Covid Induced CA (Potentially) + UARS, Looking for Help with ASV Settings

[Sleeprider]

Don't get too far down the rabbit hole with the shape of a few inspiration peaks. You have no flow limitation and excellent results. Hang in there and don't spin any dials. You can now claim you've been dialed in by both Lanky Lefty and Sleeprider.

[zfaulk]

Thanks so much, Sleeprider. Really really appreciate the help. Going to roll with these settings for a bit and see what happens. Thanks!

[zfaulk]

One last question for you, is there any benefit to getting a real AirCurve 10? I just hacked mine to have all therapy options available, but now that BiPAP looks the best I'm open to purchasing one. Thanks!

[Sleeprider]

If you can find a good deal on a Vauto, its always worth having in order to have a backup, but the real Vauto is different enough from the Airbreak version to be worthwhile.

[zfaulk]

Just wanted to check in and say thank you again. I'm feeling the best I've felt in years, even after just a few days I can notice a night and day difference. Who would have known it was this simple of a solution! Really really appreciate it once again.

[zfaulk]

Hi there wanted to follow up!

So I had about 5 days of feeling pretty damn good, now I'm back to feeling terrible again with no settings changes. I went ahead and purchased an actual VAuto machine and I'm using the same settings. Where can I go from here?

   

I was thinking of increasing trigger and cycle sensitivity to address the CAs, maybe higher EPAP to address the H & OA events?

Really appreciate your time. I'm hoping this time around we can get the good feeling to stick. Thanks!

[Sleeprider]

Only change trigger sensitivity to high. That should knock out most of the CA. Do not change cycle.

[zfaulk]

Before seeing your response I gave my theory a shot.

I increased EPAP to 10 from 9, increased PS from 4-5, and increased trigger to very high. I kept cycle at medium. Here are the results:

   

Changing trigger definitely appears to have gotten rid of the CAs, and increasing EPAP reduced the H & OA events. My question is, it seems like my waveform is still very choppy and has a lot of peaks. Is this what being properly treated looks like? 

Also, I slept more than 4.5h, just was trying some other settings earlier in the night. This 4.5h chunk with these settings looked the best to me.

Thanks again!

[Sleeprider]

Looks like very good progress, and it's fine that you moved forward on the entire agenda, it just would have been harder to tease out if there had been any problems. Probably let this settle in before diving into the weeds of wave-form shape. Everyone has their own "personality" in what the flow rate looks like.

[subconscious]

it seems trigger, pressure, pressure support, and mode are all changes you made for improvement. However you have a lot of experience w different modes and pressure - demonstrated by your prior charts... I am wondering if trigger unlocked a new door for you...

Given you have UARS and covid (sorry!) - would you be willing to try a range of trigger settings to compare waveform, inspiratory time: expiratory time? I think if your I:E ratio becomes <1, your symptoms related to UARS can substantially improve - otherwise the work of having to inspire harder through the night continues.

Also could you report how you are feeling, in terms of mental fatigue - as defined by your motivation to do things during the day, your energy in the morning and by the end of the day before going to sleep. I think we get so obsessed w the computer algorithm that we sometimes forget to report this, especially w UARS where the granularity of data is poor compared to obstructive sleep apnea.