AutoSV data interpretation assistance needed

[Sleeprider]

The desaturation is a sharp spike with nearly instant recovery and looks like a signal loss to me. There is a general desaturation at that time, but I don't think the minimum there is accurate. It doesn't make a lot of sense, because obstructive apnea normally arise out of EPAP pressure being too low, and it was raised by 3-4 cm with these settings. I was operating under the theory that your events are obstructive rather than central and a range of PS between 4-cm and 6cm should provide for ventilation needs without affecting efficacy. Anyway, I am as surprised as anyone.

[PappaJoe]

Thanks to Apneaboard wiki, I'm able to sync my [out of date] O2 ring data and PR AutoSV data!
But now the time shows 2hrs ahead. 
No matter.
I forgot to mention earlier; there is a v-com in the line.

Started the night with a Full face mask, but strap came loose after dozing off. No need to show that data.
(I must confess, cocktails may have been a contributing factor)

AirFit P10 large pillows
No humidity chamber (I'm a bit dry)

       

Better, I'd say. Any thoughts?
Actually, this looks much like the first night's chart with the AutoSV, giving me hope for improved PAP therapy.

The breaths appear to have a 'front porch'. I don't know why.
Any comments are welcome.
All suggestions will be entertained.

[PappaJoe]

Sleeprider - I missed the earlier post about O2 Ring.
Yes, O2 Ring error seems more likely.
I'll keep that in mind when i see these low numbers.
Thanks again, Sir

[Sleeprider]

Looks good to me. What are your thoughts on comfort? Do you think it was mostly related to rise time?

[PappaJoe]

Sleeprider:
Don't know about the effect of RiseTime change...but will run it through a test cycle.


Hopefully these results will repeat over the next several nights.
Will definitely try without the cocktail kicker.

Can you explain this in terms I can understand?
   The machine is "BiPap AutoSV Advanced"
   So, to be clear, at these I/E/PS settings, is the machine operating as BiPap or AutoSV?
   Nothing I've read so far says how to switch between the modes.

Nice job, Sir
Many thanks

[SarcasticDave94]

This is an Auto SV, which is within the BPAP class.

To change modes, access clinical menu.

https://www.apneaboard.com/pr-system-one...structions

[Sleeprider]

As Dave said, you are currently in AutoSV mode. The changes we tried without success were more closely BiPAP Auto because we limited PS to a narrow range. You can see in your chart that you generally operate with a relatively narrow EPAP range and PS, but there are about 5 periods where you may be experiencing the Auto SV mode. Your most recent chart shows you spent the whole night at EPAP 6.0, the only exception being the increases built into the algorithm to test up to 1.5 cm higher. Your PS remained at the minimum except for 06:20, 07:05, 07:22, and 3 blips at 08:50. I originally concluded you should tolerate BiPAP pressure, but your result yesterday suggested, there is no harm in giving you the SV mode and larger PS spread. If you were using a Resmed, I would strongly recommend the Vauto rather than the ASV, but the Philips is slow enough that it acts like a BiPAP in both modes.

[PappaJoe]

Sleeprider - 

You said: "but your result yesterday suggested, there is no harm in giving you the SV mode and larger PS spread."
Does this mean that I should try increasing the PS spread?
And, so I'm in SV mode?

I'm 75.
Before starting PAP therapy last August, I struggled to stay awake while driving, even short trips.
It came down to trying CPAP or turning in my driver's licence.
Now I take long drives. It has been a quality-of-life changer.
So PAP's value has not escaped me.

Nevertheless, I'm still not at the top of my game.
I know that there is improvement ahead if I don't settle.
So it's YouTube videos (over and over since the ol memory is not what it once was). 
It has become obvious that this is an extremely complicated topic.
And my professionals apparently cannot afford to take the time to provide complete and ongoing diagnosis and treatment recommendations.
Consequently, I cannot express my appreciation enough for the unselfish dedication to providing PAP guidance and solutions y'all at Apneaboard offer.
Thanks one and all.

[Sleeprider]

I'm 70 so not so far out, and my experience tells me every individual may not meet my expectations in how they respond to therapy variables, That sentence has a lot to unwrap. I have learned to let individual response rule over my expectations.

[SarcasticDave94]

Here's a thought to consider, and it came about by what Sleeprider reminded me regarding this being a Phillips Respironics. What if you were to attempt tuning it as if it were just a BPAP? We know it's an Auto SV, but maybe we can leverage the PR slower response.

I'll need to review what the setting trend has been, but settings as if we pretend this were VAuto or similar PR. Whatever that translates to, as I've never ran a VAuto, but moderate ranges in EPAP and PS. As I recall, this Philips Respironics should have some timing control settings. Would that set PappaJoe on the right track?