Bilevel ASV - Resuming After Septoplaasty

[Dread]

Oh I had a thought. You mentioned on another thread, asv can cause poor sleep due to the rapid adjustment of pressure, that could be it maybe? I slept good on ST, but ST didn’t adjust constantly. It was more fixed.

[Sleeprider]

ST is a fixed bilevel and can feel very artificial. You started this thread on ST and it wasn't pretty. ASV is the correct therapy since you failed CPAP and bilevel without backup. With ASV your therapy has shown generally low AHI and a much more normal respiration in spite of occasional periods of changing respiration rate and volume. I had to go back through this thread to get centered on the issues. You have good therapy results, however your respiration remains variable. We don't have controls on a Resmed ASV to set respiration rate, volume or time of inspiration, so there is very little actually that we can manipulate other than the EPAP and PS ranges. What is the reason you failed CPAP and bilevel without backup? Do you have central apnea or was the problem an issue with maintaining spontaneous respiration and volume? We really need to look at how your arrived at this therapy if we're going to consider perhaps something like AVAPS or iVAPS which is an intelligent ST machine. We also need to keep in mind your AHI is nearly zero and the apparent concern is this spontaneous shift in respiration rate and volume that occurs periodically. I don't know if we can answer that question without more health information or from Oscar data. To me, this appears outside the control of the current therapy, an I'm not sure we can impact it even with an alternative.

[Dread]

I failed bipap without a back up rate because of central’s yes. My sleep study showed TECSA that got worse until I got put on ST. Apparently no matter the pressure on bipap, I kept failing it. I’ll post today’s oscar

[Dread]

Yeah, I notice leaks and was wondering if that’s causing poor sleep. I got blood work and my Testerone is 400, Progesterone high and low LH. Maybe that as well.

[Dread]

Heres some good data. One thing I do notice. Every time I wake up, its after a big pressure drop. What can you do to mitigate it?

[Dread]

Hey sleeprider, i think I figured it out. I noted on the apple watch times I wake up, and they are the same as flow limitations on OSCAR. What should I do? They are waking me up out of sleep. I notice I only get 2 minutes of deep sleep.

[Dread]

Hi all, just got done with septoplasty on the 15th, and packing finally came out. My surgeon said i could start positive air pressure again, but my AHI is not looking good at all. Im not sure if its positional apnea or mouth breathing. Anyone mind taking a look? Im still mouth taping, wondering if i need to start chin strap? ive started to put my tongue on the roof of my mouth as before it would just fall during my sleep and stay down because my tongue tie.

[Sleeprider]

First of all, I'm tempted to merge this new thread with your previous one so we can all catch up on the history.  When we left off, you were doing fairly well with an EPAP of 8.6 and PS of about 3 to 8 cm.  Now you're at PS 6 to 14 with massive leaks and a lot of positional obstruction.  How did you get into this when you were doing just fine before?  

[Dread]

Unsure. My sleep doctor wanted to open up more of a range on the ASV. i have been rolling over to my side for first time, before i just slept totally on my back? could that be it?

[Dread]

For a while 6-14 has been fine. AHI of 0-1.
Its just right after my surgery ive been having such massive AHI.