Page 2 of 2

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 07, 2019 3:41 pm
by Pugsy
You shouldn't be having any central apneas...the machine should deal with them and not let them happen.
Any flagging should be either OA (despite the UA flag) or hyponea both related to obstructive in nature events.

Now...you can still at least try the auto ASV mode and let the machine decide what it needs to do with EPAP to deal with the obstructive stuff....
Better to have EPAP only increase when absolutely needed than use a higher baseline EPAP and feed the aerophagia monster.
Auto ASV mode will let you set a minimum and max EPAP...like the 5 min and 10 max but it won't go to 10 unless it absolutely has to for the obstructive stuff.

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 07, 2019 10:41 pm
by Weagle
screenshot-20190107-204320.png
Typical night, no apneas, but lots of bloating
screenshot-20190107-204320.png (87.92 KiB) Viewed 809 times

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 07, 2019 10:43 pm
by Weagle
screenshot-20190107-204411.png
Night with a few events
screenshot-20190107-204411.png (86.13 KiB) Viewed 809 times

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 07, 2019 10:44 pm
by Weagle
screenshot-20190107-204437.png
Zoomed in on events
screenshot-20190107-204437.png (88.83 KiB) Viewed 809 times

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 07, 2019 10:46 pm
by Weagle
screenshot-20190107-204600.png
Night with lowered EPAP and more events
screenshot-20190107-204600.png (86.97 KiB) Viewed 809 times

Re: AirCurve ASV 10 Settings

Posted: Tue Jan 08, 2019 12:33 pm
by Weagle
Everyone asked for sleephead data, now I post it and noone wants to respond? Just kidding, posting a note to bring the topic back to the top of the forum.

Re: AirCurve ASV 10 Settings

Posted: Tue Jan 08, 2019 12:48 pm
by raisedfist
Your AHI is pretty much the same whether your EPAP is 5 or 10. In the chart you posted where EPAP is set to 5, it shows your centrals are still zero. I would try the ASV Auto for a night and see what the results are, and how you feel.

Re: AirCurve ASV 10 Settings

Posted: Tue Jan 08, 2019 12:54 pm
by Pugsy
I saw it late last night...sorry....had a really, really bad day yesterday and couldn't think clearly.

Your reports are pretty much what I expected to see but the statistics helped me get an overall picture of things.

Here's the deal....you have aerophagia issues with higher EPAP and yes higher EPAP does reduce the apnea events.
BUT....even when higher those events aren't horribly high.

And what you are proposing to deal with the apnea events is very likely going to make the aerophagia worse...you are thinking about a big jump....why so big...why not try a smaller jump that might give you want you want....lower AHI and no aerophagia????

With these settings
5 EPAP
PS of 3 to 15
and whatever IPAP max
you start out the night with Exhale of 5 and inhale of 8 (the EPAP plus PS of 3)...and you don't have aerophagia issues.

With these settings
10 EPAP
PS of 3 to 15
and whatever max IPAP
you start the night with Exhale of 10 and inhale of 13...

Duh....guess which combination causes higher pressures all night even if centrals weren't even in the picture???
Guess what feeds the aerophagia monster???

You actually have several options that might work out to give you what you desire....I don't understand why you haven't looked at the in between options (unless you have and just didn't mention it).

You need PS to deal with the central stuff but you don't need higher PS all the time. Let the machine decide on PS...and you decide on EPAP.

Maybe try a little higher EPAP but not the 10... Maybe try 6 EPAP...maybe try 7...usually it doesn't take much to deal with such few obstructive events.
Maybe try auto SV with a small range for EPAP...so the machine can try to kill those OAs better and maybe not feed the aerophagia monster at the same time. Small range meaning minimum EPAP of the 5 and maybe max of 8 or 9 (stay below the known 10 cm problem line)....see what happens.

Finally...only you can decide which is worse...seeing a handful of apnea events slip past the defenses or deal with the aerophagia issues all day long. Which devil is the worse devil to deal with?

I see no reason to not try the in between stuff...won't affect the central part of your therapy which you need and it might help with the aerophagia stuff and give you a nice low AHI in the process.

Sometimes it's not so much how high the pressure is going that is feeding the aerophagia monster but the amount of time the pressure is higher that feeds the monster. Reduce the time a the higher pressures and maybe not feed the monster.

Re: AirCurve ASV 10 Settings

Posted: Tue Jan 08, 2019 1:35 pm
by Weagle
I haven't made any changes other than what was recommended by the prescribing Dr. so far. That's why I went from the 10 EPAP to the 5 EPAP and haven't tried anything else. Just recently the Dr. said that I could test out the ASVAuto, but to let them know the outcome. When I lowered the EPAP from 10 to 5 for a week, my AHI was consistently between 1-2 (yes, I know that's still low compared to most). But after a week of having the lower EPAP, I also noticed that I was more tired throughout the day also. It wasn't bad early in the week but after 6-7 days of it, I was dragging more in the afternoons.

I will play with some of the setting here later this week or next week. My cold is about gone now and want a good baseline again before I start making changes. As I suspected, it's probably going to be finding that fine line, lower pressure to fight the aerophagia monster and tired feeling throughout the day, or higher pressures and better sleep when I am sleeping. I will keep you updated when I start making the changes.

Re: AirCurve ASV 10 Settings

Posted: Mon Jan 14, 2019 10:31 am
by Weagle
Well a couple nights ago, I felt like my cold symptoms have been manageable and nearly gone, so I made the switch from ASV to ASVauto. I set the machine at the maximum ranges it would allow and let it manage both EPAP and PS. The last 3 nights my AHI has been 0.2 and I believe my aerophagia has lessened. My wife wasn't home at the time and can't speak on how gassy I was at night, but she'll be back for the next few nights.

Side note: I never sleep as well when she's not around, so I have not gotten a full night's sleep yet. Once I do, I will download the sleephead data and send a few screenshots. All I have access to while at work is the MyAir data.