Ashleybjerke - Therapy Thread

[Ashleybjerke]

I recommend ASV EPAP 8 pressure support 3-15 this is the recommendation that they gave me is this a high amount is this a low amount what does it mean?

[Ashleybjerke]

Study start time was 08:55:34 PM. Diagnostic recording time was
9h 26.0m with a total sleep time of 7h 16.5m resulting in a sleep
efficiency of 77.12%%. Sleep latency from the start of the study
was 55 minutes and the latency from sleep to REM was 126 minutes.
In total,42 arousals were scored for an arousal index of 5.8.
Respiratory:
There were a total of 26 apneas consisting of 0 obstructive
apneas, 0 mixed apneas, and 26 central apneas. A total of 18
hypopneas were scored. The apnea index was 3.57 per hour and the
hypopnea index was 2.47 per hour resulting in an overall AHI of
6.05. AHI during REM was 5.3 and AHI while supine was 5.60.
Central apneas accounted for 59.1% of total respiratory events
Oximetry:
There was a mean oxygen saturation of 92.0%. The minimum oxygen
saturation in NREM was 83.0 % and in REM was 87.0%. The patient
spent 43.9 minutes of TST with SaO2 <88%.
Cardiac:
The highest heart rate seen while awake was 94 BPM while the
highest heart rate during sleep was 84 BPM with an average
sleeping heart rate of 60 BPM.
Limb Movements: There were a total of 0 PLMs during sleep which
resulted in a PLMS index of 0.0. Of these, 2 were associated with
arousals which resulted in a PLMS arousal index of 0.3.

Titration: CPAP was tried from 5-8cm H2O. Bipap was tried from
12/8-14/9cm H2O. ASV was tried with EPAP 8cm H2O, Min PS3cm H2O
and Max PS 15cm H2O.
This was a fully attended sleep study. This test was technically
adequate. This patient was titrated on CPAP starting at 5 cm of
water pressure. Patient was titrated up to ASV EPAP 8 pressure
support 3-15 cm of water pressure. Patient did best at ASV EPAP 8
pressure support 3-15 cm of water pressure. Patient spent 60
minutes at that pressure and the AHI was 1 which is considered
treated sleep apnea.

Impression:
1. Patient used CPAP, BiPAP and ASV during out of study
2. Nocturnal hypoxia seen on CPAP with time at or below 88%
saturation of 44 minutes
3. Meets for complex sleep apnea with central apneas accounting
for greater than 50% of total respiratory events
4. Oxygen saturations appear to normalize with ASV therapy

Recommendations:
I recommend ASV EPAP 8 pressure support 3-15 cmH2O. Patient used
a medium Vitera mask during night of study.

Thanks for your help, I just don't know if this is a high amount if it's a low amount or what it all is.

[Deborah K.]

It means that you have a lot of Central Apneas, plus lower amounts of other apneas.  Because of the high Central Apneas, you need a special machine that can deal with those as well as other more common apneas.  It's called an ASV Machine.  You for sure want to request that your doctor prescribe a ResMed AirCurve 10 ASV.  That is the best one.

Best of luck with your upcoming therapy!  

[Ashleybjerke]

So is the number that they requested a high amount of air pressure?

[Ashleybjerke]

Also when I first did my sleep test it was a lot worse than this it was 188 hyponeas and 89 Central apneas threw 8.5 hours I guess my ahi was 37 so this stuff after the situation is significantly lower I think I read 4.6 ahi... I'm just really confused and curious if the amount of pressure that they requested I think it was eight is a high amount and the backup pressure I think is what the other number was is also a lot ..

[Jay51]

Those are pretty common starting pressures for ASV.  

8 is the EPAP (this pressure is fixed and keeps your airway stented open).

3-15 is your pressure support.  Pressure Support (PS) is added to your EPAP.  So when you are at 8 epap, when your ps is 3, then your IPAP is 11. 

IPAP is the maximum pressure when you are inhaling to help you breathe.  

Since your maximum ps is 15, then 8 (epap) + 15 Epap = 23 Ipap (max pressure). This is pretty high, but hopefully you won't reach it when you use your asv. 

We can always fine tune your ps max down a bit.  Or fine tune your epap and ps min also.  

I read your other thread with your sleep study results in it.  It would be best to keep your therapy threads together in one thread so that all readers can look over all of your information and give the best suggestions.

[SarcasticDave94]

You can also change your ASV to ASV Auto mode, netting you an EPAP range, where instead of 8 EPAP you might try 8 min 12 Max. It may enhance comfort.

[OpalRose]

Ashleybjerke,

I have merged both of your threads as they relate to the same subject. This makes it more efficient for others to offer you targeted advice in one thread.

[Ashleybjerke]

New to ASV it's really weird after I use the machine and take it off the whole next day I feel like it's still breathing for me like it doesn't feel right if that makes sense so it kind of feels like it's pushing the air in and out like it does when it's on but during the day and that causes issues for me during the day with shortness of breath is this normal or does anybody else have this happen to them?

[Crimson Nape]

Ashleybjerke - Your 2 threads were related to your therapy. For this reason, I have merged them. This provides the reader a history of your past settings and results. Having the ability to see past attempts and their results will help to form better recommendations. Please use this thread for all your therapy related posts.

You need to fill out your profile to display the equipment and any software you may be using. You can use the "UserCP" (User Control Panel) link in the upper right of any page to enter your profile. Here is a shortcut to help: https://www.apneaboard.com/forums/usercp.php
- Red