ASV Machine

[Sleeprider]

It's nice not to see the hypopnea, but they are reductions, rather than cessations in breathing. Kind of hard to evaluate their health impact without oximetry, however how you feel really does matter. What I am encouraging you to do is to focus on a trend rather than a night, and how you feel rather than what you see on a chart. It might help to just take a couple notes over your morning coffee to reflect back on what you think your sleep quality was like. Do this before looking at charts. Your AHI is running 2-3/hour and that is pretty darn good compared to where you came from. In addition, the events are not as severe. If I may be your example...I do not know what my AHI was last night, but I feel pretty good. I might check my data later or next week. If I sensed something is wrong, I would probably have looked for a cause. Otherwise I'm about my day and don't worry about it.

[LarryRapp]

Ok, basically when I eliminated the CA's it made a BIG difference.  I'm still rarely sleeping an entire night without waking up but I am sleeping better than I did.  

I have to keep these messages short because something is wrong with this computer and I lose stuff.

[Sleeprider]

Good luck with the computer. I'm working on an exterior basement door that was installed wrong, and it looks like I'll have to replace the door jamb. We all have breakdowns, huh?

Larry, I don't think settings will make a huge difference in your results at this point, but time will. Some people start ASV and get near-zero AHI, but many people need to heal and undo years of poor sleep and central or complex apnea. You have been at this just 2 weeks, and your progress is pretty darn good for that short period of time. Meanwhile, we are racking up nearly 8 pages per day of forum posts that I think are more confusing, conflicting and worrisome, than helpful. Let's leave the settings alone for a while and focus on the therapy, and you can relax and let it happen. If something needs to be done, I'm sure we will know it.

[LarryRapp]

Thank you, Sleeprider!  I think you're right, I just need to work on my mask.  On myAir I'm getting really good results!  Next week I should have the new mask and an elevated hose holder.  We'll see.  

Wish I could help you with the door.  I used to be very good with stuff like that!  One of the saddest things I have to deal with is my shop.  I have the most incredible shop - EVERY power tool except a lathe and now that I have it, I can't use it!

[Sleeprider]

I recommend getting back into that shop as soon as possible. The hinges on this exterior door separated from the jamb. The screws only penetrated the jamb and there is no wood frame backing it up. This apparently is not the first time, and the top hinge set actually has wall-anchors holding the screws in. To me, that means taking the whole door apart and properly framing the jambs and reassembling with new material. My first inclination was to epoxy reinforce the screw-holes and use larger screws, but the jamb is too damaged.

I have downsized my shop and use mostly hand-tools, but have some pretty good saws, mitre equipment and routers. What I don't have anymore are table mounted joining equipment, so while I can recess hinges, the accuracy on rabbeting and joining is not up to par as compared to when I could do cabinetry. Do what you can, when you can do it, and keep your fingers in sight.

[SarcasticDave94]

FWIW it took me 2 solid months on the ASV to even begin to feel better. Once I had input on some initial settings, and saw the decent results, I think it was the same first 2 months before I edited my EPAP. I actually only did that because I felt like I was getting too little air.

Sleeprider has a great suggestion, which is let some time pass and let the ASV do it's thing. Trust me on this, Larry. Within a few days or a few weeks, you will really notice you are feeling a lot better. Have a great Sunday evening.

[ajack]

Ajack - the mask I am using is a medium 20 with foam.  My nose touches sometimes.  ResMed says to try the next size larger and I've got one ordered.  I think I should at least try it.

Yes, by all means try their next size, but I meant the type of mask you used was a lot better than the other one. It gave you a lot less leaks

I take a different view to sleeprider, I think the manufacture titration guide should be followed as a first choice. After all, it is what the procedure is in a lab.
You can see the bottom line in the pressure chart rise to these events, this is the min epap line. The epap is rising to these events, so the machine is responding. I know you are in a difficult position with people telling you different things. I would follow standard ASV protocol until otherwise indicated and continue to raise the min epap. As i said, I think once you are around 7-8 you should see an improvement, I doubt you will need 9.

I wanted to tackle one thing at a time. Where I do think that a higher min PS may help you, is the 18 breaths per minute and the lower tidal volume. I was going to get you to see your doctor about it next time you went, I did mention it in my first post. I think the maximum PS in the minimum setting is PS:6. So the doctor has some leeway.

[LarryRapp]

We should probably discuss your door in email.  Mine is rapp@lmr.com.

I will never be able to use my shop and tools unless they cure my palsy.  I shake far too much and have for over 10 years.  Damn!

[LarryRapp]

This is last night.  Nice!

[SarcasticDave94]

Hey that's not bad at all, Larry. Is it helping change how you feel yet? Just be aware a no answer right now is OK too, because you have a sleep debt to pay back before you feel improvements. Biggest help I can pass on via experience is Don't Quit. Not saying you are thinking that, but just passing on what I had to encounter in similar situation. Best wishes for all the near future success.