes I should make for better adaptation with my UARS?

How old is this software version? Do I have a way of upgrading and would doing so make a difference/improvement with the ASV algorithm? Machine is model 37043 and first four digits of serial number are: 2214. What is the difference in performance between this (I assume manufactured in 2014) and one made in 2020?

[Gideon]

Let's see your daily charts and how your body reacts to all.
If you haven't already download OSCAR and post your nightly charts
Next to File click on "View / Reset Charts / Advanced" to reorder the charts.
Do include a couple of 2-minute duration zoomed views, looking for a 'normal area and a 'problem' area. They will help us figure out what is going on.

Look at http://www.apneaboard.com/wiki/index.php...ng_Therapy The last subject in this troubleshooting segment is Palatal Prolapse which you mentioned.

you said, " I find it hard to fully inhale sometimes, like there is resistance, and then sometimes also feels like it continues too long on the inhale, pushing me further than I’d like."
A technique to 'reset' the ASV is to forcibly blow back. and yes similar feelings are common.

[5931044786]

Thank you for this detailed reply. The reason I hadn't yet installed OSCAR is because I've never successfully fallen asleep with PAP therapy during my attemps over the past 2 months. Would it still be helpful to see the the data from OSCAR at this stage if I'm fully awake when using the ASV?

If I got a brand new AirCurve 10 ASV unit from the past year or so (or updated my device software to the latest version), do you think I'd notice any difference in the challenges I'm describing vs. the 2014 model I'm currently using?

[SarcasticDave94]

No differences in therapy that I'd think of with a newer 10 series ASV. And I don't think you can initiate or access any updates if there were any. Even if you could, I do not seeing it as the answer to your issue(s).

[jaswilliams]

May be try raising the min epap to 6 as 5 could be a tad low making you feel lacking in air

[Sleeprider]

I agree raising EPAP min may help. With UARS we need to provide an adequate PS min for comfort and let the adaptive PS fill in as needed. I think a PS min if 4.0 would be a good start and let’s dial back PS max to 12.