BiPap St Cost $$$$$

Brand new at Secondwind the Resmed ST and ASV differ by $200. About $400 between their used prices. ASV being higher.

I second what Pugsy says go for the Resmed ASV users often have better results with that one and its easier to setup.

It takes some getting used to sleeping with an ASV as just as you are dropping to Sleep it gives you a blast of air that wakes you up until you learn to breath smoothly as you fall asleep. The ASV is much more comfortable and natural to use than an ST

So I got my Aircurve 10 ASV and and looking my script and it doesn't make sense to me after looking in the settings and things don't add up.

Doctor/nurse wrote the following:
Min EPAP: 7
Min Pressure Support: 0
Max Pressure Support: 5
Max IPAP: 14
Rate 8

Ony thing I see is Min/max EPAP and min/max PS on the machine. I also don't see a backup rate to set, but I know these work different. I've been running 12/7 on the PR ST with backup rate of 8.

They are bound and determined to make you use those ST settings. That's pretty much what they set it at except they should have made it PS min and max of 5 to be just like the ST.

The backup rate is automatically determined by an average of your breathing rate over a little bit of time. I want to say 3 minutes but I can't swear to it. I don't have the documentation right in front of me.

By limiting PS to max of 5...it can't deal with the central apneas. Somewhere between 8 and maybe 15 is needed to adequately breathe for you when centrals happen BUT whatever it does will only be done IF/WHEN you need it and not with every single breath.

How about we try something simple and see what the machine wants to do when it can do something? It won't do anything without a good reason.

Minimum EPAP 7
Maximum EPAP 15 (you get this choice in Auto SV mode...the other mode won't have it and EPAP is fixed which you don't want)
Minimum PS 4..
Maximum PS 15 (this is what treats the centrals and it will only do what it thinks you need)

This will start you out at 7 exhale and 11 inhale and then once asleep the machine will add in more PS if it needs it and will auto adjust EPAP upwards for any obstructive stuff that happens.

pages 17 to 31 is the ASV stuff
https://www.resmed.com/us/dam/documents ... er_eng.pdf

So with settings I could see EPAP max out at 15 and IPAP at 19?

My biggest struggles with my first attempt at treatment were exhaling against the higher pressures with auto cpap use. Bipap treatment has been much better with the easier exhaling, but of course I've been fixed at 7. I'm guessing I'll wake up struggling if EPAP jumps to high. Oddly enough I have not had a single CA since the doc had me drop my backup rate from 10 to 8 on Monday which dropped my timed breath events a ton. Only 3 nights with that new setting, but AHI has also been between 4-5 in those days. I'd only hit sub 5 once before in over 6 weeks treatment.

I do see the clinical manual says this..."ResMed recommends that the Max PS should be set to ≥15 cm H2O (≥15 hPa)." so I'm guessing there is a reason for that. Still learning.

Use this for Auto setting's
Min Epap + Min PS = Min IP
Max Epap + Max PS = Max IP

Chances of your max EPAP going to 15 max are slim and none IMHO.
You won't need anywhere near that to control your OSA side of your problem. The reason I am pretty sure of this is that on the ST machine you really didn't have a truckload of OAs/hyponeas that would lead us to believe that the 7 EPAP you were using wasn't doing a good job.
I would be surprised if you EPAP goes up to 11...I just don't see you needing much more EPAP than the 7 you are/were using.
You were having mainly hyponeas and we didn't know if they were central in nature or obstructive but either way the machine will figure it out and give you either more PS if it thinks central and a little more EPAP if it thinks obstructive..
Let the machine sort it out and just give it some room to do the sorting.

Hyponeas that are obstructive in nature are usually fairly easily dealt with anyway with just a little more pressure either in the form of EPAP or IPAP.

This might be a dumb question, but the seller sent me a Climateline Air "OXY". Is it safe to assume it works the same as the normal climateline air tubing? I didn't want to open the package if this was a mistake.

The Oxy hose will work just fine. Just plug it in and the machine will recognize it and make the necessary adjustments for the hose diameter difference. You don't have to do anything in terms of hose selection in the menu.
Only time you need to choose diameter is with a non heated hose....ResMed machines recognize their heated hoses and do the choosing for us.

It's actually probably recommended for people on bilevel machines when pressures might tend to go higher but it isn't mandatory or limited to just only higher pressures.

When I titrated myself I used those settings that Pugsy gave you and the only setting I played with was the min epap, and I settled on a min epap of 6.8. I must of done something right cause my AHI is zero about 95% of the time.

tsduke wrote: ↑

Thu Sep 19, 2019 4:03 pm

So I got my Aircurve 10 ASV and and looking my script and it doesn't make sense to me after looking in the settings and things don't add up.

Doctor/nurse wrote the following:
Min EPAP: 7
Min Pressure Support: 0
Max Pressure Support: 5
Max IPAP: 14
Rate 8

Ony thing I see is Min/max EPAP and min/max PS on the machine. I also don't see a backup rate to set, but I know these work different. I've been running 12/7 on the PR ST with backup rate of 8.

Those are STUPID ASV settings. stupid stupid stupid.

minepap is fine, min PS is fine, maxps should probably be 15, and maxiap 25. there is no rate on a resmed asv, they're smarter than that.

Do they make any better sense if it were for a different brand of ASV type? I'm gonna hope the nurse screwed up because I know she was the one that actually wrote it out.

No, not really all that big of a difference between ASV brands.
The Respironics does have a separate back up rate available but other than that...the settings would have been the same.
She was trying to keep the ST settings and not letting it go auto and she would have done the same on a Respironics ASV machine.

tsduke wrote: ↑

Thu Sep 19, 2019 6:56 pm

Do they make any better sense if it were for a different brand of ASV type? I'm gonna hope the nurse screwed up because I know she was the one that actually wrote it out.

No, they don't.

She has no idea what she's doing, apparently.