Trying to understand RESMED ASV machine

[Sleeprider]

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.

You can access the clinical menus and make changes, and you can put the modem on airplane mode so it does not call out to the DME. You will still need to show minimum usage compliance in order for insurance to pay of the machine. If anyone asks, just say you don't get cell phone coverage at the house, and the DME will request data from the SD card instead.

It is not rent to own. It is rent until you prove medical efficacy through compliance and benefit. The rental periods vary but are in place so machines are not purchased for people that won't use them. A significant number of machines purchased by insurance companies end up being sold on Craigslist when the users just can't adapt to therapy. The rental period is intended to eliminate that. Not all policies require it, particularly for replacement machines.

[vsheline]

Ok, last night was the first night with the ASV. It was set to low of 4, high of 14, and EPR of 4.

According to the manual there is no EPR setting.

I think the ASV machine ignores the EPR setting except when the machine is operating in fixed-pressure CPAP therapy mode.

EPR cannot be set higher than 3, so I suppose asneiman meant Pressure Support.

[vsheline]

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?

Could you have been sleeping on top of the tube and blocking it off?

If that does not seem likely, then perhaps it would be good to call ResMed Customer Support line to ask about it.

ResMed Customer Service for the United States and Canada: 1 (800) 424-0737 (toll-free).

[JVinNE]

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).

My Aircurve 10 ASV shut itself off this morning. It scared the crap out of me, because I woke up choking. I had to unplug it, and plug it back in today after calling the DME. I use Sleepyhead for my data, and it works, but last night, the frigging machine recorded no data, and last week, the machine reset its timer in the morning, and said usage - 10 minutes, when I had the machine on for over 8 hours. I might have to have my machine switched out. Now I'm wondering if the tube was blocked or slept on? But why would it not record all of those hours I had the machine on? This is stressful. Other than this recent issue, the machine was working well, and my only problem was mask dents in my face; which still needs to be resolved, because I need a FFM, and I don't exactly enjoy being disfigured.

[vsheline]

Hi JVinNE,

Sounds like something may be intermittent in your AirCurve ASV machine and perhaps the machine should be exchanged for a new one.

But another possibility is if power is cutting out for short periods (maybe less than a second), but if that were occurring you might have noticed electrical equipment (like TV or microwave oven) needing their clock set back to the correct time.

[vsheline]

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,

Hi asneiman,

I think EEP stands for End Expiratory Pressure, which is the pressure the machine is providing at the end of exhalation, before Pressure Support kicks in to help us inhale.

Instead of EEP we usually use the term "EPAP", meaning the pressure during expiration (exhalation), as if the pressure during exhalation is the same during all phases of exhalation. EEP is a more precise term meaning the pressure reached during the ending phase of exhalation, which is the same as what we usually mean by the term EPAP.

Tutorial on ASV terms and settings and tips for performing ASV titrations:
http://www.carolinasleepsociety.org/docu...of_asv.pdf

(The above tutorial discusses ResMed ASV therapy mode and seems to have been written before ResMed released its ASVAuto therapy mode.)

Perhaps your question was in reference to the meaning of terms appearing on a standard prescription form for standard ASV therapy mode (not ASVAuto therapy mode), and that the EEP was the fixed (manually-adjusted) setting for EPAP.

Also, perhaps "the same basic min/max pressure settings" actually were not the same as the min/max settings on an APAP machine, because an APAP machine has min/max for IPAP, but the ResMed "ASV" therapy mode has min/max only for Pressure Support.

ResMed "ASVAuto" therapy mode has min/max for both Pressure Support and for EPAP, as does the Philips Respironics System One BiPAP autoSV Advanced machine.

Take care,
--- Vaughn