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Tweaked settings again to: Epapmin=5, Epapmax=9; Psmin=1.6, Psmax=6.6. AHI dropped top 0.84.
But more flow limitation, which seems tied to more leaks that I can feel on my eyes. My wife complained too about the sound of the leaks, presumably from the episode around 5Am. I try fiddling around with mask, but sometimes can 't get it to stop leaking at the peak inhalation pressure. Also, with these small increases in Psmin (from 1 to 1.6) and EPapmion (from 4 to 5), the sensation of the machine blowing at me returned.
The change in respiration/volume/leak at 2:40 coincides with me waking up. I remember looking at clock. I probably woke because of the leaks onto my eyes, but can see I made an adjustment to mask and leak reduced.
So, not sure what to do: 1) just keep using at present setting and try to get used to it (ie don't worry about flow limitations). Also try to adjust mask to eliminate the annoying leaks, or 2) make more adjustments to settings?
A month ago, I would have been over the moon with AHI=0.84, but it's not a very comfortable sleep yet.
Hi, as an update: after a little to and fro with sleep dr, decided to stop using ASVauto and switch to ASV. It is way more comfortable because the high IPAPs that were driving me nuts are eliminated.
Currently using EPAP=6.6, PSmin=0.4 PSmax=5.4
Last night's is pretty typical with no OSA and hypopnea ~1-2 (note I had a nap earlier due to getting up early to fish, so I tried to cut that off the plot but I guess the AHI includes that earlier afternoon period)
When I look at the hypopnea events in detail, it is clear that the ASV is responding, and I presume the cluster of events that would have evolved into CSR/CA previously on cpap are now controlled.
But, is there more fine tuning that can be applied to get rid of the hypopneas? With no OSA, I guess EPAP=6.6 is fine, so that would only leave adjusting the PS limits?
(as an aside, I ditched the ESON2 nasal mask and went back to the Dreamwear gel pillow, which has pretty much eliminated any leakage issues).
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Not really. The positional apnea article in the Optimizing Therapy article shows the same pattern in ASV with before and after dealing with the positional issue. Yours should be no different. You have plenty of room to increase pressure, but I assume that is not the direction you choose to go. If this is not positional, the EPAP would need to increase.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Maybe this will be my last post: I seem to have dialed in the ASV settings and regularly have AHI<1. I find this incredible, especially considering that not long ago I was getting 15-20 Centrals on CPAP.
Sleeprider: the best advice I got was to get a second hand ASV and give it a go. I did somehow manage to get on top of the positional episodes without resorting to soft collar.
So, all good now. Great board, great advice, great community (loved that somebody posted how to change the battery on the S9)
Really appreciate the feedback Harry! Glad the used S9 worked out. That should help to set you up for your doctor's support on a future replacement. Have you discussed the success with your doctor? If you don't mind, I'd like to know the model number (REF#) for your machine. The charts show a S9 Adapt PaceWave, and so you did get a more advanced ASV.
I think many people find a solution to positional issues without the need for the collar. It's always my first recommendation to think about sleep position, and possibly use a flexible low-loft pillow and pull it between your shoulder and jaw. Works for me.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Hi Sleeprider,
the Ref is 36377, which I believe is an Australian model of the S9 pacewave adapt. For your info, I got it with only 800 hours on it, but with a dead battery (wouldn't hold the date and there was spurious recording of settings).
Yes, been in communication with Dr. Coincidentally, right after I got the 2nd hand machine, he sent a prescription for the ASV but was happy that I already had a cheaper solution than buying new. I think he is a little astounded at the low numbers now. He maybe is more on the practical side, with achieving <5 and even 5-10 considered to be an acceptable outcome with a much less fancy CPAP machine.
