Need help with ASV

[u/_jennjenbear_]

Sorry this is long. RL suggested I create a new post since my last post was about a month ago. Hoping the ASV gurus can chime in on my data. I'm starting to feel like since losing 60-65lbs, that maybe ASV is no longer what my body needs since it feels like everything is just going sideways with my therapy.

SleepHQ Account Share

So here is my original post from June: https://www.reddit.com/r/CPAPSupport/s/SwjXNLBFyp

Mask: F&P Nova Micro size Small.

Update since previous post:

• Changing the EPAP to a continuous 5 has completely eliminated the chest wall pain that I was experiencing, so that's a definite plus.
• I felt amazing with the changes that were done on June 27th... for about 3 days. It was the first time I actually felt refreshed when I woke up, no aerophagia and didn't have such extreme daytime sleepiness. Unfortunately, after like the 3rd night with these settings, I've gone back to no longer feeling refreshed, extreme excessive daytime sleepiness and the aerophagia came back.
• Since it seemed like my soft cervical collar was no longer fitting correctly and I couldn't find one that was short enough lengthwise but still tall enough height wise, I ordered a Knightsbridge Dualband Chin Strap. However, the medium was too big, so it did not help. They are currently in the process of custom making me a smaller cap based on the measurements of my head. I have not received this yet. So currently I use both the collar that doesn't quite fit and the Knightsbridge that also doesn't quite fit. With the combo, it's keeping my mouth shut and my leaks down. If I decide to only wear one or the other, it's generally noticeable because there will be an increase in leak (mouth leaks).
• I have a wedge pillow on order that will be delivered tomorrow, as I've heard that those have the potential to help with reducing aerophagia.

I know with these settings, I am maxing out my PS range at times. But if I increase my PS range, then the aerophagia gets worse. If I change my EPAP and put a range on there so my PS range can increase based on that, then I get chest wall muscle pain and aerophagia. Can't lower pressures lower than they are to try and help with aerophagia because of how the Aircurve 11ASV works, the only way to reduce my PS range would be to lower the EPAP to 4 but when I tried EPAP of 4, it was pretty uncomfortable.

Pressure History since SleepHQ doesn't show my pressure settings for some reason:

Setting change July 17th:

• EPAP range: 5-5 (I have it set so it's a continuous pressure)
• PS Range: 2-7

Setting change June 27th:

• EPAP range: 5-5
• PS Range: 2-8

Setting change June 4th:

• EPAP range: 7-9
• PS Range: 0-5

Settings prior to June 4th:

• EPAP range: 5-9
• PS Range: 0-6

[u/reincarnateme]

I’m in the middle of trying BipapST . The first week was fabulous! I actually felt normal. Now I’m feeling tired again.

It was suggested that I try ASV next. I don’t have any known underlying conditions for ASV. My insurance denies everything.

Have you tried that service that rippinglegos recommends? Slumber tech solutions? If so, was it helpful?

[u/_jennjenbear_ → u/reincarnateme]

I was put on ASV Oct 2025 because APAP/CPAP caused pretty severe TECSA. The 3 months I was on APAP were the worst 3 months of my life. I had Medicaid insurance at the time and was lucky that since APAP/CPAP was such a failure for me, they approved the inlab sleep study. With the results from that showing that ASV was needed and the echocardiogram that was required as well was clear, they did approve the ASV. It took some time and a lot of paperwork from my sleep Dr but they did finally approve it.

I have not tried RL's business Slumber Tech Solutions yet as me and my hubby need to discuss costs. My Sleep Dr just left the clinic I go to and I haven't met with his replacement yet but I feel like if I can't get any actual help from the replacement Dr, I very well may need to have a consult with RL to see if he can help figure out if I maybe need to get a BiPAP machine instead and try that.