ASV stopped working

[RichCD]

Hi,

I started BiPAP about 3 years ago, and moved to ASV (VPAP) in March, 2014. I have a Resmed S9 with humidifer, Quattro Mirage FFM, and up until the beginning of June it was all working great, with AHI less than 1.0. Then it just stopped, and my AHI started going into the 8-15 range. The last 3 nights have been above 13 and I feel terrible.

At first I thought it was just a problem with my mask, but after trying everything I can think of, I am convinced it has to be something else.

Could it be a change in my sinus congestion? What about my lips sticking together more (I often breath through my mouth)? How do you determine the right humidity level - nothing seems to help?

I am going for a new sleep study, but waiting for scheduling. But this is driving me crazy. Any ideas?

Thank you!

[Wulfman...]

Hi,

I started BiPAP about 3 years ago, and moved to ASV (VPAP) in March, 2014. I have a Resmed S9 with humidifer, Quattro Mirage FFM, and up until the beginning of June it was all working great, with AHI less than 1.0. Then it just stopped, and my AHI started going into the 8-15 range. The last 3 nights have been above 13 and I feel terrible.

At first I thought it was just a problem with my mask, but after trying everything I can think of, I am convinced it has to be something else.

Could it be a change in my sinus congestion? What about my lips sticking together more (I often breath through my mouth)? How do you determine the right humidity level - nothing seems to help?

I am going for a new sleep study, but waiting for scheduling. But this is driving me crazy. Any ideas?

Thank you!

Are you using software to monitor your therapy?
I would think some answers should show up in the reports.
And, I question your premise that it "stopped working". Something may have changed, but unless it's not blowing air or it's not blowing at the pressure it's supposed to, then it hasn't "stopped working".

It would be a good idea if you'd fill out your profile with the exact equipment and settings you're using.
If you're mouth-breathing and wearing a nasal mask, that could mean your therapy is being compromised.
If your humidity setting is too high, that could lead to congestion and consequently more mouth-breathing.


Den

.

[Goofproof]

I doubt if it really stopped working, it's that you failed to do the work to learn and control your treatment.

You need to get the software for your machine so you can see what is happening. I suspect, you use a nasal mask and are mouthing worse than you were. The software would help you find out "What's Up!".

By joining here, filling in your profile in "TEXT", not iconny, our help can be closer to your needs. Jim

[RichCD]

My apologies for being so obtuse. What I meant was that my ASV was no longer working for me in my situation. The machine itself seems like it's functioning properly. My masks seem to not have too many leaks. But I am vexed at why my therapy that was working so well, all of a sudden began giving me problems.

I've only been using Sleepy Head to monitor the situation, and am unfamiliar with the others. And I am hardly an expert at reading the reports. Nonetheless, I am hoping to glean some info from anyone that has experienced a similar situation.

IMy setup:
Resmed S9 VPAP Base setting 9, High setting 14
S9 Humidifer usually set on 3, but have tried them all
Mirage Quattro Full Face Mask with headgear with all parts regularly swapped out
Use oxygen 24/7, 2lpm during the day and 3.5lpm at night.

If anyone has any ideas, or can try and point me where I should look in the data, it would be very much appreciated.

[palerider]

My apologies for being so obtuse. What I meant was that my ASV was no longer working for me in my situation. The machine itself seems like it's functioning properly. My masks seem to not have too many leaks. But I am vexed at why my therapy that was working so well, all of a sudden began giving me problems.

I've only been using Sleepy Head to monitor the situation, and am unfamiliar with the others. And I am hardly an expert at reading the reports. Nonetheless, I am hoping to glean some info from anyone that has experienced a similar situation.

IMy setup:
Resmed S9 VPAP Base setting 9, High setting 14
S9 Humidifer usually set on 3, but have tried them all
Mirage Quattro Full Face Mask with headgear with all parts regularly swapped out
Use oxygen 24/7, 2lpm during the day and 3.5lpm at night.

If anyone has any ideas, or can try and point me where I should look in the data, it would be very much appreciated.

post some charts from sleepyhead, follow these instructions: https://sleep.tnet.com/resources/sleepyhead/shorganize clickthrough all three pages.

[Pugsy]

Exactly which model machine are you using?
Your subject says ASV but you say you are using the S9 VPAP and your settings you mentioned don't sound like ASV settings.

The model name is clearly stated on top of the blower by the LCD screen...does it say
S9 VPAP S
S9 VPAP Auto
S9 Adapt
or something else?

Can you post an image of one of those high AHI nights?
Don't know how? This explains how to and what we like to see.
viewtopic/t103468/Need-help-with-screen-shots.html
https://sleep.tnet.com/reference/tips/imgur

[RichCD]

From Sleepy Head:

[Pugsy]

The machine you have chosen in your profile is incorrect. There is no choice in the equipment menu for your machine.
I suggest removing the S9 VPAP Auto totally so as to not confuse people and instead just manually type in your machine model in the comments section
S9 VPAP Adapt Auto SV. It will avoid confusion later.

For some reason the pressure settings that used to work aren't getting the job done now. From the pattern of the clusters of events I would suspect either you are on your back during those clusters or in REM stage sleep. It's common to need more pressure when on our backs or during REM sleep.
You likely need more EPAP minimum and need to open up IPAP a little so the machine can better do its job of holding the airway open.

[RichCD]

Thanks for the reply. I amended my profile accordingly. Also, you are right on about sleeping position. I sleep on my back, and these events do not normally wake me up.

[palerider]

it looks like you need a higher epap, and a higher pressure support max.

is it possible your settings have been changed?

[Sleeprider]

I'm in the increased pressure support camp. Your average tidal volume is only 200 mL. That is extremely low for most people, and a higher PS might help that. I'd try moving PS min to at least 3, and probably 4. PS max max of 5 (IPAP 14.0, may not be enough to deal with the centrals. I think you need to take the lid off PS and get a breath when you need it. I'd move PS max to at least 8 and allow IPAP to go to 20 until you figure out why you're not getting decent volume. Your minute vent and tidal volumes are exceptionally low. Do you have any health or pulmonary issues that would account for that?

[RichCD]

My settings haven't changed. I do have a physical deformity which explains the low volume.

Thanks to all for the replies.