Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.
Login or Create an Account
Hi, the AFib never keeps me awake. Having been in constant slow AFib for more than 10 years, you get used to it. But, when I get up after a bad night of apnea, I am more aware of my AFib. I wonder now if it might also be an elevation of BP as a result of the apnea that then magnifies AFib sensation. My BP is certainly higher on mornings when I sense the AFib. The sensation of the AFib is a hard to describe: not discomfort but more of a low level tension/chest tightness. All the papers I can find about AFib/apnea say they are related but it's not clear direction of causality. My cardiologist says that whatever predisposes me for AFib also predisposes me for apnea, so there is something else causing both in his view. I wouldn't be surprised if episodes of prolonged slow heart or episodes of wild AFib are involved or co-occur at onset of CSR but no one has ever diagnosed that or mentioned it to me.
Regarding male/female AFib sensation: from what I have read, a lot more women compared to men have "silent" afib. I am aware 100% of the time that I am in Afib 100% of the time. It's just not uncomfortable (unless I try sprinting on my bike).
Thanks for the link to delete old attachments. Will get onto that now.
OK, I deleted some old attachments. The report of the overnight titration study is attached. I do note some inconsistency where in one place it says optimal CPAP P=8 and in another to use P=6. Otherwise, not sure of utility of the study. Maybe somebody else has some insight as to whether there was much useful data from the study? The info on O2 desaturation (which doesn't seem that bad) doesn't seem to meaningful because there weren't any apnea events. In another post, I'll attach last nights Oscar data and CA's are back.
It doesn't seem like there are a lot of second hand ASV machines in Melbourne. I found a site sleepoz.org.au that has one and another on facebook market place. I guess the market is a lot smaller in Australia than in US.
Here are the Oscar graph's from last night. There is a full time series and a couple of zoomed in episodes. One is where respiration pattern changed dramatically and flow limit was up and then dropped (not sure what's going on?), and the other is from the cluster of CAs later on. There is periodic leaking in phase with the peak inhalation but are those leaks big enough to matter?
(08-23-2023, 01:29 AM)harry3 Wrote: Hi, the AFib never keeps me awake. Having been in constant slow AFib for more than 10 years, you get used to it.
My wife has also been in AFIB for the better part of 12 years. As I said, sometimes she is consciously aware of something going on with her heart, but most often is not consciously aware. The distinction I am making between conscious and unconscious is because ONE of the suggestions her Pulmonologist has made is that possibly her home detected clear airway apneas are a consequence of "unconscious arousals" by her AFib. Now, that connection between these unconscious arousals and clear airway apneas can be clarified by a in-lab PSG, there the technologist/doctor would edit out the clear airway apneas that occurred immediately following an arousal (or "brain tickling').
Unfortunately home machines are unable to distinguish between post-arousal clear airway apneas and non-post-arousals apneas because they have no way of detecting a "brain tickle")
BTW, she had not experienced Afib (that is always had clean ECGs) UNTIL she had a cardiac cath to rule out a suspected heart attack (her cardiac enzymes were up).
Her cardiologist now suspects that the cath may have scared the atrial wall and that scaring is the loci of ectopic electrical signals.
Hi again, I took Sleeprider's advice and purchased a cheap second hand Resmed S9 Vpap Adapt model 36367 (Australia), which I think is the same as model 36037 in USA.
Based on advice to others, it seems the best starting settings are the default. I haven't received the machine yet, so don't know how it will be set now. Maybe someone can confirm the default setting for auto? From other posts, they seem to be:
The default settings on auto: min epap 4 max epap 15 min ps 3 max ps 15
Are there other things also set by default?
It appears my optimal setting on CPAP is P=8 with EPR=1 (no OSA but clustered CAs episodically recurring). Do these CPAP settings shed any light onto the trial settings I should use for the ASV? The default minIPAP will be 7 with these settings, correct? My last sleep study and my own trial suggest OSA still controlled with CPAP with P=7.
Assuming this device as ASV auto mode, if you start with default settings, perhaps EPAP min 5.0, EPAP max 15.0, PS min 3.0, PS max 15.0 we can learn if you need higher minimum EPAP for obstruction and a lot more. I like starting near default settings to observe response and fine-tuning from there.
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.
OK, I 'll set it up as you advise. I also asked for and received the manual so will look at that too.. The machine is still in transit (courier) so won't get to try it for another day or 2.
Finally first night on the ASV (Resmed S9 Adapt). On ASVauto
EPAPmin=5 EPAPmax=10 PSmin=2 Psmax=7
So, these are a little different than the default.
Zero OA and total AHI=0.32 so a lot of progress.
But, it sure felt like it was blowing hard on every inspiration and out of synch was my natural inspiration. I think the leaks confirm that there were higher pressures (never had that much problem on CPAP). When it would wake me up, I would wonder why it was trying to do that when I was just trying to breath in a relaxed way.
thanks for that. I see now the option for the factory reset. But, maybe based on last night's trial, there might be other advice for adjusting the settings? It sure would be nice not to have it blowing so hard on every breath if that's not required.
Also, this is a low hour, second hand machine, bought privately. So, how do you know if it is working properly (seems to be but not sure how you check)?
