High pressure

It appears I am making some very slow progress towards getting a bit of real sleep, but it also appears I am going to be stuck on having to use high pressure to get there.

Right now I'm using a borrowed ASV and the IPAP pressure routinely goes to 25. The EPAP stays at a relatively comfortable 8-12. When I did a mask fit check, it seemed the machine went to full or near full pressure in a CPAP mode which made it very difficult to exhale.

My question is, are there any machines besides an ASV that can give such a low EPAP with such a high IPAP?

xxyzx wrote:Try epap min = 8 (you might even want to set it to 6 to help get to sleep easier)
epap max = 12
set ps min to 7 that makes ipap min 15
set ps max to 7 that makes ipap max 15

I have already tried with PS 5-12(?) and it was not a good night. My body seems to need the high IPAP pressures. If I had one of the machines that went to 30, I wouldn't be terribly surprised to see it spike that high.

EPAP of 8-12 doesn't seem to bother me and I find it easy enough to breathe. Overnight it tends to average under 10, so I think it's a good setting.

I was just wondering if the ASV models are the only ones that are able to adjust EPAP and IPAP on the fly.

MaxINTJ wrote:I was just wondering if the ASV models are the only ones that are able to adjust EPAP and IPAP on the fly.

Bilevel auto machines will do it but not nearly as quickly and only if certain needs cause the change and your problem is unlikely to cause it to go higher. You would have to use much higher all night long instead of part of the night.
Think of them as apap machines with exhale relief greater than the 2 or 3 cm drop that Flex or EPR offers.
That's pretty much what the regular bilevel machines are.

The ASV is the only one of the specialty machines that will auto adjust anything. The other specialty machines for centrals or COPD or whatever are fixed pressure machines with a time back up rate.

Pugsy wrote:

MaxINTJ wrote:I was just wondering if the ASV models are the only ones that are able to adjust EPAP and IPAP on the fly.

Bilevel auto machines will do it but not nearly as quickly and only if certain needs cause the change and your problem is unlikely to cause it to go higher. You would have to use much higher all night long instead of part of the night.
Think of them as apap machines with exhale relief greater than the 2 or 3 cm drop that Flex or EPR offers.
That's pretty much what the regular bilevel machines are.

The ASV is the only one of the specialty machines that will auto adjust anything. The other specialty machines for centrals or COPD or whatever are fixed pressure machines with a time back up rate.

Well, thanks Pugsy, I was kinda thinking that would be the answer. So no compromise with the VA - I will fight for an ASV because I think it's going to end up working.

xxyzx wrote:

MaxINTJ wrote:

xxyzx wrote:Try epap min = 8 (you might even want to set it to 6 to help get to sleep easier)
epap max = 12
set ps min to 7 that makes ipap min 15
set ps max to 7 that makes ipap max 15

I have already tried with PS 5-12(?) and it was not a good night. My body seems to need the high IPAP pressures. If I had one of the machines that went to 30, I wouldn't be terribly surprised to see it spike that high.

EPAP of 8-12 doesn't seem to bother me and I find it easy enough to breathe. Overnight it tends to average under 10, so I think it's a good setting.

I was just wondering if the ASV models are the only ones that are able to adjust EPAP and IPAP on the fly.

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afaik -- but there might be really fancy machines for really sick people that do it
for sure you can get some that go to 30 for pressure
but that is the number one doctors study flagged as the max to avoid lung damage

your body may need higher ipap
but that does not mean you will feel better

PERFECTION IS NOT POSSIBLE

you may have to accept that you are going to have some ahi no matter how you set it
and be happy if you minimised it while not causing arousals and other sleep issues

Max believes he has UARS - not SA - AHI is not an issue for him. You have disparaged his trying first APAP then ASV to treat UARS, now you are back on the AHI. How long do you recall what you have commented on? Might want those world-class docs. you use to check out your short-term memory.