Newby user of ASV Any tips/sage advice?

So after a long saga :using auto CPAP for over a month with no effect on AHI (lots of advice taken/tried for setting and pressure changes), a switch to a less clueless sleep center, a sleep study at the new center with a BIPAP that showed central apneas (complex sleep apnea) and another sleep study with an ASV finally I got a new ASV machine today. Recommended starting settings: EPAP min 8, EPAP max 15, PS min 0, PS max 6, IPAP max 25 Auto Back up rate. According to the sleep study the obstructive apnea and desat was controlled at EPAP min of 10.
What I would really like to ask is whether there are other ASV users in the community and if they have any advice or words of wisdom?
Thanks for any input!

Welcome to the Respironics ASV club. My main suggestion is to not fiddle with the settings for a long time.
ASV machines are very different from other CPAP machines and the parameters interact in strange and wonderful ways.
That said, it's a good idea to get a copy of all of your sleep studies so that you can see down in the details about what is going on. My ASV reports quite a few hypopneas while my most recent sleep study didn't report any at all.
The difference is that in scoring, hypopneas associated with some arousals are ignored since they occur during the sleep-wake transitions and the scoring rules say those don't matter. The point is that with your new machine, you may see more hypopneas than before but likely it's not something to worry about.

It is my observation that the ASV machine is a little more twitchy about reporting things that my prior AutoBiPap machine was. I attribute that to a difference in algorithms between the machines. Remember that your machine can and will react to what it perceives as the beginning of a central apnea within a single breath cycle. It happens to me lots of times during the night. Again, not to worry because that's what its supposed to do.

One last item to consider, the ASV can manipulate the pressures a little more aggressively than the BiPap did and will sometimes adjust the pressure, in your case to an EPAP of 8 and an IPAP of 25 as it tries to stop a central and get you breathing again. For many folks, there is a transition period during which time they need to become used to this sharp pressure swing. When that happens just remember what is going on - you stopped breathing with a central and some time has passed and you are still not breathing. The machine switches to what I call ventilator mode and keeps you breathing until you take over for yourself. The longest time I ever spent in this mode was 2-1/2 hours one night. For the most part though the interval is much shorter. You will get used to it. Don't fight the machine.

Do ask questions on this forum and always put the term "ASV" in the subject line so those of use using similar equipment will notice.

Thanks so much for replying1 This whole process has made me feel a little too "special", as it's doesn't seem to be the norm route for most folks with apnea. It's nice to hear from someone else who's in the same boat.
It's useful info to know not to tamper with the settings. That being said, is there anything that you would recommend? Humidifier setting? Ramp?
How long did it take you to get used to the ASV? During the sleep study, it seemed like every time I would start to fall asleep the machine would give me a puff of air and I would jolt back to being awake. Do you use a FFM ?
Thanks again for your reply

Ramp is useful for a while but you should try to get off of using it as soon as you can feel comfortable.
This is especially true of ASV machines which, if they detect a central apnea, abort the ramp function and try to treat it right away.

That feeling of being jolted awake by the sudden pressure increase is exactly what I was referring to. Normal CPAP machined don't do that so prior experience with one of them is not helpful. It sometimes takes quite a while to train your brain to ignore those events and treat them as being helpful for your condition and not a hindrance.

On the subject of humidity, that area is one of personal comfort and some experimentation with the humidity levels is entirely appropriate even in the first few weeks. The one thing to watch for is having a dry mouth in the morning. This is an indication that either the mask is leaking too much or that the humidity level is too low. If you don't have one, get a heated hose for your machine as it will be helpful in controlling problems that arise as additional humidity is supplied. As the humidity level is increased, a phenomenon called rainout occurs. This is the cause of water condensing inside the air hose and makes noise, drips into the mask and other issues. A heated hose will prevent most of those effects.

I use an Oracle 2 mask which is very different from any other mask on the market. If you are curious, you can take a look at my post with the link down in the signature block on this reply. BTW, Unless you really cannot tolerate your current mask or some other nasal mask or FFM, I don't recommend switching to the Oracle mask. It works great for me but only after a struggle. I cannot tolerate any form of FFM even for a few seconds.

With a FFM, one thing that can happen is that as you drop off to sleep, your facial muscles relax and your jaw can drop. This pulls the FFM out of position and can cause leaks. Some recommend a chin strap to help with this problem but I prefer using a cervical collar to support the jaw from below. That's what I use. I started out with a soft one like those you can order from Amazon but, over time, it did not provide sufficient support so I switched to a stiffer one that is available locally at WalMart or other pharmacy locally.

Hang in there, it will get better and the "jolting awake" will gradually fade away as you become familiar with how it all works.

JDS74 wrote: That's what I use. I started out with a soft one like those you can order from Amazon but, over time, it did not provide sufficient support so I switched to a stiffer one that is available locally at WalMart or other pharmacy locally.

Hi JDS... have you got a model name, model number or store code for that collar I'd be interested in checking it out.

The part number printed on the collar is WRX277304.
I need to get a new one tomorrow and will post better details then.

I did get one this morning and the part number at Walgreens is 277-304.
$15.95 is the cost.