Trying to understand RESMED ASV machine

[asneiman]

I have had both OSA and CSA for 15 years. At first my OSA's went away with a pressure of 14, but it caused several CSA's. After my 2nd or 3rd sleep study, they dropped the pressure to around 7-8, which gave me a better mix of apneas. I later moved to a RESMED Auto which does pretty good, but I am still very tired during the day. It is set with a min of 4, and a max of 14. (Without any treatment, my OSA is > 60, and I do not have any CSA)

I am getting ready to receive a new Resmed S10 ASV unit, and without a sleep study focusing on the ASV technology, we are guessing at the settings.

It appears as if the ASV unit has the same basic min/max pressure settings, but it also has a EEP setting. The default is 5, which we are starting with. What is this setting for, and how should it be adjusted?

thanks,

[iSnore]

With your automatic CPAP, inspiratory pressure (IPAP) equaled expiratory pressure (EPAP) and the auto-adjusted pressure within your set minimum and maximum pressure applied to both. Unless you were using a feature called Expiratory Pressure Relief (EPR), there was no "Pressure Support," a difference between IPAP and EPAP pressures.

With ASV, you set an EPAP pressure, as well a minimum and maximum Pressure Support. EPAP + auto-adjusted Pressure Support then determines IPAP. If you switch to AutoASV, you'll also have a minimum and maximum value for EPAP.

[archangle]

I am getting ready to receive a new Resmed S10 ASV unit, and without a sleep study focusing on the ASV technology, we are guessing at the settings.

If your doctor knows what he's doing and reads the data from your SD card for actual usage in the home, it's probably better than an in-lab ASV titration. Good providers will even send you an envelope to mail the SD card to them. Unfortunately, most doctors aren't smart enough or motivated enough to do that.

The A10 machines also send data via cell phone modem that the doctor can look at, but it's MUCH less data than the SD card records.

Your doctor can use the SD card or the cell modem to update the settings on your machine.

You can also look at the data yourself on your own PC by reading the SD card with software you can download for free. There's a link to SleepyHead at the top of the page, and there's something else in the "CPAP setup manuals" link.

I forget whether SleepyHead works with the AirCurve 10 ASV yet.

[justMongo]

It appears as if the ASV unit has the same basic min/max pressure settings, but it also has a EEP setting. The default is 5, which we are starting with. What is this setting for, and how should it be adjusted?

thanks,

The EEP is a pressure pulse that inflates the lungs when a missed breath is detected. Sort of like mouth-to-mouth by machine.

[JVinNE]

I have a ResMed Aircurve 10, ASV Bilevel, and my doctor controls the pressures on it. She has changed my settings at least two times. My max pressure is now around 11, and low (during ramp) is 4. When I get up to use the bathroom, I shut the ramp off, or I put it on 5 minute ramp time.

It is an amazing machine, and I got it because I was having sleep-onset Hypopnea, and some of them were centrals; as seen in the lab. This morning, I had an AHI of 0.0, with no CA's. My centrals in the lab were 5.1, and my overall AHI was 12.

[trish6hundred]

Hi asneiman,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to you as you continue your CPAP therapy and also with the new machine.

[DariaVader]

I have had both OSA and CSA for 15 years. At first my OSA's went away with a pressure of 14, but it caused several CSA's. After my 2nd or 3rd sleep study, they dropped the pressure to around 7-8, which gave me a better mix of apneas. I later moved to a RESMED Auto which does pretty good, but I am still very tired during the day. It is set with a min of 4, and a max of 14. (Without any treatment, my OSA is > 60, and I do not have any CSA)

What I see here is that without xpap, you did not have CA. Therefore it would be a reasonable postulation that your CA are therapy or pressure induced... One thing I would try if it were me would be to take it out of auto entirely set it on a single pressure without EPR to see if changes in pressure are what is inducing the CA, and then move on to the ASV if that didnt help... (you said they dropped pressure.. I am assuming just max pressure and that the min is still 4) try a straight 8 or even 10 if you want to play with it

[JVinNE]

How do you get to play with your own machine? Is this after it has been paid for? My health insurance has compliance rules, and I can't adjust the machine pressure settings at all; doctor has to do it via the modem. It is a "rent to own" situation.

[asneiman]

Ok, last night was the first night with the ASV. It was set to low of 4, high of 14, and EPR of 4. The first 2+ hours, the machine turned off, and I woke up to the error of "tube blockage". I restarted it, and eventually turned it to auto-ASV. About 2:00 AM, I changed it to CPAP only mode, with a pressure of 7.5 or so. Once during this period I woke up to the tube blockage error.

Why would the ASV unit have so many errors? Is it bad? Or is it flagging my Apnias as the tube being blocked?

[iSnore]

Ok, last night was the first night with the ASV. It was set to low of 4, high of 14, and EPR of 4. The first 2+ hours, the machine turned off, and I woke up to the error of "tube blockage". I restarted it, and eventually turned it to auto-ASV. About 2:00 AM, I changed it to CPAP only mode, with a pressure of 7.5 or so. Once during this period I woke up to the tube blockage error.

Why would the ASV unit have so many errors? Is it bad? Or is it flagging my Apnias as the tube being blocked?

If you have the ASV in ASV mode, you'll have EPAP, Min PR and Max PR settings. I'm guessing you had EPAP at 4, Min PS at 4 (which means IPAP = 8) and Max PS at 14 (meaning IPAP would = 18). According to the manual there is no EPR setting.

If in the ASVAuto mode, EPAP will be replaced with Min EPAP and Max EPAP.

I've seen several reports of various models in the ResMed 10 line erroneously reporting a tube problem. In some cases, it was resolved by unplugging the unit and plugging it back in. In others, the unit was replaced. If it persists, I'd return it to the DME (along with the hose).