Best mask for ASV??

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
StephenR
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Best mask for ASV??

Post by StephenR » Tue May 05, 2015 11:35 am

Hi there..

I am soon to take possession of an ASV machine, I was wondering if there is any particular advantage to any type of mask for this type of machine. At present with the CPAP set at 8, I am using nasal pillows, but have issues with leaks and the mask slipping off. So I am thinking of getting a full face or nasal mask to insure I keeping it on...any opinions??

Stephen

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Darth Lady
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Re: Best mask for ASV??

Post by Darth Lady » Tue May 05, 2015 12:30 pm

I use an Airfit F10. It's a pretty minimalist full face mask and works well with my ASV.

The biggest issue with ASV mask adjustment is that they can go to pretty high pressures (depending on your settings - do you know them yet?), which can generate leaks, which of course can wake you up and screw up your therapy.

I often turn Dartha on and breathe very lightly, to tempt her into raising the pressure, so I can see if I got it right. With practice, you can learn to adjust pretty accurately the first time. Some machines even have a mask fit feature that will send your highest pressure at you so that you can check and adjust.

Others here have had success with ASV (or with high pressure in general) with all kinds of different masks. Good luck

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jnk...
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Re: Best mask for ASV??

Post by jnk... » Tue May 05, 2015 12:39 pm

IMO, the BEST mask for any ASV-type machine is one recognized by the machine and recommended by the manufacturer of that particular ASV.

That said, Phillips says of one of its ASV-type machines: "The BiPAP autoSV can work with almost every mask type. However, controlling unintentional leak is very important for the algorithm to work effectively. If a patient presents with higher than expected leaks, move them to a full-face type of mask."

ResMed actually has a list specifying compatibility of its masks and machines, with a few masks marked as N/V, for not validated, for a few machines. The list can give some idea of compatibility in general: http://www.resmed.com/us/dam/documents/ ... er_eng.pdf

My guess is that about any mask can be made to work well enough in most circumstances. But if the question is "best," I hope the above proves helpful.
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palerider
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Re: Best mask for ASV??

Post by palerider » Tue May 05, 2015 1:19 pm

I know at least two people on ASV machines that quite like their P10 masks.

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StephenR
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Re: Best mask for ASV??

Post by StephenR » Tue May 05, 2015 2:50 pm

palerider wrote:I know at least two people on ASV machines that quite like their P10 masks.
OK, I will have to see if I can find a way to stop the P10 from sliding around, its worth a shot...Thanks for the reply

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Re: Best mask for ASV??

Post by StephenR » Tue May 05, 2015 2:53 pm

Darth Lady wrote:I use an Airfit F10. It's a pretty minimalist full face mask and works well with my ASV.

The biggest issue with ASV mask adjustment is that they can go to pretty high pressures (depending on your settings - do you know them yet?), which can generate leaks, which of course can wake you up and screw up your therapy.

I often turn Dartha on and breathe very lightly, to tempt her into raising the pressure, so I can see if I got it right. With practice, you can learn to adjust pretty accurately the first time. Some machines even have a mask fit feature that will send your highest pressure at you so that you can check and adjust.

Others here have had success with ASV (or with high pressure in general) with all kinds of different masks. Good luck
I will try with the P10 mask I have, but will keep in mind the F10....
I am on my own with pressures, the docs here are not helpful with my CA's...I have some guidance, here is what I have so far:

EPAP Min: 7; EPAP Max: 12; PS Min: 3; PS Max: 5; IPAP max: 20.

How does that sound??

Stephen

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Re: Best mask for ASV??

Post by JDS74 » Tue May 05, 2015 3:03 pm

An important issue is looking at the intentional leak chart for a mask to see what the manufacturer has for a highest pressure. Some masks only go to 20 cm H2O while ASV machines frequently can spike to 25 cm H2O.

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Re: Best mask for ASV??

Post by grayghost4 » Tue May 05, 2015 3:09 pm

the Swift FX is also a good pillow mask with a more stable headgear... it is my wifes choice

On the other hand I use the Pilaro Q with the larger headgear and it is much more stable on the nose
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Re: Best mask for ASV??

Post by Darth Lady » Tue May 05, 2015 3:28 pm

StephenR wrote: I will try with the P10 mask I have, but will keep in mind the F10....
I am on my own with pressures, the docs here are not helpful with my CA's...I have some guidance, here is what I have so far:

EPAP Min: 7; EPAP Max: 12; PS Min: 3; PS Max: 5; IPAP max: 20.

How does that sound??

Stephen
An ASV is not an easy DIY machine. Especially if you have CA's, which you say you do, I'd really, really advise you to find a doc to directly address that.

Someone please correct me if I'm wrong, but the advice I've gotten when I asked about it is that EPAP min + PS max have to = IPAP max. So if your EPAP min is going to be 7 and your max pressure is going to be 20, PS max needs to be 13 (7+13=20). This is so the machine can support a breath, if necessary, all the way from the minimum pressure you could be receiving all the way to the maximum pressure you could be receiving. The algorithms work that fast.

It's not a great machine to be dial-winging on. I do hope you can get good, solid advice from someone with major experience who can evaluate your particular problem.

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Re: Best mask for ASV??

Post by palerider » Tue May 05, 2015 4:57 pm

[quote="StephenR"here is what I have so far:

EPAP Min: 7; EPAP Max: 12; PS Min: 3; PS Max: 5; IPAP max: 20[/quote]

restricting the ps on an asv hobbles it's ability to do it's job, resmed recommends something like at least 10, maybe 15 max ps.

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palerider
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Re: Best mask for ASV??

Post by palerider » Tue May 05, 2015 6:00 pm

Darth Lady wrote:Someone please correct me if I'm wrong, but the advice I've gotten when I asked about it is that EPAP min + PS max have to = IPAP max. So if your EPAP min is going to be 7 and your max pressure is going to be 20, PS max needs to be 13 (7+13=20). This is so the machine can support a breath, if necessary, all the way from the minimum pressure you could be receiving all the way to the maximum pressure you could be receiving. The algorithms work that fast.

It's not a great machine to be dial-winging on. I do hope you can get good, solid advice from someone with major experience who can evaluate your particular problem.
the resmed ASV machines have a different way of being set up, so it depends on which ASV he's getting as to exactly what the setup needs to be

for many, with the resmed machine, factory defaults are good, it's that good a machine. I dropped my friend the heart failure patient on one, at defaults, and all I did was raise min epap a bit to keep his o2 stats up... it takes care of the rest.

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StephenR
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Re: Best mask for ASV??

Post by StephenR » Tue May 05, 2015 6:03 pm

palerider wrote:
Darth Lady wrote:Someone please correct me if I'm wrong, but the advice I've gotten when I asked about it is that EPAP min + PS max have to = IPAP max. So if your EPAP min is going to be 7 and your max pressure is going to be 20, PS max needs to be 13 (7+13=20). This is so the machine can support a breath, if necessary, all the way from the minimum pressure you could be receiving all the way to the maximum pressure you could be receiving. The algorithms work that fast.

It's not a great machine to be dial-winging on. I do hope you can get good, solid advice from someone with major experience who can evaluate your particular problem.
the resmed ASV machines have a different way of being set up, so it depends on which ASV he's getting as to exactly what the setup needs to be

for many, with the resmed machine, factory defaults are good, it's that good a machine. I dropped my friend the heart failure patient on one, at defaults, and all I did was raise min epap a bit to keep his o2 stats up... it takes care of the rest.
He is getting a ResMed S9 VPAP Adapt SV with Heated Humidifier - REF - 36007



Stephen

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palerider
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Re: Best mask for ASV??

Post by palerider » Tue May 05, 2015 6:17 pm

StephenR wrote:He is getting a ResMed S9 VPAP Adapt SV with Heated Humidifier - REF - 36007



Stephen
ok, you don't have a min/max epap with that one, you just have epap. and min-max ps.

7 is probably a good starting point for epap, but you'll have to monitor with sleepyhead to see if it's enough pressure to prevent most obstructives and hypos.

the default maxps is 15, if it were me, I'd leave it at that, and see what the data looks like after a sleeping.

the mask pressure chart will show you whether the machine is acting to squash centrals or not.

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StephenR
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Re: Best mask for ASV??

Post by StephenR » Tue May 05, 2015 6:34 pm

palerider wrote:
StephenR wrote:He is getting a ResMed S9 VPAP Adapt SV with Heated Humidifier - REF - 36007



Stephen
ok, you don't have a min/max epap with that one, you just have epap. and min-max ps.

7 is probably a good starting point for epap, but you'll have to monitor with sleepyhead to see if it's enough pressure to prevent most obstructives and hypos.

the default maxps is 15, if it were me, I'd leave it at that, and see what the data looks like after a sleeping.

the mask pressure chart will show you whether the machine is acting to squash centrals or not.
I guess I should have got the next machine up, but I just wanted to titrate my sleep with this...
Thanks Palerider...

Stephen

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Re: Best mask for ASV??

Post by Pugsy » Tue May 05, 2015 6:51 pm

The absence of having a min and max EPAP is unlikely to be a big deal and if it had been I would have strongly suggested the next model up. Only thing missing is the max EPAP and it isn't a make it or break it thing.
The machine sort of sorts out what it needs or wants to do anyway.

You don't want to restrict PS though because it is PS that is going to help you with your centrals so it needs a lot of room to do its job quickly. So I would suggest minimum PS at 3 or 4 and leave the max wide open at 15 (the machine will only use what it thinks it needs to use...and leave max IPAP at 25.
Minimum EPAP will need to be determined based on what we see on the reports as it is instrumental in dealing with the Obstructive stuff. So 7 cm is a reasonable place to start and go from there once we see what the reports show.

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