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ASV: AHI zero, flow limitation mucho
#1
ASV: AHI zero, flow limitation mucho
Hey good people of the Apnea board,

I've been trying different pressure settings for my Resmed ASV(auto) machine for a while now and I think I have to draw the conclusion that it's failing to help. A quick background:
  • CPAP: Using it with EPR showed inspiratory flow limitation, and could not tolerate exhaling against the pressure.
  • BiPap: Used 14Ipap, 10 epap), I would still notice a lot of apnea's, hypopnea's and flow limitations: imgur.com/a/qz0DiYT
  • ASV(auto): much more comfortable breathing with neglectible AHI, still disordered breathing: imgur.com/a/OhnFVrZ
  • DISE/Sleep endoscopy: 75-100% collapse of the eppiglottis, velum and tongue base with and without MAD device + mallampati 4 tongue
Since I have been using PAP therapy for a number of years now, without a noticeable improvement in my symptoms I had an appointment with a maxillofacial surgeon to check if it's the airways that are too narrow to blow open with pressurized air. He did notice crowding of teeth in the upper jaw and a narrow pharyngeal airway and has requested approval from my health insurance for double jaw surgery. Assuming I get the okay eventually, orthodontics and the surgery will take a while and until then I'd appreciate it if you could glance at the sleep data in the links and offer some feedback. 

Muchas gracias!
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