ASV software

JDS74 wrote:Looking at your graphs, it seems as if your machine is keeping the inhale pressure up near 20 cm H2O for most of the night in response to your central apneas. You might think about going back to your doctor and seeing if raising the maximum pressure to 25 cm H20 will help. The report of PTB% of 96% seems at odds with the pressure graphs. Without seeing the Encore Pro graphs, its a little difficult to tell when and where the machine is switching into ventilator mode. Perhaps there is another part of the graphs that shows that.
I think that I will have to download Sleepyhead and run a comparison.

It is basically gibberish to me at this point. This is the fifth day of treatment and they are all very much the same. When I was first diagnosed I was told I have 72.4 episodes an hour my SPO2 was as low as 78%. With central apnea, obstruct apnea and cheyne-stokes.

Well your obstructives seem to be under control. It would be nice if the number was zero but it is very low.
The centrals are not.
And there is also an indication that Cheyne-stokes breathing is controlled since the Periodic Breathing number is zero.
Your machine should nail the centrals and since it isn't, you need to look for why not.

1) What is your machine set to for the various parameters (see list of parameters below)?
2) In particular, what is the Back-Up rate set to? If it is set to a low number, then perhaps it is not reacting quickly enough to the onset of a central. Your machine has a selection between an actual number, such as 10, 11, ... and Auto. With Auto, it will react to a central within one breath interval.

Was your prescription written by someone most familiar with the ResMed machine and not the Respironics? If so, then many of the parameters got set to whatever the DME guessed they should be. Mine came that way. Do you have a copy of your prescription? Does it list all of these parameters? Do you know how to get into the clinician's menu so you can see what your settings are?
If not, PM me and I will send you the information you need to see them.

My current settings are:
Settings
Min EPAP: ..................10.0
Min Pressure Support:......7.5
Max EPAP:..................15.0
Max Pressure Support:....14.5
Max Pressure:..............25.0
Flex Setting:..................1
Backup Rate:................Auto
Humidification Mode:......System One
Humidifier Setting:...........5

Encore Pro v2.12 or higher is probably the best bet for now, that is, until Sleepyhead v9.6 comes out (supposedly soon and presumably it will support the newer model 960 PR autoSVs). SH v9.5x was known to have a lot of bugs regarding autoSV - however Mark was VERY clear in telling people that the v9.5 was a beta version for advanced testers only.

JDS74 wrote:
1) What is your machine set to for the various parameters (see list of parameters below)?
2) In particular, what is the Back-Up rate set to? If it is set to a low number, then perhaps it is not reacting quickly enough to the onset of a central. Your machine has a selection between an actual number, such as 10, 11, ... and Auto. With Auto, it will react to a central within one breath interval.

Was your prescription written by someone most familiar with the ResMed machine and not the Respironics? If so, then many of the parameters got set to whatever the DME guessed they should be. Mine came that way. Do you have a copy of your prescription? Does it list all of these parameters? Do you know how to get into the clinician's menu so you can see what your settings are?
If not, PM me and I will send you the information you need to see them.

My current settings are:
Settings
Min EPAP: ..................10.0
Min Pressure Support:......7.5
Max EPAP:..................15.0
Max Pressure Support:....14.5
Max Pressure:..............25.0
Flex Setting:..................1
Backup Rate:................Auto
Humidification Mode:......System One
Humidifier Setting:...........5

My settings
Min EPAP....................6.0
Min Pressure Support......4.0
Max EPAP..................15.0
Max Pressure Support...15.0
Max Pressure.............25.0
Bi-Flex........................2
BPM...........................4
I have never met or spoken to my doctor all communication is done through sleep center staff then reports are sent to doctor. When I was given my machine and the info gone over I was told I didn't have access to some settings or control over them. I can change humidity setting and ramp but that is about all.

Forgot to add it says auto on.

The problem is likely the BPM setting.
A value of 4 means that the machine won't react to some centrals for 15 seconds (4 breaths per minute).
So you get lots of fairly short centrals that aren't treated.
Changing that to Auto will likely help and won't hurt.

The rest of your numbers look in a normal range sort of way for an ASV machine.
If your machine would actually switch into ventilator mode, then you would see the max pressure get up to 25 some of the time.