BiPap St Cost $$$$$

[Pugsy]

Actually I think she had a plan to mimic the ST settings but didn't quite understand how to do it.
If she had done PS min and max of 5...it would work like the ST.
I am pretty sure that was her plan all along.

[palerider]

Actually I think she had a plan to mimic the ST settings but didn't quite understand how to do it.
If she had done PS min and max of 5...it would work like the ST.
I am pretty sure that was her plan all along.

The stampeding incompetence of people in the medical field is simply amazing at times.

[zonker]

Actually I think she had a plan to mimic the ST settings but didn't quite understand how to do it.
If she had done PS min and max of 5...it would work like the ST.
I am pretty sure that was her plan all along.

The stampeding incompetence of people in the medical field is simply amazing at times.

coupled with the god complex.

[palerider]

Actually I think she had a plan to mimic the ST settings but didn't quite understand how to do it.
If she had done PS min and max of 5...it would work like the ST.
I am pretty sure that was her plan all along.

The stampeding incompetence of people in the medical field is simply amazing at times.

coupled with the god complex.

truer words, etc.

[tsduke]

First night trying the ASV. Didn't sleep as well with it, but sure brought the AHI down in the first night. Guesing some of the hgher IPAP pressures woke me up and then I just could not get back to sleep after getting woke around 4:30. Also had some leaks I wasn't dealing with much before.

screenshot-20190921-071803.png (518.35 KiB) Viewed 317 times

[Pugsy]

Looks like you could probably reduce your minimum EPAP (try 6 minimum or even 5) a little and minimum PS to 3 and not have it allow too much obstructive stuff happen.
This might reduce the overall IPAP a little and be less annoying and less likely to cause a leak.

I was trying to come close to what you were using for comfort more than anything else with the idea of 7/11.
Had to start somewhere.

Yes...it does take some getting used to when PS kicks in but you can get there.

When PS kicks in for the centrals it doesn't stay up there very long. Zoom in on the flow rate breath by breath and you will see the pressure go up and down fairly quickly when PS is working. The rather wide difference will make keeping the mask sealed a bit more challenging but you just have to be a bit more pre-emptive about fitting to anticipate the higher settings.
I think you should have a mask fit feature....try it as it will use higher pressures so you can seal at higher pressures vs the lower starting points.

[tsduke]

I think the settings were a good start. The treatment is just different enough that I'll take some getting used to it. The leaks didn't feel terribile, but but when trying to get back to sleep the mask air flow was louder than usual. I need to understand the leak report better to understand what is really bad #'s. I definitely have higher large leak rate now. I've had pretty good luck with the Airfit N20 and very little leak issues compared to the F&K Eson 2. Fitting will need more attention with the wide pressure differences it seems. With old machine I just put it on and didn't have many issues.

I did notice the pressure spikes are quick as well as the median pressure not real high compared to my old machine. With them being fairly quick I'm not 100% sure they wake me up, I'm just suspicious they do. Squid mentioned the ASV wants to zap the PS right as you fall asleep. He's not kidding. That happened a few times before I finally stayed asleep.

[Pugsy]

If those leaks didn't wake you up I wouldn't worry about them. They are very brief and short lived. I suspect mask movement for some reason. Might be some mouth opening stuff but I again....very brief no matter what it was from. I would shrug my shoulders and move on as long as they didn't wake me up.

Anything that wakes us up is unwanted and with ASV you have the initial slamming of the pressure to deal with each time you wake up and try to go back to sleep. We want to limit those unwanted wake ups at least until your brain and body gets used to the slamming....and it will get used to it.
Eventually the brain will say "oh..just the machine breathing for me and that's a good thing so I don't care anymore"....but right now the brain says "OMG, whoa Nellie".

Your machine reports excess only leaks. It removes the expected vent rate from the calculations so what you see being reported in the leak graph is all excess leak. ResMed draws a line in the sand at 24 L/min for marking large leak territory. It's an ultra conservative line in the sand IMHO. The machine can still do a very decent job of compensating and sensing and responding and recording up to around 35 L/min excess leak. Once you go above that it starts getting iffy and the farther you go higher than 35 the iffier it gets.
Very brief short lived large leaks deep into large leak territory (if they didn't wake you up) really aren't the end of the world either.
5 minutes out of a 7 hour night in large leak...not going to make that big of a difference in overall therapy.
Now if you spent 30 minutes in a solid block of large leak at say 45 L/min....that's a problem that needs to be worked on if you saw it happening often.
Random or rare ugly leak...I don't worry about....again as long as I sleep through it.

First night with a totally new machine that is real good at slamming you with big PS....it might just be the brain being on hyper alert status that caused the wake ups and not so much the leaks. We just don't know for sure and don't really have anyway to know for sure.

We do the best we can to prevent it by maybe a little better fitting at the beginning of the night and deal with it.