Central & Obstructive - AHI always around 10 with ASV. Tweak Settings?>?

[metsfan302]

My AHI simply never seems to get below 5, most of the time it is around 10. I am wondering if this is simply something I need to live with or might it be possible to adjust some setting to help? Sure I feel better then I did when I was using my Cpap and had an AHI of around 50-60, and a ton better then untreated. I guess I am wondering if its even possible to get my AHI below the "5" benchmark and feel even Better?

Not sure if anyone might have some input or opinions, ideas etc. I am no expert at reading the data but it seem's to me that the pressure I need thru the night is high and the machine runs near the top of its limit? Let me know too what info/screenshots you might need from my Sleeyhead data etc......


I have had my Resmed Aircurve ASV since they come out with this model, I am due for a new one and well not sure if I should get another Resmed Aircurve ASV or a different company?> Does Phillips make an ASV or do they call it something else?

Here is a summary of my Stat's



Last Night's Data

[Pugsy]

The only other company that makes ASV that I know about is Phillips Respironics
They make them...current model is the DreamStation ASV. I don't think you would like it...it's slower to respond than the ResMed...I am betting your AHI would be higher with it. I don't think you want to go there. I think the ResMed is a better option.

Can you increase MinEPAP any from the 12 and allow it to go higher than 15..as in max EPAP setting?
If we are to believe ResMed...those apnea flags (and hyponeas) are obstructive in nature and you need more EPAP to deal with them and right now your max EPAP is 15.
BUT....you also need PS being available higher to deal with the centrals..and sometimes you can't get both with the various setting options available if you have to have a wide PS range too.

If I was going to try tweaking more.....it would be with more min EPAP and maybe more max IPAP if I could get it.

[metsfan302]

I'll see if I can increase those, thought I was at the max on my settings on this Resmed Aircurve 10 ASV. Let me check it out once home

yea no we don't want to go down that road, I'll just get a fresh resmed Aircurve 10 ASV like I have when I get the script later this month = sell it or keep it as a back up

[metsfan302]

the max epap is 15 and the max ps is 13 even when i raise the min #'s

[Pugsy]

I was afraid that would be the case with Max EPAP....but let's see what results you can get with just a little more minimum EPAP.
It didn't hurt PS max much so worth trying.

[palerider]

I'd raise the minEPAP and *lower* the minPS (if it'll go below 5).

[metsfan302]

Well I went to see my sleep dr yesterday , I think shes an amazing sleep dr I really do. So glad I switched years ago from the pulmonologist who had me on the cpap for 2 years and thought he knew it all and really would not listen to me.

She thinks there might be an issue with my ASV (Resmed Aircurve ASV ) - I got it 3 years ago and she thinks it is covered under a 5 year warranty thru the dme supplier I got it from.... I think she might be wrong as I just looked up on Resmed's site and it says 2 year warranty... She wrote a script to have them look at the machine and repair/replace but I feel they may just tell me to pound rock salt. That dealer also does not deal with Remed anymore.

She also wrote a new script for a New ASV as my insurance changed (currently have medicaid thru my state - blue cross blue shield) - they said they do not have any asv machine on record as I had a diff plan when I got my machine 3 years ago. I had my most recent sleep study done 3 years ago the ASV one so she thinks since its under the 5 years i wont have to retest foe the new insurance

That being said, The new DME I deal with also does not deal with Resmed so It looks like I am going to be getting the - Philips DreamStation BiPAP autoSV

Anyone know if the Dreamstation ASV / Bipap AutoSV lol - works on sleepyhead now? wonder how this reports vs the resmed? Guess ill find out after I hear back from the DME place

[metsfan302]

I myself do not think anything is wrong with my current ASV. She thinks my AHI numbers should be below 5 and even lower since my weight loss surgery and it might be machine related vs pressure related. I told her I am maxed on the settings end of my machine - she said she can raise the lower numbers if the machine is ok ..... my numbers have always been in the 5-10 range since being on ASV.

[Pugsy]

Anyone know if the Dreamstation ASV / Bipap AutoSV lol - works on sleepyhead now?

Nope. SleepyHead version 1.0 beta.xxx isn't compatible with the DreamStation ASV?
Version 1.1 supposedly is compatible. The version AKLERK is talking about needing help with.

[metsfan302]

ugg i am so nervous if this dreamstation will work for me--- as ill have to live with said new machine for another 5 years...... or do I just find a place that will take my insurance and get another Resmed Aircurve ASV

[Pugsy]

I am not so sure that your ResMed is ailing.
I think you just need more EPAP to deal with the obstructive stuff you are having.

[metsfan302]

Not sure how to get more EPAP, I think it is as high as it will go. In the clinical settings - The min Epap is 13 - max is 15 and wont let me bring that figure up..? I assume ipap is exhale pressure and epap exhale pressure?

Who knows what my settings will need to be if indeed I do end up with the Dreamstation Bipap Auto SV - it seems to have a few diff settings then my Aircurve. or maybe they are just settings ill need to tweak to get it to run like the resmed does automatically ...... either way ill have one of each

[Pugsy]

I don't think you are going to like the Resprionics ASV algorithm. When I was using one...I needed a lot more EPAP with it than I did with the ResMed ASV. Respironics is not nearly as quick to respond to anything.

Any chance sleeping position is now a factor in pressure needs?
Change in any meds?...anything that might make the airway tissues floppier?

[metsfan302]

I usually only sleep on my right side. No medicine change - I am no longer Sniffing heroin and or taking 100 - 30mg oxycodone/roxicet every 2 weeks + time release morphine daily. I am taking Methadone 130mg liquid once daily but have for a couple years now. I am sure the opiate use in general is why I am having the centrals. I have lost about 100lbs and continue to lose since my Bariatric Sleeve surgery in October. My sleep dr would of thought my AHI would be coming down vs going up with weight loss etc. Sleeprider on "the other side" said to try a cervical collar - I did get one, but am still trying to get use to sleeping an entire night with it

[metsfan302]

Should I let the dr know I would rather go with another Resmed Aircurve ASV and have a diff DME get me one or special order one?

I am sure she won't mind...... I am either going to sell (depending on how much I might be able to get) or give my wife whatever one I do not like as she can use the Cpap Auto feature of either machine...

Thanks too everyone for your replies - pugs / pail....!!