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

[zfaulk]

Hello!

Honestly I have not been doing great. I've had ups and downs, but overall no real improvement. I will say I consistently feel the best on ASVAuto. Not really sure what to do anymore so I'm considering surgical options.

Mental fatigue, motivation, fatigue, crankiness, etc. are all pretty bad right now!

Will update if I get anywhere surgically.

Here is a screenshot of last night for fun:

   

ASVAuto
Min EPAP: 9.8
Max EPAP: 15.0
Min PS: 6
Max PS: 20

[SarcasticDave94]

Just my opinion but the ASV would possibly need different settings compared to VAuto.

ASV Auto defaults to EPAP 4-15 and PS 3-15 and machine Max is physically capped at 25. You can have some intentional overlap between EPAP and PS, because in ASV Auto they're ranges. All 3 of EPAP, PS, and IPAP can slide around as necessary to give needed settings. At least this is true of an actual ASV like what I had.

Your PS will possibly be closer to default than PS 6-20. 6 sounds a bit high given it'll range up if necessary, which I've felt it does move up rather quickly. Again this may only apply to you when attempting ASV style of therapy.

My thinking is that different emulations of various machines ought to require different pressure sets, because there's different goals intended.

As you can see though, yours doesn't stop at 25 max. If I'm reading it right it's going up to 28.26, which may be an overdoing it situation.

[subconscious]

Hey there,
So i recently had a consultation with a professionally trained sleep study expert. It's $400 and he does it over zoom. He looks at your Oscar data and then teaches you how to read the data, and then goes on to provide recommendations, and we'll meet you several times until you have good results. He also has a YouTube channel.

What I learn from him was pretty remarkable. First of all he completely disregards everything on the left side in the panel. That's because that is not Oscar data, but rezma data and the algorithm is highly unreliable. He demonstrated by going through my waveform data how there were numerous incorrectly marked hypopneas, apnea's, flow limits, and even more missed events throughout the night. 

He actually taught me how to look at the waveform and how I thought seemingly normal or good waveform patterns were actually bad. As an example a night where my ahi was less than 1 and I did not have a massive amount of flow limits, actually contained at least a dozen hypopneas within a 1 or 2 hour time frame, all missed. Turns out my pressure settings and my approach to leak were completely way off despite all the advice.

This form has taught me a lot, but it shouldn't be your last stop. In your case, kind of like mine, a lot of independent fix-it was tried but yielded subpar results, working with an expert can help a lot. And compared to the cost of other options you're thinking this is substantially cheaper. Also even after surgery or dental appliances, using CPAP in conjunction is still not a bad idea.

Here's the guy

https://youtube.com/@Freecpapadvice?si=3Jol2xzxo_0luXHs

[zfaulk]

Thanks for the recommendation! I'm glad you found Jason, I've actually done a few sessions with him and keep in contact with him every so often.

He posted a video about UARS and talked about how he found S mode to be very effective for UARS, more so than ASV. I put the AirCurve VAuto firmware on my machine and am going to give it a shot. 

Happy to write up a guide if anyone needs. It's pretty easy to turn your AirSense 10 into an AirCurve VAuto or even ASV. Don't mess around with AirBreak. Now that the firmware for all machines is readily available, it's worth using them over AirBreak's limited functionality.

Still pursuing surgical options, working through the insurance process. Dr. Kasey Li said I'm a great MMA or EASE candidate. But in the meantime it would be nice to see if I can feel better using PAP therapy.

[SarcasticDave94]

Hmmm interesting. Free CPAP advice for $400?! Whereas the real free CPAP advice is called Apnea Board.

[subconscious]

Kasey Li is the man. Before surgery, have you considered appliance expansion?

I'm undergoing a custom designed marpe expansion w Rose Tan in Honolulu. Results have been very good for several patients. The expansion has demonstrated significant structural changes on CT, and functional changes on rhinomanometry measuring flow, with corresponding improvement in subjective sleep and daytime fatigue/behavior.

She has a california counterpart, Eric Phelps in San Jose CA. Also highly talented. An assessment from him may be helpful to capture his insights and recommendations. I believe he knows Kasey Li as well.

Can you please share how to modify the airsense 10. I have several for family members. This would be a huge help as trying to airbreak is complex.