Advantages of ASV

[stevew77]

I have been using a ResMed ASV for about 2 months. Since i have central apneas, obstructive apneas, complex apneas, and Cheyne-Stokes respiration, it has worked extremely well. Here are a couple of screenshots from OSCAR from last night. I use a video camera in infrared mode to watch my sleep positions and correlate with OSCAR. All of the clusters of apneas, likely obstructive, and hypopneas occur when I'm sleeping on my back, something I'm trying to eliminate. Without back sleeping my AHI would be close to or below 2. SpO2 is very high and consistent. I plan to get a device that straps around your abdomen and causes a slight discomfort when you lay on your back. The settings I'm currently using with my ASV, which have almost totally eliminated aerophasia, are EPAP: 5.8-10, and Pressure Support: 3-15. These are slightly higher than my doctor prescribed, but they work well until I can stop sleeping on my back.

[enigmatic]

Thanks for sharing this. I have a few observations and questions. My Dr. suggested ASV since I feel terrible, but CA are non existent in sleep study, only OSCAR shows some (still have low AHI under 2 mostly).

I also found that most CA do occur on back in middle of night and like your idea to correct it. As a stomach sleeper, I think I get hot and rotate and throw off blankets landing on my back subconsciously.  But I also found something else interesting, which is looking at MOST of my CAs when zoomed in on camera, I can clearly see my abdomen breathing in and out, another reason I question them (I think for a true CA your abdomen should stop oscillating). I also try to correlate those observations with the 'junk' erratic signals just prior to CA events. Have you looked at that at all (visible stomach breathing oscillations still oscillating though app event flow rate shows flat line)?

And also, your Sp02 looks really good. Did you have more noticeable dips and volatility before ASV? On CPAP?

Also, please let us know what device you get to train avoiding back and if it works well.

[stevew77]

You are correct that moving of the thoracic and abdominal muscles, out of phase however, suggest obstructive, not central apneas. I did have much greater drops in SpO2 levels using the ResMed AirSense 10 AutoSet compared to the ASV, especially compared to the most recent settings on the ASV.

This is one of the devices I am considering to buy to avoid sleeping on my back. I tried the ball types, but could not tolerate them.

https://www.amazon.com/WoodyKnows-Upgrad...274&sr=1-8

[Sleeprider]

Steve, the UA cluster in the chart above is obstructive, and persists in spite of the EPAP rising to your highest setting. I'm pretty certain the event is positional, and you may want to review what conditions precipitate the clusters of OA/UA that are the only problem I see.

[stevew77]

I agree. The clusters of obstructive apneas are occurring when I sleep on my back. I do so when I am asleep and am trying to stop, but sometimes it happens. I am planning to order a device which has a pad that is vertical on my back to make it uncomfortable to sleep in that position. If I can avoid sleeping in the supine position I should have very few apneas or hypopneas.

[Sleeprider]

On most charts, you will find the mask pressure more helpful than pressure, especially in zoomed shots.  This lets you see the pressure following spontaneous respiration and lets you see when the pressure support is at a very high rate, but respiratory flow does not respond.  Good luck with the positional therapy.

[stevew77]

What the ASV does when I turn onto my back (spine position) and start having obstructive apneas and hypopneas? Close to magic.