Breathing Pattern Disorder During Day, ASV?

[Try00]

Hi everyone!

I came here seeking a bit of help. For the past year, I have been dealing with pretty severe shortness of breath/air hunger during the day. I have been working with several specialists (pulmonologist, cardiologist - seeing a neurologist soon) but not able to figure out what's wrong as of now.

During the day it seems my body forgets to breath and I have to play catchup by taking a deep breath. I was wondering if anyone more knowledgeable than me can see if I'm having any type of abnormal breathing during my sleep? I did have a BiPap titration study last week but they're telling me I won't be able to see a doctor for another 2 weeks to get the results, which is frustrating. Just trying to educate myself and get to the bottom of what's going on.

Included 2 images. 1 standard how I read it was requested to be and 1 I included the respiration settings (unsure if that could help shed light on anything)

Thank you in advance for any help!

[SarcasticDave94]

Daytime breathing issues might be found with the pulmonary function test. The pulmonologist should be able to get it ordered. Any idea where your oxygen levels are?

To me, the OSCAR charts look decent.

[gainerfull]

Looks like you could use more minimum pressure and I'd work on the mask leak (it's constant).

[Try00]

Hey! Thanks for the reply. All pulm tests have come back normal. O2 levels are always fine throughout the day. Unsure about at night!

Not really sure where else to go with it medically. Been a journey for sure. Thanks for the help

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Looks like you could use more minimum pressure and I'd work on the mask leak (it's constant).

Will make these adjustments tonight! Thanks for the help

[Try00]

I wanted to update with last night's data, I adjusted EPAP to 7 and increased the trigger from high to very high.

I have a follow-up question:

Would I qualify for an ASV machine? If I left trigger on medium I would normally have been 10-15 AHI (central). Increasing the trigger makes it look treated on paper but I don't feel treated. Still very tired in the morning. I also wear an Oura ring, which shows I have lots of drops in my O2's throughout the night. It doesn't go into specifics though, which is a bad feature. 

I found a deal on a used ASV online and was considering ordering it but worried about not knowing what settings to use and causing more problems.

[SarcasticDave94]

Is the ASV in mind because V is ventilator in Adaptive Servo Ventilator?

This ventilator action is only useful for breath jump-starts during Central Apnea treatments. It's not really going to breathe for you like true ventilation will.

If that's what you're after, ResMed AirCurve ST-A or ST are closer to that. ST though is rather stupid and issues static EPAP and IPAP but can be timed for backup breath rate. ST-A can be set to be a mini ventilator running iVAPS, ResMed version of AVAPS.

If you are needing something daytime and night, full ventilator is probably better. They aren't exactly compact but do have internal batteries, and connections for external.

If any are best for your use and need, I'm not yet certain honestly. I do think ASV will fall short unless it's just CA treatment as it's designed for.

[Try00]

I did not have it in mind for that specific reason. I am nowhere near the point where I need a true ventilator. I meant strictly from treating the CA's. I wake up a lot in between the point of being awake and falling asleep because I feel like I stop breathing during the transition. Why the trigger function has helped, I feel as if it's not addressing the underlying cause.

[SarcasticDave94]

ASV will treat Central Apnea. I've used it for 2 years in '17-19. From tested 124 CA a night in the PSG diagnostic to almost zero CA per night is what ASV got me. Total AHI per night was 3 or less on same ASV.

You certainly can buy the ASV, trial it and if it works for you great. If it doesn't resell somewhere.

[Try00]

Awesome went ahead and ordered it. Will probably make a post once I try a night with it to help with the settings. Thanks for all your help

[SarcasticDave94]

Heads up on settings. As a former ASV user, you'll want this:

ASV Auto mode
EPAP 5-15
PS 3-15
IPAP isn't manually set, but it's the sum of EPAP and PS that moment

Your EPAP Min can also be 6 like you're running now if that's what you want to start at.